Sanabria A, Rojas A, Arevalo J, Kowalski LP, Nixon I. Microscopically positive surgical margins and local recurrence in thyroid cancer. A meta-analysis.
Eur J Surg Oncol 2019;
45:1310-1316. [PMID:
30795955 DOI:
10.1016/j.ejso.2019.02.007]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/06/2019] [Accepted: 02/05/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND
Microscopically 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.
METHODS
Clinical 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.
RESULTS
Six 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).
CONCLUSION
Meta-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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