[ incidence of thyroid papillary cancer in the contralateral lobe]

ABSTRACT

Papillary thyroid cancer [PTC] usually has an excellent prognosis with more than 90% survival rate at 10 years. Papillary thyroid cancer may be diagnosed with histological examination in patients underwent lobectomy. The necessity of performing a completion thyroidectomy [CT] is still a controversial issue. This study investigated the rate of contraralateral PTC in patients, who had completion thyroidectomy. We retrospectively reviewed the medical and pathologic data of 82 patients with PTC. These patients underwent thyroid lobectomy, followed by completion thyroidectomy during 1997-2007. Thirty three patients [40%] had PTC in the contralateral lobe. There was no significant difference between patients with or with out contralateral tumor regarding gender, age, primary tumor size or time to completion thyroidectomy.The presence of lymph node metastases and multifocality of cancer in the ipsilateral lobe increased the risk of residual disease in the contralateral lobe. The postoperative complication were infrequent and included 6 [3.7%] patients with transient recurrent laryngeal nerve palsy, 2 [2.5%] patients with permanent recurrent laryngeal nerve palsy, 9 [11%] patients with transient hypocalcemia and 1 [1.2%] patient with permanent hypoparathyroidism. Five patients [6%] developed hematoma in 2 of whom re-exploration was required. The prevalence of residual disease in the contralateral lobe of patients with PTC is significant. We recommend that a completion thyroidectomy should be considered for PTC treatment. Completion thyroidectomy can be done safely with acceptable low morbidity