Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy
Abstract The management of papillary thyroid carcinoma (PTC) concurrent with Hashimoto’s thyroiditis (HT) lacks standardized guidelines, especially concerning surgical strategies. This study aimed to compare unilateral thyroidectomy (UT) with total thyroidectomy (TT) in PTC-HT patients to optimize c...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-12-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-82626-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850086585592184832 |
|---|---|
| author | Xiaoyong Wen Shiwei Zhou Wu Li Hui Li Xiaohua Song Yu Mao Zeyu Li Guangji Chen Xiaowei Peng Peng Wu |
| author_facet | Xiaoyong Wen Shiwei Zhou Wu Li Hui Li Xiaohua Song Yu Mao Zeyu Li Guangji Chen Xiaowei Peng Peng Wu |
| author_sort | Xiaoyong Wen |
| collection | DOAJ |
| description | Abstract The management of papillary thyroid carcinoma (PTC) concurrent with Hashimoto’s thyroiditis (HT) lacks standardized guidelines, especially concerning surgical strategies. This study aimed to compare unilateral thyroidectomy (UT) with total thyroidectomy (TT) in PTC-HT patients to optimize clinical management and improve postoperative outcomes. This retrospective study included PTC-HT patients undergoing thyroid surgery at a tertiary academic medical institution from January 2018 to August 2023. The patients were grouped according to the quartiles of preoperative thyroid peroxidase antibody (TPOAB) levels at the last follow-up. Additionally, patients were divided into UT and TT groups, with propensity score matching (PSM) to ensure comparability. Patients were also stratified by TPOAB levels (L: 100–400, M: 400–1000, H: >1000). Patient-reported outcomes (PROMs), including quality of life and fatigue, were compared between UT and TT groups within each TPOAB subgroup (ΔPROMs = UT-TT). 246 patients were included. Those with higher TPOAB levels at the last follow-up reported increased physical fatigue scores. After PSM, there were no significant demographic differences between UT and TT groups. During a median follow-up of 16 months for UT and 20 months for TT, no recurrence or metastasis occurred. Compared to the UT group, the TT group exhibited lower TPOAB levels at the last follow-up (65.7 ± 78 vs. 374.6 ± 331.9, p < 0.001), and lower physical fatigue scores (3.6 ± 2.5 vs. 4.5 ± 2.8, p = 0.039). However, TT was associated with a higher incidence of transient hypoparathyroidism (7.8% vs. 1.1%, p = 0.030). Stratified analysis by preoperative TPOAB levels revealed significant differences in ΔPROMs (Physical fatigue) between L and H groups (0.2 ± 3.5 vs. 4.6 ± 2, p = 0.004) and between M and H groups (0.6 ± 4.5 vs. 4.6 ± 2, p = 0.037). ΔPROMs (Mental fatigue) also significantly differed between L and H groups (0 ± 1.8 vs. 1.6 ± 0.9, p = 0.026). For PTC-HT patients, particularly those with high preoperative TPOAB levels, TT offers advantages in alleviating fatigue symptoms but carries a higher risk of complications. Therefore, clinical decision-making should consider patient-specific factors, particularly preoperative TPOAB levels, to determine the optimal surgical approach. Trial registration: Chinese Clinical Trial Registry. ID ChiCTR2300069240. |
| format | Article |
| id | doaj-art-e9a2a0720bd74dc7ab4d8fbf9682d331 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-e9a2a0720bd74dc7ab4d8fbf9682d3312025-08-20T02:43:25ZengNature PortfolioScientific Reports2045-23222024-12-0114111010.1038/s41598-024-82626-xOptimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomyXiaoyong Wen0Shiwei Zhou1Wu Li2Hui Li3Xiaohua Song4Yu Mao5Zeyu Li6Guangji Chen7Xiaowei Peng8Peng Wu9Department of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalUniversity hospital, Central South UniversityDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalDepartment of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalAbstract The management of papillary thyroid carcinoma (PTC) concurrent with Hashimoto’s thyroiditis (HT) lacks standardized guidelines, especially concerning surgical strategies. This study aimed to compare unilateral thyroidectomy (UT) with total thyroidectomy (TT) in