Tanaz M Vaghaiwalla, Jonathan Chang, Victoria DeTrolio, Cima Saghira, Mehmet Akcin, Cheng-Bang Chen, John I Lew
{"title":"慢性淋巴细胞性甲状腺炎不会恶化甲状腺乳头状癌的早期手术结果。","authors":"Tanaz M Vaghaiwalla, Jonathan Chang, Victoria DeTrolio, Cima Saghira, Mehmet Akcin, Cheng-Bang Chen, John I Lew","doi":"10.1002/wjs.70012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic lymphocytic thyroiditis (CLT), an autoimmune thyroid disorder that most commonly causes hypothyroidism in women, may confer a higher surgical risk for patients undergoing thyroidectomy for papillary thyroid carcinoma (PTC). This study evaluates surgical treatment outcomes for patients with a diagnosis of PTC with and without CLT.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data for patients who underwent thyroidectomy from 2009 to 2020 at a tertiary institution was performed. Patients ≥ 18 years of age were subdivided into 2 groups: patients with CLT and PTC and patients with PTC alone. Sociodemographic factors, tumor characteristics, final histopathology, thyroidectomy-specific outcomes, and postoperative course were evaluated. Chi-squared tests were used for categorical variables and comparisons based on t-tests.</p><p><strong>Results: </strong>Of 1073 patients with PTC, most were women n = 872 (81%), Caucasian n = 933 (87%) with a mean of 48 (± 13) years of age, mean tumor size of 1.8 cm (± 1.3 cm), and low stage disease I/II n = 1049 (98%). Among patients with PTC n = 167 (16%) had a concurrent diagnosis of CLT. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in age, race, or tumor size, respectively. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in permanent recurrent laryngeal nerve injury (1.2% [n = 2] vs. 0.2% [n = 2]), bleeding and/or return to OR (0.6% [n = 1] vs. 0.7% [n = 6]), persistent hypocalcemia (0% [n = 0] vs. 0.33% [n = 3]), wound infection (0.6% [n = 1] vs. 0.4% [n = 4]), and radioactive iodine therapy (35.9% [n = 60] vs. 31.2% [n = 283]). Rates of lymph node positivity (26.9% [n = 45] vs. 30.1% [n = 273]), extrathyroidal extension (14.3% [n = 24] vs. 16.5% [n = 150]), and PTC recurrence (4.19% [n = 7] vs. 4.75% [n = 43]) were similar between groups.</p><p><strong>Conclusion: </strong>Of those undergoing total thyroidectomy for PTC, 16% of patients have concurrent underlying CLT. Underlying CLT is not associated with more aggressive tumor biology, higher rates of surgical complications, or PTC recurrence when performed by high-volume thyroid surgeons.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2457-2463"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435607/pdf/","citationCount":"0","resultStr":"{\"title\":\"Chronic Lymphocytic Thyroiditis Does Not Worsen Early Surgical Outcomes in Papillary Thyroid Cancer.\",\"authors\":\"Tanaz M Vaghaiwalla, Jonathan Chang, Victoria DeTrolio, Cima Saghira, Mehmet Akcin, Cheng-Bang Chen, John I Lew\",\"doi\":\"10.1002/wjs.70012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic lymphocytic thyroiditis (CLT), an autoimmune thyroid disorder that most commonly causes hypothyroidism in women, may confer a higher surgical risk for patients undergoing thyroidectomy for papillary thyroid carcinoma (PTC). This study evaluates surgical treatment outcomes for patients with a diagnosis of PTC with and without CLT.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data for patients who underwent thyroidectomy from 2009 to 2020 at a tertiary institution was performed. Patients ≥ 18 years of age were subdivided into 2 groups: patients with CLT and PTC and patients with PTC alone. Sociodemographic factors, tumor characteristics, final histopathology, thyroidectomy-specific outcomes, and postoperative course were evaluated. Chi-squared tests were used for categorical variables and comparisons based on t-tests.</p><p><strong>Results: </strong>Of 1073 patients with PTC, most were women n = 872 (81%), Caucasian n = 933 (87%) with a mean of 48 (± 13) years of age, mean tumor size of 1.8 cm (± 1.3 cm), and low stage disease I/II n = 1049 (98%). Among patients with PTC n = 167 (16%) had a concurrent diagnosis of CLT. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in age, race, or tumor size, respectively. