Evidence map›Paper›PMID 37393154›Full record

Observational studySurgery2023

Reassessing surgical guidelines for papillary thyroid cancer impact on survival: Expanding indications for lobectomy.

Audrey Stevens, Jennie Meier, Archana Bhat, Sara J Knight, David J Vanness, Courtney Balentine

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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

6 authors at 4 institutions in 1 country.

Audrey StevensDepartment of Surgery, University of Texas Southwestern, Dallas, TX.
Jennie MeierDepartment of Surgery, University of Texas Southwestern, Dallas, TX.
Archana BhatDepartment of Surgery, University of Texas Southwestern, Dallas, TX.
Sara J KnightDepartment of Medicine, University of Utah, Salt Lake City, UT.
David J VannessHealth Policy and Administration, Penn State, University Park, PA.
Courtney BalentineDepartment of Surgery, University of Wisconsin - Madison, Madison, WI. Electronic address: cbalentine@wisc.edu.
The University of Texas Southwestern Medical Center · USPennsylvania State University · USUniversity of Utah · USUniversity of Wisconsin–Madison · US

Funding

A Pilot Study of Local Anesthesia for Inguinal Hernia Surgery in Older AdultsK76AG068515 · NIA · UT SOUTHWESTERN MEDICAL CENTER · PI BALENTINE, COURTNEY J · 2021 to 2024
$939k
NIA NIH HHS K76 AG068515
6 · The paper itself

Abstract

backgroundComparisons of lobectomy versus total thyroidectomy for papillary thyroid cancer have not addressed significant threats to valid inference from observational data. The purpose of this study was to compare survival after lobectomy versus total thyroidectomy for papillary thyroid cancer while addressing bias from unmeasured confounding.

methodsThis retrospective cohort study included 84,300 patients treated with lobectomy or total thyroidectomy for papillary thyroid cancer in the National Cancer Database from 2004 to 2017. The primary outcome was overall survival evaluated by flexible parametric survival models and inverse probability weighting on the propensity score. Bias from unobserved confounding was assessed using two-way deterministic sensitivity analysis and 2-stage least squares regression.

resultsThe median age of treated patients was 48 years (interquartile range, 37-59), 78% were women, and 76% were white. We found no statistically significant differences in overall survival or 5- and 10-year survival between patients treated with lobectomy or total thyroidectomy. Additionally, we found no statistically significant difference in survival by subgroups, including tumor size (<4 cm or ≥4 cm), age (<65 or ≥65), or estimated risk of mortality. Sensitivity analyses suggested that an unmeasured confounder would need to have an extremely large effect to change the primary finding.

conclusionThis is the first study to compare lobectomy and total thyroidectomy outcomes while adjusting for and quantifying the potential effects of unmeasured confounding variables on observational data. The findings suggest that total thyroidectomy is unlikely to offer a survival advantage over lobectomy regardless of tumor size, patient age, or overall risk of death.

Indexed as

Carcinoma, PapillaryThyroid NeoplasmsFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalRetrospective StudiesThyroid Cancer, PapillaryThyroidectomy

Identifiers

PMID37393154
PMCPMC10526679
OpenAlexW4382700730

What OpenQuestion holds

Textmetadata
LicenceTDM
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 OpenQuestion graph.