PTC-HT patients to optimize clinical management and improve postoperative outcomes. This retrospective study included PTC-HT patients undergoing thyroid surgery at a tertiary academic medical institution from January 2018 to August 2023. The patients were grouped according to the quartiles of preoperative thyroid peroxidase antibody (TPOAB) levels at the last follow-up. Additionally, patients were divided into UT and TT groups, with propensity score matching (PSM) to ensure comparability. Patients were also stratified by TPOAB levels (L: 100–400, M: 400–1000, H: >1000). Patient-reported outcomes (PROMs), including quality of life and fatigue, were compared between UT and TT groups within each TPOAB subgroup (ΔPROMs = UT-TT). 246 patients were included. Those with higher TPOAB levels at the last follow-up reported increased physical fatigue scores. After PSM, there were no significant demographic differences between UT and TT groups. During a median follow-up of 16 months for UT and 20 months for TT, no recurrence or metastasis occurred. Compared to the UT group, the TT group exhibited lower TPOAB levels at the last follow-up (65.7 ± 78 vs. 374.6 ± 331.9, p < 0.001), and lower physical fatigue scores (3.6 ± 2.5 vs. 4.5 ± 2.8, p = 0.039). However, TT was associated with a higher incidence of transient hypoparathyroidism (7.8% vs. 1.1%, p = 0.030). Stratified analysis by preoperative TPOAB levels revealed significant differences in ΔPROMs (Physical fatigue) between L and H groups (0.2 ± 3.5 vs. 4.6 ± 2, p = 0.004) and between M and H groups (0.6 ± 4.5 vs. 4.6 ± 2, p = 0.037). ΔPROMs (Mental fatigue) also significantly differed between L and H groups (0 ± 1.8 vs. 1.6 ± 0.9, p = 0.026). For PTC-HT patients, particularly those with high preoperative TPOAB levels, TT offers advantages in alleviating fatigue symptoms but carries a higher risk of complications. Therefore, clinical decision-making should consider patient-specific factors, particularly preoperative TPOAB levels, to determine the optimal surgical approach. Trial registration: Chinese Clinical Trial Registry. ID ChiCTR2300069240.https://doi.org/10.1038/s41598-024-82626-xPapillary thyroid carcinomaHashimoto’s thyroiditisUnilateral thyroidectomyTotal thyroidectomyPreoperative thyroid peroxidase antibodyFatigue |
| spellingShingle | Xiaoyong Wen Shiwei Zhou Wu Li Hui Li Xiaohua Song Yu Mao Zeyu Li Guangji Chen Xiaowei Peng Peng Wu Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy Scientific Reports Papillary thyroid carcinoma Hashimoto’s thyroiditis Unilateral thyroidectomy Total thyroidectomy Preoperative thyroid peroxidase antibody Fatigue |
| title | Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy |
| title_full | Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy |
| title_fullStr | Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy |
| title_full_unstemmed | Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy |
| title_short | Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy |
| title_sort | optimizing surgical outcomes in papillary thyroid carcinoma with hashimoto s thyroiditis a retrospective comparative study of unilateral and total thyroidectomy |
| topic | Papillary thyroid carcinoma Hashimoto’s thyroiditis Unilateral thyroidectomy Total thyroidectomy Preoperative thyroid peroxidase antibody Fatigue |
| url | https://doi.org/10.1038/s41598-024-82626-x |
| work_keys_str_mv | AT xiaoyongwen optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT shiweizhou optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT wuli optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT huili optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT xiaohuasong optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT yumao optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT zeyuli optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT guangjichen optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT xiaoweipeng optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy AT pengwu optimizingsurgicaloutcomesinpapillarythyroidcarcinomawithhashimotosthyroiditisaretrospectivecomparativestudyofunilateralandtotalthyroidectomy |