Microscopically positive surgical margins and local recurrence in thyroid cancer. A meta-analysis |
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| Affiliation: | 1. Department of Surgery, School of Medicine, Universidad de Antioquia, Cra. 51d #62-29, Medellín, Antioquia, Colombia;2. Head and Neck Service, Clínica Vida, Carrera 50 A # 64 – 42, Medellin, Colombia;3. Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211, Liberdade, Sao Paulo, SP, Brazil;4. ENT Department, NHS Lothian, Waverley Gate 2-4 Waterloo Place, Edinburgh, UK;1. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;2. Department of Surgery, Changwon Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea;3. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea |
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| Abstract: | BackgroundMicroscopically positive surgical margins are a prognostic factor of recurrence in advanced thyroid carcinoma. However, information on early and completely resected thyroid tumors is scarce. Some studies do not identify any association between positive margin and local recurrence. The objective of this study was to perform a meta-analysis to measure the association of microscopically positive surgical margins and local recurrence in patients who underwent total thyroidectomy.MethodsClinical trials assessing the association between microscopically positive surgical margin and local recurrence in patients with early-stage, well-differentiated thyroid carcinoma who underwent total thyroidectomy were evaluated. The outcome measured was local recurrence in the thyroid bed. A systematic review and meta-analysis was done using a random-effects model.ResultsSix studies with 7696 patients were identified. Methodological quality was good, and we did not identify statistical heterogeneity or publication bias. The risk difference for microscopically positive surgical margin and local recurrence was 0% (95% CI 0 to 1).ConclusionMeta-analysis did not find a statistically significant association between microscopically positive surgical margin and local recurrence in this population. A finding of microscopically positive surgical margin in the absence of other adverse factors is not an indication for adjuvant treatment. |
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| Keywords: | Thyroidectomy Recurrence Margin Meta-analysis Systematic review |
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