Aidan, Patrick1; Monpeyssen, Herve2; Balay Garonnaire, Marie Alix3; Chougnet, Cecile N3
1 Department of Otolaryngology – Head and Neck Surgery, American Hospital of Paris, Neuilly sur seine, France
2 Division of Thyroidology, Department of radiology, American Hospital of Paris, Neuilly sur seine, France
3 Division of Endocrine Cancer Nuclear Medicine, Saint Louis Hospital, Paris, France
Introduction: Transaxillary robotic thyroidectomy (TARS) has been reported to be a safe approach in patients with differentiated thyroid carcinoma (DTC) but oncological response are unknown. This study aimed to evaluate the oncological outcomes of TARS and RAI therapy in patient with DTC.
Methods: Between 2011 and 2016, patients treated for DTC by TARS in a single institution, followed by RAI therapy (iodine 131) were retrospectively included. The oncological response was performed according to the 2015 ATA guidelines 6-12 months later and at the last available visit.
Results: 42 patients (30 females) were included, with median tumor size 20mm, 12 cases N1a and 5 cases N1b on initial pathology report. 17 and 25 patients were respectively classified low and intermediate initial risk.
The RAI dose administered was 1.1 and 3.7GBq for 18 and 24 patients respectively, with thyrotropin stimulation in 27 cases. All patients had a normal post therapeutic whole body scan, except one (pathological LN uptake), but not unusual uptake was seen. 3 patients had post-operative abnormal ultrasound.
At 6-12 months evaluation (n=33), 22 and 6 patients had excellent and indeterminate response respectively, 5 patients had incomplete response (2 biological and 3 structural), no distant metastasis was found. At the end of follow up, a second surgery was necessary to treat persistent LN for 3 patients (intermediate risk) in total.
Conclusions: In this study, TARS followed by RAI therapy seems to be as oncological curative as open thyroidectomy, even for patients with LN metastases, after good pre-operative staging.