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in permanent recurrent laryngeal nerve injury (1.2% [n = 2] vs. 0.2% [n = 2]), bleeding and/or return to OR (0.6% [n = 1] vs. 0.7% [n = 6]), persistent hypocalcemia (0% [n = 0] vs. 0.33% [n = 3]), wound infection (0.6% [n = 1] vs. 0.4% [n = 4]), and radioactive iodine therapy (35.9% [n = 60] vs. 31.2% [n = 283]). Rates of lymph node positivity (26.9% [n = 45] vs. 30.1% [n = 273]), extrathyroidal extension (14.3% [n = 24] vs. 16.5% [n = 150]), and PTC recurrence (4.19% [n = 7] vs. 4.75% [n = 43]) were similar between groups.</p><p><strong>Conclusion: </strong>Of those undergoing total thyroidectomy for PTC, 16% of patients have concurrent underlying CLT. Underlying CLT is not associated with more aggressive tumor biology, higher rates of surgical complications, or PTC recurrence when performed by high-volume thyroid surgeons.</p>\",\"PeriodicalId\":23926,\"journal\":{\"name\":\"World Journal of Surgery\",\"volume\":\" \",\"pages\":\"2457-2463\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435607/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/wjs.70012\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjs.70012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：慢性淋巴细胞性甲状腺炎（CLT）是一种自身免疫性甲状腺疾病，最常导致女性甲状腺功能减退，可能会给接受甲状腺乳头状癌（PTC）甲状腺切除术的患者带来更高的手术风险。本研究评估诊断为PTC的患者合并和不合并CLT的手术治疗结果。方法：对2009年至2020年在某高等教育机构接受甲状腺切除术的患者的前瞻性数据进行回顾性分析。年龄≥18岁的患者再分为两组：CLT合并PTC患者和单独PTC患者。评估社会人口统计学因素、肿瘤特征、最终组织病理学、甲状腺切除术特异性结果和术后病程。分类变量采用卡方检验，比较采用t检验。结果：1073例PTC患者中，女性872例（81%），白种人933例（87%），平均年龄48（±13）岁，平均肿瘤大小1.8 cm（±1.3 cm），低期I/II 1049例（98%）。在PTC患者中，167例（16%）同时诊断为CLT。当将PTC和CLT患者与单独PTC患者进行比较时，分别在年龄，种族或肿瘤大小方面没有显着差异。当将PTC和CLT患者与单独PTC患者进行比较时，永久性喉返神经损伤（1.2% [n = 2] vs. 0.2% [n = 2]）、出血和/或重返手术室（0.6% [n = 1] vs. 0.7% [n = 6]）、持续性低钙血症（0% [n = 0] vs. 0.33% [n = 3]）、伤口感染（0.6% [n = 1] vs. 0.4% [n = 4]）和放射性碘治疗（35.9% [n = 60] vs. 31.2% [n = 283]）无显著差异。淋巴结阳性率（26.9% [n = 45] vs. 30.1% [n = 273]）、甲状腺外展（14.3% [n = 24] vs. 16.5% [n = 150]）、PTC复发率（4.19% [n = 7] vs. 4.75% [n = 43]）组间比较相似。结论：在因PTC而接受甲状腺全切除术的患者中，16%的患者同时有潜在的CLT。潜在的CLT与更具侵袭性的肿瘤生物学、更高的手术并发症发生率或大容量甲状腺外科医生的PTC复发率无关。
Chronic Lymphocytic Thyroiditis Does Not Worsen Early Surgical Outcomes in Papillary Thyroid Cancer.
Background: Chronic lymphocytic thyroiditis (CLT), an autoimmune thyroid disorder that most commonly causes hypothyroidism in women, may confer a higher surgical risk for patients undergoing thyroidectomy for papillary thyroid carcinoma (PTC). This study evaluates surgical treatment outcomes for patients with a diagnosis of PTC with and without CLT.
Methods: A retrospective review of prospectively collected data for patients who underwent thyroidectomy from 2009 to 2020 at a tertiary institution was performed. Patients ≥ 18 years of age were subdivided into 2 groups: patients with CLT and PTC and patients with PTC alone. Sociodemographic factors, tumor characteristics, final histopathology, thyroidectomy-specific outcomes, and postoperative course were evaluated. Chi-squared tests were used for categorical variables and comparisons based on t-tests.
Results: Of 1073 patients with PTC, most were women n = 872 (81%), Caucasian n = 933 (87%) with a mean of 48 (± 13) years of age, mean tumor size of 1.8 cm (± 1.3 cm), and low stage disease I/II n = 1049 (98%). Among patients with PTC n = 167 (16%) had a concurrent diagnosis of CLT. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in age, race, or tumor size, respectively. When comparing patients with PTC and CLT to PTC alone, there were no significant differences in permanent recurrent laryngeal nerve injury (1.2% [n = 2] vs. 0.2% [n = 2]), bleeding and/or return to OR (0.6% [n = 1] vs. 0.7% [n = 6]), persistent hypocalcemia (0% [n = 0] vs. 0.33% [n = 3]), wound infection (0.6% [n = 1] vs. 0.4% [n = 4]), and radioactive iodine therapy (35.9% [n = 60] vs. 31.2% [n = 283]). Rates of lymph node positivity (26.9% [n = 45] vs. 30.1% [n = 273]), extrathyroidal extension (14.3% [n = 24] vs. 16.5% [n = 150]), and PTC recurrence (4.19% [n = 7] vs. 4.75% [n = 43]) were similar between groups.
Conclusion: Of those undergoing total thyroidectomy for PTC, 16% of patients have concurrent underlying CLT. Underlying CLT is not associated with more aggressive tumor biology, higher rates of surgical complications, or PTC recurrence when performed by high-volume thyroid surgeons.
期刊介绍：
World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.
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