Table 1 Demographic and clinical characteristics of patients who underwent thyroidectomy for thyroid cancer by surgeons who use IONM in ≥ 90% of cases (routine IONM use) or less (no routine IONM use)
No Routine IONM use (n = 1,715) | Routine IONM use (n = 3,731) | P value* | |
|---|---|---|---|
Patient Characteristics | |||
Female sex | 1323 (77.1%) | 2858 (76.6%) | 0.66 |
Age, years, mean (SD) | 48.8 (15.5) | 49.6 (15.2) | 0.12 |
Race | < 0.01 | ||
Black | 52 (3.0%) | 247 (6.6%) | |
White | 1037 (60.8%) | 2509 (67.4%) | |
Other | 223 (13.1%) | 399 (10.7%) | |
Hispanic | 330 (19.4%) | 381 (10.2%) | |
Asian | 63 (3.7%) | 186 (5.0%) | |
BMI > 40 | 124 (7.3%) | 336 (9.0%) | 0.03 |
Pre-op compressive symptoms | 242 (15.2%) | 673 (19.9%) | < 0.01 |
Preoperative FNA Result | < 0.01 | ||
Bethesda 1 | 17 (1.2%) | 43 (1.3%) | |
Bethesda 2 | 103 (7.5%) | 354 (11.0%) | |
Bethesda 3 | 172 (12.5%) | 676 (21.1%) | |
Bethesda 4 | 233 (16.9%) | 335 (10.5%) | |
Bethesda 5 | 221 (16.1%) | 478 (14.9%) | |
Bethesda 6 | 629 (45.7%) | 1318 (41.1%) | |
Prior anterior neck surgery | 114 (6.7%) | 235 (6.3%) | 0.60 |
Prior neck irradiation | 33 (1.9%) | 106 (2.8%) | 0.05 |
Perioperative Characteristics | |||
Extent of Surgery | < 0.01 | ||
Lobectomy | 398 (23.2%) | 1044 (28.0%) | |
Total thyroidectomy | 1303 (76.0%) | 2666 (71.5%) | |
Completion thyroidectomy | 14 (0.8%) | 21 (0.6%) | |
Central neck dissection performed | 550 (32.5%) | 1289 (35.0%) | 0.07 |
Lateral neck dissection performed | 179 (10.6%) | 344 (9.3%) | 0.16 |
Recurrent laryngeal nerve transection | 15 (0.9%) | 35 (0.9%) | 0.82 |
Operative time | < 0.01 | ||
<1 h | 317 (18.5%) | 223 (6.0%) | |
1–2 h | 885 (51.6%) | 1975 (52.9%) | |
2–3 h | 288 (16.8%) | 991 (26.6%) | |
>3 h | 225 (13.1%) | 542 (14.5%) | |
Length of stay | < 0.01 | ||
Same-day discharge | 524 (30.6%) | 1594 (42.7%) | |
1 day | 964 (56.2%) | 1958 (52.5%) | |
2 days | 133 (7.8%) | 109 (2.9%) | |
>2 days | 90 (5.2%) | 63 (1.7%) | |
Already inpatient | < 10 (0.2%) | < 10 (0.2%) | |
Pathologic Characteristics | |||
Thyroid cancer histology | 0.03 | ||
Papillary thyroid cancer | 1482 (86.4%) | 3124 (83.7%) | |
Follicular thyroid cancer | 137 (8.0%) | 383 (10.3%) | |
Oncocytic carcinoma | 44 (2.6%) | 92 (2.5%) | |
Medullary thyroid cancer | 34 (2.0%) | 102 (2.7%) | |
Poorly differentiated thyroid cancer/ anaplastic thyroid cancer | 18 (1.0%) | 30 (0.8%) | |
Extent of cancer | < 0.01 | ||
Intrathyroidal | 1609 (93.8%) | 3544 (95.0%) | |
Extrathyroidal | 90 (5.2%) | 123 (3.3%) | |
Unknown | 16 (0.9%) | 64 (1.7%) | |
N-stage | 0.48 | ||
N0 | 638 (37.2%) | 1366 (36.6%) | |
N1 | 481 (28.0%) | 1007 (27.0%) | |
Nx | 596 (34.8%) | 1358 (36.4%) | |
M-stage | < 0.01 | ||
M0 | 470 (27.4%) | 822 (22.0%) | |
M1 | 29 (1.7%) | 37 (1.0%) | |
Mx | 1216 (70.9%) | 2872 (77.0%) |