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Diferansiye tiroid kanserlerinde yetersiz tedavi nedeniyle yapılan reoperasyonların morbidite, mortalite ve maliyetlere etkisi

Yıl 2023, Cilt: 16 Sayı: 4, 736 - 741, 01.10.2023

Hasan Acar Arkın Akalın

https://doi.org/10.31362/patd.1322477

Öz

Diferansiye tiroid kanseri (DTK) insidansı yüksek olmakla birlikte mortalitesi oldukça düşüktür. Düşük ve orta riskli DTK'lerinde yetersiz tedavi nedeniyle yeniden yapılan ameliyatlar hastalarda morbidite, mortalite ve maliyetleri artırabilir. Çalışmamızda bu konuda yayınlanmış güncel makaleler incelenip değerlendirilmiştir. Sonuçlarımıza göre, DTK'lerinde yetersiz tedavi nedeniyle morbidite, mortalite ve maliyetler artmaktadır. Bu nedenle, düşük ve orta riskli DTK vakalarında bile, yüksek hacimli endokrin cerrahlar tarafından total veya totale yakın tiroidektomi gibi yeterli ameliyatlar yapılmalı ve tüm vakalarda orta derecede TSH supresyonu uygulanmalıdır.

Anahtar Kelimeler

Etkileri reoperasyonlar diferensiye tiroid kanserler

Kaynakça

  • 1. Pizzato M, Li M, Vignat J, et al. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022;10:264-272. https://doi.org/10.1016/S2213-8587(22)00035-3
  • 2. Cavalheiro BG, Shah JP, Randolph GW, et al. Management of recurrent well-differentiated thyroid carcinoma in the neck: a comprehensive review. Cancers 2023;15:923-936. https://doi.org/10.3390/cancers15030923
  • 3. Scheller B, Culie D, Poissonnet G, Dassonville O, D’Andrea G, Bozec A. Recent advances in the surgical management of thyroid Cancer. Curr Oncol 2023;30:4787-4804. https://doi.org/10.3390/curroncol30050361
  • 4. Coca Pelaz A, Rodrigo JP, Shah JP, et al. Recurrent differentiated thyroid cancer: the current treatment options. Cancers 2023;15:2692-2700. https://doi.org/10.3390/cancers15102692
  • 5. Nieto HR, Thornton CEM, Brookes K, et al. Recurrence of papillary thyroid cancer: a systematic appraisal of risk factors. Endocrinol Metab 2022;107:1392-1406. https://doi.org/10.1210/clinem/dgab836
  • 6. Harries V, Wang LY, McGill M, et al. Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma? Surgery 2020;167:10-17. https://doi.org/10.1016/j.surg.2019.03.031
  • 7. Shaunak N, Shinn JR, Rohde SL, Nagup MM, Rohde SL. Risk factors and outcomes of postoperative recurrent well-differentiated thyroid cancer: a single institution’s 15-year experience. Otolaryn–Head and Neck Surg 2020;162:469-475. https://doi.org/10.1177/0194599820904923
  • 8. Kaliszevsky K, Diakovska D, Woshtczak B, Migon J, Kasprzyk A, Rudnicki J. The occurrence of and predictive factors for multifocality and bilaterality in patients with papillary thyroid microcarcinoma. Medicine 2019;98:e15609. https://doi.org/10.1097/MD.0000000000015609
  • 9. Shen X, Ding J, Chen H, Cui A, Chen X. Reoperative thyroid surgery: a report of 110 cases. J Surg Con Prac 2019;24:79-84. https://doi.org/10.16139/j.1007-9610.2019.01.017
  • 10. Wilson DB, Staren ED, Prinz RA. Thyroid reoperations: indications and risks. Am Surg 1998;64:674-678.
  • 11. Araz M, Özkan E, Gündüz P, Soydal C, Küçük NO, Kır M. Negative histopathological prognostic factors affecting morbidity in t1 differentiated thyroid carcinoma. Cancer Biother Radiopharm 2022;37:56-62. https://doi.org/10.1089/cbr.2020.4679
  • 12. Christison Lagay ER, Baertschiger RM, Dinauer C, et al. Pediatric differentiated thyroid carcinoma: an update from the APSA Cancer Committee. J Ped Surg 2020;55:2273-2283. https://doi.org/10.1016/j.jpedsurg.2020.05.003
