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Thyroid cancer surgery guidelines vary widely across patients and practitioners

(RxWiki News) Standard surgical guidelines are put in place to encourage the best possible results for patients. What are acceptable reasons for not following those approved guidelines?

A recent study looked at variables in thyroid cancer surgeries. Researchers found inconsistencies based on gender, race, age and surgical institution.

"Talk to your doctor about what’s best for your surgery."

Katherine Hayes, MD, otolaryngology resident at Emory University Hospital in Atlanta, led the investigation.

For the study, researchers looked at 127,192 patient files with papillary and follicular thyroid cancer who had undergone surgery between 1998 and 2009.

Dr. Hayes and her team classified information from the patient files based on: insurance status, race, gender, age, education level, size of tumor, surgeries and hospital data.

Even though there is a standard set of guidelines from the American Thyroid Association (ATA) for differentiated thyroid cancer surgery, researchers found actual surgical practices varied.

Total removal of the thyroid was done 51 percent of the time, and 49 percent of patients also had their lymph nodes dissected.

Of the patients who underwent lymph node dissection, 55 percent had one to three lymph nodes removed, while 45 percent had more than three lymph nodes removed.

Tumors bigger than 1 cm were more likely to be removed than tumors smaller than 1 cm.

Women, older patients and African Americans were less likely than the rest of the group to have lymph nodes surgically removed.

Patients treated at National Cancer Institute Designated Centers were likely to have more than three lymph nodes removed.

Study authors said, “The results from this study identify disparities in the surgical management of lymph nosed in differentiated thyroid cancer (DTC) among several clinical and demographic factors.”

“In spite of existing guidelines, clinical preferences as well as patient characteristics contribute to the variability in the extent of surgery for DTC.”

No success or cancer recurrence rates were taken into account in this study, only surgical practices.

This research was presented at the 82nd Annual Meeting of the American Thyroid Association September 19-23, 2012 in Quebec City, Canada. All research is considered primary until it has been published in a peer-reviewed journal.

Review Date: 
September 20, 2012