OP16 – Factors influencing individual decision in extent of thyroidectomy for 1-4 cms Differentiated Thyroid cancer

     

    Murthy, Samskurthi P.1, Balasubramanian, Deepak1, Nair, Vasantha2, Thankappan, Krishnakumar1, Iyer, Subramania1
    1 Department of Head and Neck Oncology, Amrita Institute of Medical Science, Kochi, India
    2 Department of Endocrinology, Amrita Institute of Medical Science, Kochi, India


    Aim:
    2015 ATA recommends the decision for extent of thyroidectomy in 1-4 cms DTC is left to the patient1 .  Patient decision-making is based on several factors. We studied the rationale of individual choice in our population

    Materials and methods: A questionnaire with 7 questions. Was administered to three groups of healthy volunteers. Group 1 (N=30, public); group 2(N=30, nursing staff) and group 3 (N=30), doctors) the individuals were asked to answer the questions assuming that they had a 1-4cm DTC

    Results: 90 individuals were enrolled. Hemithyroidectomy was preferred in 16 subjects (17.8%) most were women (N=14, 87.5%) and commonest reason being to avoid drug supplementation. (N=10,62.5%). In this group, 7 patients (43.8%) were concerned with completion thyroidectomy. Total thyroidectomy was preferred in 29 patients (32.2%) commonest reason being avoidance of serial ultrasound follow up (N=21, 72.4 %). Majority of respondents were undecided N=45(50%). and had concerns about hormone replacement (N=30, 66.6%) and regarding resurgery and its complications (N=28, 62.2%).

    Conclusion: Majority of individuals do not have a preference for the extent of surgery. Patients who preferred hemithyroidectomy were concerned about the completion thyroidectomy if required. The difficulties of follow up were the reasons for election of total thyroidectomy in most individuals. Institutional and regional data regarding complications, completion thyroidectomy and risk stratified follow up will help to counsel the undecided patient


    References:

    1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schulumberger M, Schuff KG, Sherman SI, Sosa JA, Sterward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines for adult patients and differentiated thyroid cancer. Thyroid 2016; 26(1): 1-133

 

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    Rocco Bellatone, Co-Chair
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    Ian J. Witterick, MD
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