OUTCOMES OF SURGICAL TREATMENTS FOR HYPERTHYROIDISM IN 1308 PATIENTS- SINGLE CENTER EXPERIENCE

AUTHORS:
N.E. Akti (Istanbul, Turkey) , M. Tuncak (Istanbul, Turkey) , M. Yanik (Istanbul, Turkey) , Y. Iscan (Istanbul, Turkey) , H. Hacisahinogullari (Istanbul, Turkey) , G. Yegen (Istanbul, Turkey) , S. Onder (Istanbul, Turkey) , I.C. Sormaz (Istanbul, Turkey) , N. Aksakal (Istanbul, Turkey) , F. Tunca (Istanbul, Turkey) , Y. Giles Senyurek (Istanbul, Turkey)
Background:
To investigate the extent of thyroidectomy during the former and latter time frames of the study as well as the rate of thyroid cancer (TC) and morbidity in patients with hyperthyroidism(HT).
Methods:
Records of 1308 patients who underwent surgery for Graves' disease (GD)(n=591 ),toxic multinodular goiter(TMNG)(n=495 ),and toxic adenoma (TA) (n=222) between 1992 and 2022 were retrospectively analyzed.
Results:
Thyroid cancer was found in 16.8% (220/1308) patients,the incidence of 14%,21%,and 14 % in GD,TMNG, and TA,respectively.The majority (75%,165/220) of TC was papillary microcarcinoma(PMC). The rates of TC>1 cm in the GD,TMNG, and TA groups were 2.9 %, 6% and 3.6 %,respectively (GD vs. TMNG; p =0.01).The incidence of TC in GD with coexistent nodules vs with no nodules was [51/243 (20%) vs. 32/348 (9%);p<.0001].The majority (84%) of patients with TMNG and TC had preoperative sonographic or cytopathological suspicion of malignancy.In TA patients,TC >1 cm was found within the TA in 5 (2.2%).In TA patients with coexisting nodules, the TC rate was 24.4% (27/109). The rate of less than total thyroidectomy (TT) in the former and latter periods was 62% vs12 %, respectively(p=.0001).The rates of temporary and permanent hypoparathyroidism and vocal cord palsy were 21% and 2.2% and 6% and 1%,respectively.
Conclusions:
The overall rate of TC>1 cm was 4% in all hyperthyroid patients;the majority of TC coexisting with HT was PMC. The patients with TMNG had the highest rate of TC>1 cm.The rate of less than TT significantly decreased in the latter period compared with the former period of the study.