  • 13. Sakız D, Sencar ME, Calapkulu M, et al. The effects of chronic lymphocytic thyroiditis on clinicopathologic factors in papillary thyroid cancer. Endocr Prac 2021;27:1199-1204. https://doi.org/10.1016/j.eprac.2021.07.011
  • 14. Ullmann TM, Papaleontiou M, Sosa JA. Current controversies in low-risk differentiated thyroid cancer: reducing overtreatment in an era of overdiagnosis. Endocrinol Metab 2023;108:271-280. https://doi.org/10.1210/clinem/dgac646
  • 15. Dahan M, Hequet D, Bonneau C, Paoletti X, Rouzier R. Has tumor doubling time in breast cancer changed over the past 80 years? A systematic review. Cancer Med 2021;10:5203-5217. https://doi.org/10.1002/cam4.3939
  • 16. Oh HS, Kim HI, Ha J, et al. Cancer volume doubling time in the active surveillance of papillary thyroid carcinomas. Clin Thyroidol Pub 2019;29:642-649. https://doi.org/10.1089/thy.2018.0609
  • 17. Giovenella L, Garo MS, Albano D, Görges R, Cerianil L. The role of thyroglobulin doubling time in differentiated thyroid cancer: a meta-analysis. Endoc Con 2022;11:e210648. https://doi.org/10.1530/EC-21-0648
  • 18. Park S, Jeon MJ, Oh HS, et al. Changes in serum thyroglobulin levels after lobectomy in patients with low-risk papillary thyroid cancer. Thyroid 2018;28:997-1003. https://doi.org/10.1089/thy.2018.0046
  • 19. Dong W, Horuichi K, Tokumitsu H, et al. Time-varying pattern of mortality and recurrence from papillary thyroid cancer: lessons from a long-term follow-up. Thyroid 2019;29:802-808. https://doi.org/10.1089/thy.2018.0128
  • 20. Freeman JL, Sewell AB, Hales NW, Randolph GW. Surgery of the thyroid and parathyroid glands 50 - reoperative thyroid surg. Science Direct 2021:461-471. https://doi.org/10.1016/B978-0-323-66127-0.00050-8
  • 21. Harries V, Wang LY, McGill M, et al. Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma? Surgery 2020;167:10-17. https://doi.org/10.1016/j.surg.2019.03.031
  • 22. Bates MF, Lamas MR, Randle RV, et al. Back so soon? – Is early recurrence of Papillary Thyroid Cancer really just persistent disease? Surgery 2018;163:118-123. https://doi.org/10.1016/j.surg.2017.05.028
  • 23. Bilimoria KY, Bentrem DJ, Ko CY, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg 2007;246:375-381. https://doi.org/10.1097/SLA.0b013e31814697d9
  • 24. Jin M, Kim HI, Ha J, et al. Tumor volume doubling time in active surveillance of papillary thyroid microcarcinoma: a multicenter cohort study in Korea. Thyroid 2021;31:1491501. https://doi.org/10.1089/thy.2021.0094
  • 25. Sciuto R, Romano L, Rea S, Marandino F, Sperduti I, Mainin CL. Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution. Ann of Oncol 2009;20:1728-1735. https://doi.org/10.1093/annonc/mdp050
  • 26. Benkhaudoura M, Taktuk S, Alobedi R. Recurrent laryngeal nerve injury and hypoparathyroidism rates in reoperative thyroid surgery. Turk. J Surg 2017;33:14-17. https://doi.org/10.5152/UCD.2017.3369
  • 27. Colombo C, Leo SD, Di Stefano M, et al. Total thyroidectomy versus lobectomy for thyroid cancer: single-center data and literature review. Ann Surg Oncol 2021;28;4334-4342. https://doi.org/10.1245/s10434-020-09481-8
  • 28. Medas F, Tuveri M, Canu GL, Erdas E, Calo PG. Complications after reoperative thyroid surgery: retrospective evaluation of 152 consecutive cases. Updates Surg 2019;71:705-710. https://doi.org/10.1007/s13304-019-00647-y
