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Surgery. 2007 Dec;142(6):906-13; discussion 913.e1-2. Epub 2007 Nov 5.

Utilization of total thyroidectomy for papillary thyroid cancer in the United States.

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1
Department of Surgery, Division of Surgical Oncology, Northwestern University, Chicago, Ill., USA.

Erratum in

  • Surgery. 2008 Feb;143(2):302.

Abstract

BACKGROUND:

Despite guidelines that recommend total thyroidectomy for papillary thyroid cancer (PTC) greater than or equal to 1 cm, the extent of surgery remains controversial. We examined surgical practice patterns for PTC greater than or equal to 1 cm and identified factors that predict the use of total thyroidectomy.

METHODS:

Of 90,382 patients in the National Cancer Center Data Base (NCDB) with PTC from 1985 to 2003, 57,243 patients had tumors greater than or equal to 1 cm and underwent total thyroidectomy or lobectomy. Trends in extent of surgery for PTC were examined over 2 decades. Logistic regression was used to identify factors that predict use of total thyroidectomy compared with lobectomy.

RESULTS:

Use of total thyroidectomy increased from 70.8% in 1985 to 90.4% in 2003 (P < .0001). Patients were less likely to undergo total thyroidectomy if they were black, older than 45 years, had Medicare, had lower household incomes, or had less education (P < .0001). Moreover, patients treated at high-volume or academic centers were more likely to undergo total thyroidectomy than were patients examined at low-volume or community hospitals (P < .0001).

CONCLUSIONS:

Use of total thyroidectomy for PTC greater than or equal to 1 cm increased over time. Differences in use of total thyroidectomy are related to patient, tumor, and hospital factors and likely reflect disparities in access to care.

PMID:
18063075
DOI:
10.1016/j.surg.2007.09.002
[Indexed for MEDLINE]
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