Optimal surgery for papillary thyroid carcinoma

Robert Udelsman, Edward Lakatos, Paul W Ladenson

Research output: Contribution to journalArticle

Abstract

There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to design a randomized prospective trial comparing the endpoints of complications, recurrence, and cause-specific mortality. A complication comparison trial is prohibitive owing to the large population required-approximately 12,000 randomized patients. A recurrence trial appears feasible based on sample size: approximately 360 to 800 patients with a 6 to 10-year follow-up. However, recurrence detection would be severely compromised in the lobectomy arm, and a unilateral lag-time bias would occur. A cause-specific mortality trial proves to be the least objectionable, although a large sample size (n = 3100) would be required. Such a trial is critically dependent on the ability to select an appropriate endpoint. A cause-specific mortality trial proves to he the most objective and statistically valid endpoint.

Original languageEnglish (US)
Pages (from-to)88-93
Number of pages6
JournalWorld Journal of Surgery
Volume20
Issue number1
DOIs
StatePublished - 1996

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Sample Size
Recurrence
Mortality
Thyroid Neoplasms
Population
Papillary Thyroid cancer

ASJC Scopus subject areas

  • Surgery

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Optimal surgery for papillary thyroid carcinoma. / Udelsman, Robert; Lakatos, Edward; Ladenson, Paul W.

In: World Journal of Surgery, Vol. 20, No. 1, 1996, p. 88-93.

Research output: Contribution to journalArticle

Udelsman, Robert ; Lakatos, Edward ; Ladenson, Paul W. / Optimal surgery for papillary thyroid carcinoma. In: World Journal of Surgery. 1996 ; Vol. 20, No. 1. pp. 88-93.
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