Implications of a background of Hashimoto’s thyroiditis on the current conservative surgical trend towards papillary thyroid carcinoma

• Published in: Updates in surgery 2021-10, Vol.73 (5), p.1931-1935
• Main Authors: Hamouri, Shadi, Bakkar, Sohail, Aljaafreh, Almoutuz, Bani Hani, Mohammed, Heis, Hussein, Qasaimeh, Ghazi, Alrabadi, Nasr, Al Gargaz, Wisam, Odat, Haitham, Alkurdi, Yazan, Manasreh, Tarek, Matalka, Mohammad, Badwan, Moamin
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery
• ISSN: 2038-131X; 2038-3312
• DOI: 10.1007/s13304-021-01087-3

The purpose is to delineate the clinico-pathologic features of papillary thyroid carcinoma (PTC) occurring in a background of Hashimoto’s thyroiditis (HT). A retrospective analysis of consecutive PTC patients who underwent surgery at an academic center between Jan. 2010 and Jan. 2020 was performed. The primary end point was to assess whether a background of HT implied a higher likelihood for postoperatively determined high-risk histopathologic features. Accordingly, its implication on initial surgical planning. Tumor high-risk features included aggressive histologic variants, lymphovascular invasion, extrathyroidal extension, multifocality, and positive nodal metastasis. To achieve the primary outcome of interest, a two group-designation was followed: group A (none-HT-group) and group B (HT-group). The two groups were also compared regarding postoperative complications as a secondary outcome of interest. In the specified period, 331 patients were found to have a histologically proven diagnosis of PTC. Group A accounted for 80% (265/331) of the study cohort, while group B accounted for the remainder 20%. PTC was significantly more prevalent in the absence of HT ( p   0.05). Nevertheless, transient hypoparathyroidism was considerably higher in group B (12% vs. 23%; p  = 0.02). A background of HT does not seem to reflect a more aggressive cancerous biologic behavior. Therefore, it should not preclude the conservative surgical strategy adopted by the most recent clinical practice guidelines.