ArticleMedicine2016
Patient outcomes following surgical management of multinodular goiter: Does multinodularity increase the risk of thyroid malignancy?
Article in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
- Diagnostic value of thyroglobulin levels in fine-needle aspiration for evaluating metastatic cervical lymph nodes in papillary thyroid cancer.Irish journal of medical science · 2026Article
- Management of a huge cystic multi-nodular goiter with retro-sternal extension. Case report.International journal of surgery case reports · 2025Article
- The impact of air pollutants on the risk of goiter based on a 9-year time series data.Frontiers in public health · 2025Article
- Article
- Clinicopathologic characteristics of incidental thyroid carcinoma in euthyroid patients receiving total thyroidectomy for multinodular goiter: A retrospective cohort study.Journal of the Chinese Medical Association : JCMA · 2022Article
- Risk of thyroid carcinoma in patients treated surgically with assumed benign cytology in Riyadh, Saudi Arabia.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2022Article
- Incidental thyroid carcinoma: Correlation between FNAB cytology and pathological examination in 1093 cases.Clinics (Sao Paulo, Brazil) · 2022Article
- The risk of thyroid carcinoma in multinodular goiter compared to solitary thyroid nodules: A retrospective analysis of 600 patients.Medical journal, Armed Forces India · 2020Article
- Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2019Article
- Less than total thyroidectomy for goiter: when and how?Gland surgery · 2017Review
- Case Report: Papillary Thyroid Cancer in a Patient with Celiac Disease and Thalassemia Trait.Case reports in oncologyArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundthe difference in the risk of thyroid malignancy for patients with multinodular goiter (MNG) and solitary nodular goiter (SNG) remains controversial. Although total thyroidectomy (TT) is the current preferred surgical option for MNG, permanent hypothyroidism in these patients may be a concern. Therefore, we discuss whether nontotal thyroidectomy is a reasonable alternative surgical option.
methodsA retrospective cohort study was performed for 1598 consecutive patients who underwent thyroid surgery for nodular goiter between January 2007 and December 2012. Numerous clinical parameters were collected and analyzed.
resultsWe reviewed 795 patients with MNG and 803 patients with SNG. The prevalence of malignancy on final pathology was significantly higher in the patients with MNG than in the patients with SNG (15.6% vs 10.1%, P = 0.001). However, a multivariate analysis revealed that this difference was insignificant (P = 0.50). Papillary carcinoma was the predominant type in both groups, but papillary microcarcinoma was more frequently found (41.1%) in the patients with MNG. The only multifocal cancers were of the papillary carcinoma histologic type, and the incidence of multifocal papillary carcinoma was significantly higher in the patients with MNG (23.4% vs 7.4%, P = 0.005). Reoperation was not required for the patients who underwent TT for goiter recurrence or incidental carcinoma. The overall rate of recurrence following nontotal thyroidectomy was 12.2%. Among the patients who underwent reoperation for goiter recurrence, 2 (20.0%) were complicated with permanent hypoparathyroidism. Among the patients who underwent a nontotal bilateral thyroidectomy, an average of 56.5% had permanent hypothyroidism.
conclusionsMultinodularity does not increase the risk of thyroid malignancy. However, patients with MNG who develop papillary carcinoma are at an increased risk of cancer multifocality. If a patient can tolerate lifelong thyroid hormone replacement, TT is the preferred surgical option because it helps avoid reoperation and the associated complications. Nontotal bilateral thyroidectomy does not ensure the preservation of thyroid hormone function.
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