A meta-analysis on the effect of operation modes on the recurrence of papillary thyroid microcarcinoma

// Dandan Yi 1,* , Peng Song 2,* , Tao Huang 1,* , Xiaoqiao Tang 2 and Jianfeng Sang 2 1 Department of general surgery, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu Province, China 2 Department of General Surgery, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China * These authors have contributed equally to this work Correspondence to: Jianfeng Sang, email: // Keywords : papillary thyroid microcarcinoma (PTMC); recurrence rate; total thyroidectomy; non-total thyroidectomy; meta-analysis Received : July 30, 2016 Accepted : October 10, 2016 Published : October 15, 2016 Abstract Whether total thyroidectomy reduces the recurrence rate in patients with papillary thyroid microcarcinoma (PTMC) is currently controversy. Conclusions of sporadic, inconsistent, and mono-institutional studies need a meta-analysis to evaluate. 525 relevant studies were obtained from initial search on PubMed, 511 studies were excluded by inclusion and exclusion criteria. Eligible data were extracted from each included study. The Odds ratios (ORs) and 95% confidence interval (CI) were used to assess the difference in the recurrence rates between PTMC patients treated with total thyroidectomy and non-total thyroidectomy. OR and 95% CI were calculated using a fixed-effects or a random-effects model. The Q statistic was used to evaluate homogeneity and Begg’s test was used to assess publication bias. 14 studies meeting the inclusion criteria were included in this meta-analysis. The over all recurrence rates of pooled patients with total thyroidectomy and non-total thyroidectomy were 2.83% and 2.84% respectively. Primary random-effects model analysis showed, no significant difference of recurrence rates existed between two operation modes (OR = 0.732, 95% CI: 0.444 - 1.208), while, high heterogeneity among studies was found, I-squared index (I 2 ) = 40.2%. After remove one study with high heterogeneity, the OR of the pooled recurrence rates of the total thyroidectomy and the non-total thyroidectomy groups was 0.786 (95% CI: 0.363 - 1.701), further suggesting no significant difference of the recurrence rate exists between two operation modes. Our meta-analysis demonstrated postoperative recurrence of PTMC is not reduced by total thyroidectomy, non-total thyroidectomy is also a good choice to treat PTMC patients.