The role of conservative surgery in the treatment of Papillar thyroid microcarcinoma at Thong Nhat Hospital

Abstract

Background: Although very common and full of the dangers of cancer, many recent studies have noted that small papillary thyroid carcinoma progresses slowly and there are cases where conservative thyroidectomy gives good results even though it is not from the perspective of radical surgery. In Vietnam, there is currently little information on this issue. What are the results of surgical treatment in these cases?.

Objectives and method: the descriptive cross-sectional study of 49 cases of small papillary thyroid cancer, evaluation of surgical results and mid-term follow-up from 01/2022 to 01/2025 at Thong Nhat Hospital.

Results and discussion: The mean age was 45.1. The male/female ratio was 1/3.9(p=0.003). Multiple tumors were 22.4%. Tumors invading the capsule were 16.3%. Neck lymph node metastasis was 16.3%. There was no distant metastasis. Stage I according to cTNM was 91.8%. The total lobectomy and isthmus group had 34 cases; the total thyroidectomy group had 15 cases. In the two groups: hypothyroidism after 6 months of surgery was 36.7%, 30.6% (p=0.002); 12 months was 06.1%, 28.6% (p=0.001). In each group: total lobectomy with isthmus, postoperative hypothyroidism at 6 months and 12 months was 36.7% and 06.1% (p=0.002); Total thyroidectomy, the rate was 30.6% and 28.6% (p=0.52). 01 case of hoarseness, 01 thoracic duct rupture, 02 cases of tetany. There was no surgery-related death. Recurrence was 2% in 24-month follow-up.

Conclusion: Microcarcinoma papillary thyroid cancer is mainly stage 1. Surgery gives good results. There is no surgery-related mortality. Hypothyroidism after total lobectomy is lower than total thyroidectomy and recovery after 12 months. low recurrence rate in 24 months follow-up.