Evidence map›Paper›PMID 39808211›Full record

ArticleAnnals of surgical oncology2025

Predictors of Bilateral Disease in Low-Risk Papillary Thyroid Cancer: Histopathologic Insights and Preoperative Ultrasonography.

P M Rodriguez Schaap, A Papachristos, H Serrao-Brown, A Aniss, E J M Nieveen van Dijkum, A J Gill, L Delbridge, A F Engelsman, S Sidhu, M Sywak

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

P M Rodriguez SchaapDepartment of Surgery, Amsterdam University Medical Centres, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands.
A PapachristosDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
H Serrao-BrownDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
A AnissDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
E J M Nieveen van DijkumDepartment of Surgery, Amsterdam University Medical Centres, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands.
A J GillNorthern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
L DelbridgeDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
A F EngelsmanDepartment of Surgery, Amsterdam University Medical Centres, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands.
S SidhuDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
M SywakDepartment of Endocrine Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia. marksywak@nebsc.com.au.

Funding

Amsterdams Universiteitsfonds 5Cancer Center Amsterdam 4CSRD VA 1Michaël-van Vloten fund 3René Vogels Stichting 2
6 · The paper itself

Abstract

backgroundWith the current shift toward de-escalation of surgical management in low-risk papillary thyroid cancer (PTC), understanding predictors and the clinical significance of additional tumors in the contralateral lobe is important. This study investigated the histopathologic predictors of bilateral disease in low-risk PTC patients and the utility of preoperative ultrasonography in guiding completion thyroidectomy decisions.

methodsPatients treated with total thyroidectomy (TT) for low-risk PTCs (< 4 cm) at the Endocrine Surgical Unit of the Royal North Shore Hospital, University of Sydney from 2013 to 2020 were identified from a prospectively maintained database. The primary objective was to evaluate whether specific histopathologic factors can reliably predict the likelihood of bilateral disease in low-risk PTC patients after hemithyroidectomy. The secondary objective was to assess the accuracy of preoperative ultrasonography for patients with bilateral disease.

resultsOf the 737 patients in this study, 194 (26.3%) had bilateral disease. The multivariate analysis showed that larger median tumor size (odds ratio [OR] 1.043 per mm; 95 % confidence interval [CI] 1.025-1.062; P < 0.001), ipsilateral multifocal disease (MFD) (OR 2.010; 95% CI 1.338-3.020; P < 0.001), and venous invasion (OR 1.693; 95% CI 1.058-2.707) had a significant association with bilateral disease. However, in the prediction of clinically significant contralateral disease (≥ 10 mm), median tumor size (OR 1.104 per mm; 95% CI 1.059-1.152; P < 0.001) and venous invasion (OR 2.815; 95% CI 1.044-7.589; P = 0.041) were significantly correlated, whereas ipsilateral MFD lost its significance. These significant contralateral tumors were identified preoperatively and associated with higher Thyroid Imaging, Reporting and Data System (TIRADS) and/or Bethesda cytology classifications in 94% of cases.

conclusionIn low-risk PTC patients, larger tumor size, venous invasion, and ipsilateral MFD are significantly associated with disease in the contralateral thyroid lobe.

Indexed as

Thyroid Cancer, PapillaryThyroidectomyThyroid NeoplasmsAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm InvasivenessPreoperative CarePreoperative PeriodPrognosisProspective StudiesRetrospective StudiesBilateralityHemithyroidectomyMultifocalityNeck ultrasoundThyroid cancer

Identifiers

PMID39808211
PMCPMC11882697

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.