Risk Factors Associated With Reoperative Surgery for Thyroid Malignancies: A Retrospective Cohort Study.

Autor: Hutchinson KA; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada., Guerra A; Department of Chemical Engineering, Faculty of Engineering, McGill University, Montréal, Canada., Payne AE; Health Sciences, Marianopolis College, Montréal, Canada., Turkdogan S; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada., Forest VI; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada., Hier MP; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada., Payne RJ; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Mar; Vol. 168 (3), pp. 392-397. Date of Electronic Publication: 2023 Jan 29.
DOI: 10.1177/01945998221099799
Abstrakt: Objective: To examine various factors associated with an increased risk of reoperation for persistent or recurrent malignant thyroid cancers.
Study Design: Retrospective cohort study.
Setting: Tertiary academic hospital centers.
Methods: Patients undergoing surgery for thyroid cancer at 2 tertiary academic institutions from 2006 to 2020 were included. Those who underwent a reoperative procedure were compared with patients only requiring 1 procedure. The Pearson chi-square and independent t test were used to compare group data accordingly. Furthermore, a binomial logistic regression was performed, while machine learning models were used to construct a predictive algorithm.
Results: This study included 2266 patients with surgically managed thyroid malignancy, of which 54 (2.4%) necessitated reoperations. Those requiring a second surgical procedure were more likely to be male (40.7% vs 20.9%, P < .001), undergo bilateral (24.1% vs 3.3%, P < .001) and lateral (16.7% vs 1.8%, P < .001) neck dissections, and have a greater number of metastatic lymph nodes (mean, 9.1 vs 3.5; P < .001) and a larger tumor size (mean, 3.0 vs 2.0 cm; P < .001). According to the binomial logistic regression model, lateral neck dissection, greater number of metastatic lymph nodes, and larger tumor size significantly increased the odds of necessitating a second procedure by 7.8 (95% CI, 2.523-24.083), 1.1 (95% CI, 1.032-1.152), and 1.3 (95% CI, 1.064-1.559), respectively. Last, machine learning models could not significantly predict the occurrence of reoperation.
Conclusion: This study identified patient- and cancer-related characteristics associated with an increased risk of requiring reoperation for thyroid malignancies.
(© 2022 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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