  • 29. Young S, Harari A, Smooke Praw S, Ituarte PH, Yeh M. Effect of reoperation on outcomes in papillary thyroid cancer. Surgery 2013;154:1354-1362. https://doi.org/10.1016/j.surg.2013.06.043
  • 30. Yim JH, Kim WB, Kim EY, et al. The outcomes of first reoperation for locoregionally recurrent/persistent papillary thyroid carcinoma in patients who initially underwent total thyroidectomy and remnant ablation. J Clin Endoc Met 2011;96:2049-2056. https://doi.org/10.1210/jc.2010-2298
  • 31. Bojoga A, Koot A, Bonenkamp J, et al. The impact of the extent of surgery on the long-term outcomes of patients with low-risk differentiated non-medullary thyroid cancer: a systematic meta-analysis. J Clin Med 2020;9:2316-2326. https://doi.org/10.3390/jcm9072316
  • 32. Lee EK, Kang YE, Park YJ, et al. A multicenter, randomized, controlled trial for assessing the usefulness of suppressing thyroid stimulating hormone target levels after thyroid lobectomy in low to intermediate risk thyroid cancer patients (master): a study protocol. Thyroid Endocrinol Metab 2021;36:574-581. https://doi.org/10.3803/EnM.2020.943
  • 33. Carhill AA, Litofsky DR, Ross DS, et al. Long-term outcomes following therapy in differentiated thyroid carcinoma: NTCTCS registry analysis 1987–2012. Endocrinol Metab 2015;100:3270-3279. https://doi.org/10.1210/JC.2015-1346
  • 34. Petersen K, Bengtsson C, Lapidus L, Lindstedt G, Nyström E. Morbidity, mortality, and quality of life for patients treated with levothyroxine. Arch Intern Med 1990;150:2077-2081. https://doi.org/10.1001/archinte.1990.00390210063015
  • 35. Kandil EV, Noureldin SI, Abbas A, Tufano RP. The impact of surgical volume on patient outcomes following thyroid surgery. Surgery 2013;154:1346-1353. https://doi.org/10.1016/j.surg.2013.04.068
  • 36. Minuto MN, Reina S, Monti E, Ansaldo GL, Varaldo E. Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients. Endocrinol Invest 2019;42:1291-1297. https://doi.org/10.1007/s40618-019-01064-z
  • 37. Patel KN, Yip L, Lubitz CC, et al. The American association of endocrine surgeons guidelines for the definitive surgical management of thyroid disease in adults. Ann Surg 2020;271:21-93. https://doi.org/10.1097/SLA.0000000000003580
  • 38. Kluijfhout WP, Pasternak JD, Drake FT, et al. Application of the new American Thyroid Association guidelines leads to a substantial rate of completion total thyroidectomy to enable adjuvant radioactive iodine. Surgery 2017;161:127-133. https://doi.org/10.1016/j.surg.2016.05.056
  • 39. Dhir M, McCoy KL, Ohori NP, et al. Correct extent of thyroidectomy is poorly predicted preoperatively by the guidelines of the American Thyroid Association for low and intermediate risk thyroid cancers. Surgery 2018;163:81-87. https://doi.org/10.1016/j.surg.2017.04.029
  • 40. DiMarco AN, Wong MS, Jayasekara J, et al. Risk of needing completion thyroidectomy for low-risk papillary thyroid cancers treated by lobectomy. BJS Open 2019;3:299-304. https://doi.org/10.1002/bjs5.50137
  • 41. Mammen JS, Cooper DS. Lobectomy versus total thyroidectomy in suspicious or malignant thyroid nodules. Transoral Neck Surgery 2020:63-67. https://doi.org/10.1007/978-3-030-30722-6_6
  • 42. Kim K, Kim M, Lim W, Kim BH, Park SK. The concept of economic evaluation and its application in thyroid cancer research. Endocrinol Metab 2021;36:725-736. https://doi.org/10.3803/EnM.2021.1164
  • 43. Kahaly GJ, Dietlein M. Cost estimation of thyroid disorders in Germany. Thyroid 2002;12:909-914. https://doi.org/10.1089/105072502761016548

