ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1564752
Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis
Provisionally accepted
- 1Postgraduate training base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Jiangsu Province, China
- 2Department of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou, Jiangsu Province, China
- 3Department of Medical Records and Statistics, Zhejiang Cancer Hospital, Hangzhou, Jiangsu Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: This study aimed to compare the prognosis of unilateral papillary thyroid carcinoma(PTC) patients with ipsilateral cervical lymph node metastasis(IC-LNM) under the treatment of unilateral lobectomy(uLT) vs total thyroidectomy(TT) in order to find out the optimal surgery for these patients without other clinical risk characteristics. Methods: PTC patients at Zhejiang Cancer Hospital between 2012 and 2022 were retrospectively reviewed. Additionally, a propensity score matching(PSM) was performed on patients treated with uLT or TT. Recurrence-free survival(RFS), overall survival(OS), hospitalization costs, postoperative complications, and other clinical characteristics were analyzed between the two groups.Results: Ultimately, 682 unilateral PTC patients with IC-LNM were available in the study. After PSM with possible prognostic factors(such as gender, age, primary tumor size, multifocality, extrathyroidal invasion, and T-stage), 225 pairs of patients were available. With a median of 81(5-154) months follow-up, 22 patients(9.8%) in the uLT and 12(5.3%) in the TT recurred. There were no significant differences in 5-year RFS and 5-year OS between uLT and TT groups. However, TT group was significantly correlated with higher risk of transient and permanent hypoparathyroidism, higher levothyroxine doses, longer hospital stays, and higher hospitalization costs than uLT group(p<0.05). Conclusions: Our study indicated that there were no differences in recurrence and survival between unilateral PTC patients with IC-LNM treated with uLT or TT for the primary tumor. However, uLT group had a lower risk of postoperative complications and a lower hospitalization cost than TT group. Thus, for selected unilateral PTC patients with IC-LNM without other risk features, uLT could be recommended.
Keywords: unilateral lobectomy, Total thyroidectomy, Papillary thyroid cancer, Recurrence-free survival, Propensity score matching
Received: 22 Jan 2025; Accepted: 09 Jul 2025.
Copyright: © 2025 Zhang, Zhou, Wang, Zhao, Mao, Shang and Lan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiabin Lan, Postgraduate training base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Jiangsu Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.