Optimal timing of surgery in well-differentiated thyroid carcinoma detected during pregnancy

Abstract

BACKGROUND: To determine the optimal timing at which to perform surgery for well-differentiated thyroid carcinoma detected during pregnancy. OBJECTIVES: We retrospectively analyzed 20 cases of women diagnosed during pregnancy with well-differentiated thyroid carcinoma between July 1991 and June 2004, all of whom underwent surgery. The patients were divided into three groups according to the timing of surgery. Group I (n = 9) had thyroidectomy after delivery, Group II (n = 6) had thyroidectomy during the second trimester, and Group III (n = 5) had thyroidectomy after abortion. Group III was excluded from the study because we were interested in determining the optimal timing of surgery in pregnant women. RESULTS: No significant differences were noted between Groups I and II with regard to patient age, tumor size, TNM stage, and the timing of diagnosis. There were no TNM stage changes in Group I, although there was a slight increase in tumor size during pregnancy in this group. Surgical outcome, with regard to type of operation, operation time, perioperative complications, length of hospital stay, and treatment outcome, did not differ significantly between Groups I and II. CONCLUSIONS: In most patients, surgery on well-differentiated thyroid carcinoma detected during pregnancy can be delayed until after delivery.