Table 1. Overview of all studies with information about recurrence rates after subtotal thyroid resection that are cited in the meta-analyses of Agarwal (10) and Moalem (9).
| Year | EL | Operation | Recurrence rate | Surgery for rec. | Follow-up | Author; comments |
|---|---|---|---|---|---|---|
| Agarwal | ||||||
| 1996 | IV | STR bilat. | 39% | 16% | max. 192 mo. | 73% of recurrences were without thyroxine |
| 1998 | I–II | DP | 14% | 13% | max. 173 mo. | surgical techniques unclear |
| 1998 | III–IV | all STR* | 26% | 13% | n.d. | |
| 1999 | IV | all STR | 12% | n.d. | n.d. | RR hypothetical |
| 2000 | III–IV | STR | HT 13% STR bilat. 32% STR unilat. 60% |
4% | 93 mo. (mean) | no morbidity after surgery for recurrences |
| 2000 | IV | all STR | 14% | n.d. | 40 mo. (mean) | low case numbers, 30% hypocalcemia after TT |
| 2001 | IV | all STR | HT 18% STR 12% |
n.d. | n.d. | low case numbers, 23% hypocalcemia after TT |
| 2004 | III–IV | only HT | 34% | 7% | 80 mo. (mean) | only unilat. goiter (TT not an option) |
| 2005 | IV | STR bilat. | 1% | n.d. | 53 mo. (mean) | hypocalcemia after STR, 8%; after TT, 30% |
| 2005 | III–IV | STR | DP 33% STR bilat. 50% HT 62% STR unilat. 70% |
21% | max. 180 mo. | only patients under 30 years of age, low case numbers, 25% hypocalcemia after TT vs. 0% after STR, reop. in 41% only when desired by patient, no definition of “recurrence” |
| 2007 | IV | only HT | 11 % | 11% | max. 145 mo. | hypocalcemia after HT 0%, after TT 6%; no morbidity from reop. |
| Moalem | ||||||
| 1990 | III | n.d. | 5% | 0% | 124 mo. (mean) | small subgroup without thyroxine (14 pts.): recurrence rate 43% |
| 2002 | III | n.d. | 29% | n.d. | 100 mo. (mean) | little information provided |
| 1993 | III | all STR | 2.5% | 2% | 60–240 mo. | |
| 1994 | III | STR | HT 30% STR bilat. 11% |
n.d. | 89 mo. (mean) | low case numbers, 54% of recurrences were “subclinical” |
| 1987 | III | all STR | n.d. | n.d. | n.d. | meta-analysis states RR is 7.5% after STR; data not in original paper |
| 2005 | III | STR | DP 0% STR bilat. 33% HT 14% STR unilat. 100% |
18% | 98 mo. (mean) | small case numbers, only toxic goiter |
| 1995 | III | all STR | 42% | n.d. | 360 mo. | old study (1960), small case numbers |
| 2007 | III | TT | 0.3% | 0.3% | 56 mo. | only total thyroidectomies, 9/10 recurrences not “genuine” |
| 2007 | III | all STR | STR bilat. 8% | n.d. | 212 mo. | after radiation therapy, 31% without thyroxine |
| 1999 | III | HT | 12% | 6% | 168 mo. | only hemithyroidectomy |
bilat., bilateral; DP, Dunhill procedure; EL, evidence level; HT, hemithyroidectomy; max., maximum; mo., months; reop., reoperation; RR, recurrence rate; STR, subtotal resection; TT, total thyroidectomy; unilat., unilateral; pts, patients; *all types of subtotal resection taken together without further differentiation