Surgical management of low-risk papillary thyroid cancer in real life in Spain: a nationwide survey of endocrine neck surgeons and endocrinologists.

Díez, Juan J; Parente, Pablo; Durán-Poveda, Manuel

Díez, Juan J; Parente, Pablo; Durán-Poveda, Manuel.

Afiliación

Díez JJ; Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain. juanjose.diez@salud.madrid.org.
Parente P; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain. juanjose.diez@salud.madrid.org.
Durán-Poveda M; Department of Otorhinolaryngology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.

Endocrine ; 83(2): 422-431, 2024 Feb.

Article en En | MEDLINE | ID: mdl-37592163

RESUMEN

BACKGROUND: The extent of surgery in patients with papillary thyroid cancer (PTC) is a subject of ongoing debate. We aimed to explore the attitude of Spanish specialists (endocrinologists, surgeons, and otolaryngologists) in real life on the surgical management of low-risk PTC. METHODS: We designed an anonymous, web-based survey to inquire information regarding the preferences of interviewees for hemithyroidectomy (Hem), total thyroidectomy (TT) and prophylactic central neck dissection (pCND) in one standard patient with PTC and six clinical variants. We differentiated between small (1.1-2.5 cm) and large (2.6-4.0 cm) tumors. RESULTS: A total of 278 valid responses were received and divided into two groups: group END (n = 135) and group SUR (n = 143, 101 general surgeons and 42 otolaryngologists). The preference for Hem was low in the standard patient and similar between both groups (40.6 vs 49.0%, NS). This preference decreased for tumors measuring 2.6-4.0 cm, multifocal, with risk location, family history of thyroid cancer, or history of irradiation, and increased in patients older than 65 years or with comorbidity. Preference for pCND ranged from 12.6-71.1% in the group END and from 22.4-65.0% in the group SUR, with few differences between the two. In multivariate analysis, being a high-volume specialist was associated with a lower preference for Hem, while having private practice was associated with a more favorable opinion of Hem. CONCLUSION: The real clinical practice of Spanish specialists is far from what is recommended by the clinical guidelines in patients with low-risk PTC, especially among high-volume professionals.

Asunto(s)

Carcinoma Papilar; Neoplasias de la Tiroides; Humanos; Cáncer Papilar Tiroideo/cirugía; Carcinoma Papilar/patología; Endocrinólogos; España; Neoplasias de la Tiroides/patología; Disección del Cuello/efectos adversos; Tiroidectomía; Estudios Retrospectivos

Palabras clave

Central neck dissection; Clinical practice.; Hemithyroidectomy; Papillary thyroid carcinoma; Survey

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Tiroides / Carcinoma Papilar Tipo de estudio: Etiology_studies / Guideline / Qualitative_research / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Endocrine Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos

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