Table 4. The demographic, clinical intra operative and histopathological characteristics of low-risk patients who were operated before and after the introduction of 2015 ATA guidelines.
| Parameter | Before 2015 ATA (n=287) | After 2015 ATA (n=14) | |||||
|---|---|---|---|---|---|---|---|
| No upscale (n=243) | Upscaled (n=44) | P value | No upscale (n=12) | Upscaled (n=2) | P value | ||
| Mean age (years) | 48.7±14.9, 49.0 [36.0–60.0] | 53.4±16.4, 52.0 [39.0–67.7] | 0.08 | 52.8±14.8, 52.5 [40.7–61.7] | 47.50±9.192, 47.5 [41.00–47.5] | 0.56 | |
| Gender (male) | 42 (17.3%) | 5 (11.4%) | 0.33 | 4 (33.3%) | 0 (0.0%) | >0.99 | |
| Family history of thyroid cancer | 15 (11.3%) | 3 (10.0%) | >0.99 | 3 (30.0%) | 0 (0.0%) | >0.99 | |
| Radiation exposure | 12 (10.4%) | 4 (13.8%) | 0.74 | 0 (0.0%) | 1 (50.0%) | 0.182 | |
| Hoarseness | 12 (7.9%) | 1 (3.6%) | 0.69 | 1 (8.3%) | 1 (100.0%) | 0.154 | |
| Dyspnea | 21 (13.6%) | 3 (10.7%) | >0.99 | 1 (8.3%) | 0 (0.0%) | >0.99 | |
| Dysphagia | 26 (16.8%) | 3 (10.3%) | 0.58 | 1 (8.3%) | 0 (0.0%) | >0.99 | |
| Physical examination | |||||||
| Vocal cord paralysis | 0 (0.0%) | 0 (0.0%) | >0.99 | 0 (0.0%) | 0 (0.0%) | >0.99 | |
| Palpated lesion | 133 (60.2%) | 25(58.1%) | 0.80 | 3 (30.0%) | 1 (50.0%) | >0.99 | |
| US | 0.391 | 0.26 | |||||
| US lesion size | 20.8±9.1, 19.0 [14.0–27.0] | 23.5±12.4, 20.0 [13.7–33.5] | 20.3±8.2, 17.5 [14.2–26.5] | 14.5±0.7, 14.5 [14.0–15.0] | |||
| Number of thyroid lesions | |||||||
| 1 | 61 (26.8%) | 13 (29.5%) | 5 (4.7%) | 0 (0.0%) | |||
| 2 | 64 (28.1%) | 9 (20.5%) | 1 (8.3%) | 0 (0.0%) | |||
| 3 | 17 (7.5%) | 6 (13.6%) | 0 (0.0%) | 0 (0.0%) | |||
| 4 | 1 (0.4%) | 1 (2.3%) | 0 (0.0%) | 0 (0.0%) | |||
| Multiple lesions | 85 (37.3%) | 15 (34.1%) | 6 (50.0%) | 2 (100.0%) | |||
| Surgery extent | 0.18 | >0.99 | |||||
| TT | 162 (66.7%) | 31 (70.5%) | 5 (41.7%) | 1 (50.0%) | |||
| TT ND | 1 (0.4%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |||
| Completion thyroidectomy | 43 (17.7%) | 11 (25.0%) | 0 (0.0%) | 0 (0.0%) | |||
| HT | 37 (15.2%) | 2 (4.5%) | 7 (58.3%) | 1 (50.0%) | |||
| Intraoperative impression of macroscopic ETE | 18 (7.4%) | 24 (54.5%) | >0.001 | 1 (8.3%) | 2 (100.0%) | 0.03 | |
| Final histopathology | |||||||
| Minor ETE | 64 (26.3%) | 32 (72.7%) | >0.001 | 1 (8.3%) | 2 (100.0%) | 0.033 | |
| Multifocal lesion | 122 (50.2%) | 22 (50.0%) | 0.98 | 6 (50.0%) | 0 (0.0%) | 0.47 | |
| Microcarcinoma | 5 (2.1%) | 0 (0.0%) | >0.99 | – | – | – | |
| Positive microscopic margins | 37 (15.2%) | 19 (43.2%) | >0.001 | 0 (0.0%) | 1 (50%) | 0.14 | |
| Vascular invasion | 0 (0.0%) | 15 (34.1%) | >0.001 | 0 (0.0%) | 0 (0.0%) | >0.99 | |
| Perineural invasion | 0 (0.0%) | 3 (6.8%) | 0.003 | 0 (0.0%) | 0 (0.0%) | >0.99 | |
| Size of largest lesion in cm | 1.6±0.7, 1.5 [1.2–2.0] | 1.9±0.8, 1.7 [1.2–2.5] | 0.039 | 1.5±0.6, 1.3 [1.0–1.6] | 1.1±0.1, 1.1 [1.0–2.0] | 0.55 | |
ATA, American Thyroid Association; US, ultrasound; TT, total thyroidectomy; ND, neck dissection; HT, hemi-thyroidectomy; ETE, extrathyroidal extension.