Surgical approaches for papillary microcarcinomas: Turkey’s perspective
Özer Makay1 , Murat Özdemir1 , Yasemin Giles Şenyürek2 , Fatih Tunca2 , Mete Düren3 , Mehmet Uludağ4 , Mehmet Hacıyanlı5 , Gökhan Içöz1 , Adnan Işgör6 , Serdar Özbaş7 , Zehra Özcan8 , Serdar Tezelman9
From the Departments of General Surgey (Ö.M., M.Ö. muratozdemir.md@gmail.com, G.İ.) and Nuclear Medicine (Z.Ö.), Ege University School of Medicine, İzmir, Turkey; Department of General Surgey (Y.G.Ş., F.T.), İstanbul University İstanbul School of Medicine, İstanbul, Turkey;Department of General Surgery (M.D.), İstanbul University Cerrahpaşa School of Meidicine, İstanbul, Turkey; Department of General Surgey (M.U.), Şişli Etfal Training and Research Hospital, İstanbul, Turkey; Department of General Surgery (M.H.), İzmir Katip Çelebi University, Atatürk Tranining and Research Hospital; Department of General Surgery (A.İ.), Bahçeşehir University School of Medicine, İstanbul, Turkey; Department of General Surgery (S.Ö.), Güven Hospital, Ankara, Turkey; Department of General Surgery (S.T.), Koç University School of Medicine, İstanbul, Turkey.
Abstract
Objectives: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of <10mm in size, has been increasing in the last decade. Herein, we present internet-based questionnaire results performed by the Turkish Association of Endocrine Surgery with the aim to evaluate the perspective of the management of papillary microcarcinomas in Turkey.
Material and Methods: The user-friendly questionnaire consisted of 13 questions in total. These questions mainly addressed the surgical management of nodules and cancer of <1 cm in size. Patient management before, during, and after surgical intervention was also included; additionally, the “active surveillance approach” was questioned.>
Results: There were 420 responders in total who were of multidisciplinary origin (endocrinologists, surgeons, nuclear medicine specialists, pathologists, and oncologists). Total thyroidectomy was the predominant treatment approach (65%) for the classical type of microcarcinoma limited in one lobe, whereas in cases of microcarcinomas incidentally diagnosed during hemithyroidectomy, complementary surgery approach was advised by 40% of the responders. The responders found capsule invasion (86%) and patient based management (94%) of high importance. The percentage of the responders who recommended radioactive iodine ablation in incidental cancers having no aggressive criteria was 51%. The survey participants that were against routine central dissection in these cases accounted for 73% of the responders. The recommendation of active surveillance (follow-up without any interventional therapy) was limited with 9% responders.
Conclusion: The results of the questionnaire demonstrated that there have been various choices in Turkey for the surgical treatment of the papillary microcarcinomas.
Keywords: Papillary microcarcinoma, Turkey, thyroidectomy
Cite this paper as: Makay Ö, Özdemir M, Giles Şenyürek Y, Tunca F, Düren M, Uludağ M, et al. Surgical approaches for papillary microcarcinomas: Turkey’s perspective. Turk J Surg 2018; 34: 89-93.
This study was presented at the “7th National Endocrine Surgery Congress”, 2015, Antalya, Turkey.
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Externally peer-reviewed.
Concept - Ö.M., Y.G.Ş., M.U.; Design - F.T., M.D., M.U.; Supervision - M.H., G.İ., A.İ., S.Ö., Z.Ö., S.T.; Resource - G.İ., A.İ., S.Ö.; Materials - Ö.M., M.Ö.; Data Collection and/or Processing - Ö.M., M.Ö.; Analysis and/or Interpretation - A.İ., S.Ö., Z.Ö., S.T.; Literature Search - Ö.M., M.Ö., M.H.; Writing Manuscript - Ö.M., M.Ö.; Critical Reviews - Ö.M., Y.G.Ş., M.U., F.T., M.D.
The authors has no conflicts of interest to declare.
The authors declared that this study has received no financial support.