Isthmusectomy shines in patients with solitary PTC confined to the isthmus

Isthmusectomy is an effective procedure for patients with a solitary papillary thyroid carcinoma (PTC) confined to the isthmus, a recent study has found.

Researchers retrospectively reviewed the medical records of 65 patients (median age 35 years, 86.2 percent women), looking at their demographic characteristic, surgical procedure, pathological factors, and tumour staging. All patients underwent isthmusectomy. Outcomes of interest were tumour recurrence and/or death.

Majority (58.5 percent; n=38) of patients had tumour stage pT1a, while 29.2 percent (n=19), 7.7 percent (n=5), and 4.6 percent (n=3) were stage pT1b, pT2, and P3b, respectively. The median tumour size was 1 cm. None of the patients showed distant metastases, though in general, they had 1–5 positive lymph nodes <1 m in diameter.

Over a median follow-up time of 78 months, one patient saw tumour recurrence in the lateral neck compartment and subsequently underwent total thyroidectomy with right neck dissection. Another patient recurred in the left thyroid lobe, needing total thyroidectomy with left central neck dissection. Both survived and reached remission.

There were no cases of temporary or permanent recurrent laryngeal nerve palsy and hypocalcaemia, nor of recurrence in the central neck compartment or in a distant organ. One patient eventually died due to ovarian cancer liver metastasis. The 10-year overall, recurrence-free, and disease-specific survival rates were 92.1 percent, 98.3 percent, and 100 percent, respectively.