Table 9.
Recent studies assessing the relationship between surgeon volume and results for thyroid cancer procedures
| Author | Year | Type of study | N | Population characteristics | Main conclusions |
|---|---|---|---|---|---|
| Kim [54] et al. | 2018 | Unicentric | 1103 | N1b PTC |
1.HVS associated with low structural recurrence. 2.Distant metastasis and disease-specific mortality not affected. |
| Papaleon-tiou [55] et al. | 2017 | Survey | 269a | Referring physicians | Those treating > 10 thyroid cancer patients/year select HVS for advanced PTC and/or frail patients. |
| Youngwirth [56] et al. | 2016 | Registryb | 31,129 | PTC with TT |
1.Both micro- and macroscopically positive margins associated with compromised survival. 2.Reception of surgery at a high-volume facility was protective. |
| Oltmann [57] et al. | 2014 | Unicentric | 45 | TT vs. CT followed by RAI ablation | If a staged operation for cancer is necessary, surgeon volume may impact the completeness of resection |
| Adkisson [44] et al. | 2014 | Unicentricc | 362 | DTC ≥ 10 mm |
1.Surgeons ≥ 30 TT/year more likely to TT and initial resection more complete. 2.For patients with advanced stage disease, a threshold of ≥ 50 TT/year needed for improvements in I123 uptake |
| Yap [58] et al. | 2013 | Unicentric | 651 |
TT for DTC TxNxM0 > 3000 MBq 131I |
1. Clear relationship between volume and size of thyroid remnant. 2. Specialist surgeons: smallest remnant |
| Schneider [59] et al. | 2013 | Unicentric | 223 | TT for DTC+RAI ablation | Remnant uptakes of HVS (≥ 20 TT/year) significantly smaller than LVS. |
| Gourin [6] et al. | 2010 | Registryd | 21,270 | Thyroidectomy | Thyroid cancer surgery was less likely to be performed by high-volume surgeons despite an increase in surgical cases |
| Mitchell [15] et al. | 2008 | Unicentric | 134 | Reoperations for DTC | The majority of avoidable thyroid reoperations came from LVC. |
PTC papillary thyroid cancer; HVS high-volume surgeon; LVS low-volume surgeon; TT total thyroidectomy; CT completion thyroidectomy; RAI radioactive iodine; DTC differentiated thyroid cancer; LVC low-volume centers
aMembers of the Endocrine Society, American College of Physicians and American Academy of Family Practice
bThe National Cancer Data Base (USA)
cUniversity of Pittsburgh Medical Center (USA)
dMaryland Health Service Cost Review Commission (USA)