The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs

Yıl 2023, Cilt: 16 Sayı: 4, 736 - 741, 01.10.2023

Hasan Acar Arkın Akalın

https://doi.org/10.31362/patd.1322477

Öz

Although the incidence of differentiated thyroid cancer (DTC) is high, mortality is quite low. In low and intermediate risk DTCs, reoperations due to inadequate treatment can increase morbidity, mortality, and costs in patients. In our study, current articles published on this subject were reviewed and evaluated. According to our results, morbidity, mortality and costs increase due to inadequate treatment in DTCs. Therefore, even in low and intermediate risk DTC cases, adequate surgeries such as total or near total thyroidectomy should be performed by high volume endocrine surgeons and moderate TSH suppression should be applied in all cases.

Anahtar Kelimeler

Effects reoperations differentiated thyroid cancers

Kaynakça

  • 1. Pizzato M, Li M, Vignat J, et al. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022;10:264-272. https://doi.org/10.1016/S2213-8587(22)00035-3
  • 2. Cavalheiro BG, Shah JP, Randolph GW, et al. Management of recurrent well-differentiated thyroid carcinoma in the neck: a comprehensive review. Cancers 2023;15:923-936. https://doi.org/10.3390/cancers15030923
  • 3. Scheller B, Culie D, Poissonnet G, Dassonville O, D’Andrea G, Bozec A. Recent advances in the surgical management of thyroid Cancer. Curr Oncol 2023;30:4787-4804. https://doi.org/10.3390/curroncol30050361
  • 4. Coca Pelaz A, Rodrigo JP, Shah JP, et al. Recurrent differentiated thyroid cancer: the current treatment options. Cancers 2023;15:2692-2700. https://doi.org/10.3390/cancers15102692
  • 5. Nieto HR, Thornton CEM, Brookes K, et al. Recurrence of papillary thyroid cancer: a systematic appraisal of risk factors. Endocrinol Metab 2022;107:1392-1406. https://doi.org/10.1210/clinem/dgab836
  • 6. Harries V, Wang LY, McGill M, et al. Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma? Surgery 2020;167:10-17. https://doi.org/10.1016/j.surg.2019.03.031
  • 7. Shaunak N, Shinn JR, Rohde SL, Nagup MM, Rohde SL. Risk factors and outcomes of postoperative recurrent well-differentiated thyroid cancer: a single institution’s 15-year experience. Otolaryn–Head and Neck Surg 2020;162:469-475. https://doi.org/10.1177/0194599820904923
  • 8. Kaliszevsky K, Diakovska D, Woshtczak B, Migon J, Kasprzyk A, Rudnicki J. The occurrence of and predictive factors for multifocality and bilaterality in patients with papillary thyroid microcarcinoma. Medicine 2019;98:e15609. https://doi.org/10.1097/MD.0000000000015609
  • 9. Shen X, Ding J, Chen H, Cui A, Chen X. Reoperative thyroid surgery: a report of 110 cases. J Surg Con Prac 2019;24:79-84. https://doi.org/10.16139/j.1007-9610.2019.01.017
  • 10. Wilson DB, Staren ED, Prinz RA. Thyroid reoperations: indications and risks. Am Surg 1998;64:674-678.
  • 11. Araz M, Özkan E, Gündüz P, Soydal C, Küçük NO, Kır M. Negative histopathological prognostic factors affecting morbidity in t1 differentiated thyroid carcinoma. Cancer Biother Radiopharm 2022;37:56-62. https://doi.org/10.1089/cbr.2020.4679
  • 12. Christison Lagay ER, Baertschiger RM, Dinauer C, et al. Pediatric differentiated thyroid carcinoma: an update from the APSA Cancer Committee. J Ped Surg 2020;55:2273-2283. https://doi.org/10.1016/j.jpedsurg.2020.05.003
  • 13. Sakız D, Sencar ME, Calapkulu M, et al. The effects of chronic lymphocytic thyroiditis on clinicopathologic factors in papillary thyroid cancer. Endocr Prac 2021;27:1199-1204. https://doi.org/10.1016/j.eprac.2021.07.011
  • 14. Ullmann TM, Papaleontiou M, Sosa JA. Current controversies in low-risk differentiated thyroid cancer: reducing overtreatment in an era of overdiagnosis. Endocrinol Metab 2023;108:271-280. https://doi.org/10.1210/clinem/dgac646
  • 15. Dahan M, Hequet D, Bonneau C, Paoletti X, Rouzier R. Has tumor doubling time in breast cancer changed over the past 80 years? A systematic review. Cancer Med 2021;10:5203-5217. https://doi.org/10.1002/cam4.3939
  • 16. Oh HS, Kim HI, Ha J, et al. Cancer volume doubling time in the active surveillance of papillary thyroid carcinomas. Clin Thyroidol Pub 2019;29:642-649. https://doi.org/10.1089/thy.2018.0609
  • 17. Giovenella L, Garo MS, Albano D, Görges R, Cerianil L. The role of thyroglobulin doubling time in differentiated thyroid cancer: a meta-analysis. Endoc Con 2022;11:e210648. https://doi.org/10.1530/EC-21-0648
  • 18. Park S, Jeon MJ, Oh HS, et al. Changes in serum thyroglobulin levels after lobectomy in patients with low-risk papillary thyroid cancer. Thyroid 2018;28:997-1003. https://doi.org/10.1089/thy.2018.0046
  • 19. Dong W, Horuichi K, Tokumitsu H, et al. Time-varying pattern of mortality and recurrence from papillary thyroid cancer: lessons from a long-term follow-up. Thyroid 2019;29:802-808. https://doi.org/10.1089/thy.2018.0128
  • 20. Freeman JL, Sewell AB, Hales NW, Randolph GW. Surgery of the thyroid and parathyroid glands 50 - reoperative thyroid surg. Science Direct 2021:461-471. https://doi.org/10.1016/B978-0-323-66127-0.00050-8
  • 21. Harries V, Wang LY, McGill M, et al. Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma? Surgery 2020;167:10-17. https://doi.org/10.1016/j.surg.2019.03.031
  • 22. Bates MF, Lamas MR, Randle RV, et al. Back so soon? – Is early recurrence of Papillary Thyroid Cancer really just persistent disease? Surgery 2018;163:118-123. https://doi.org/10.1016/j.surg.2017.05.028
  • 23. Bilimoria KY, Bentrem DJ, Ko CY, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg 2007;246:375-381. https://doi.org/10.1097/SLA.0b013e31814697d9
  • 24. Jin M, Kim HI, Ha J, et al. Tumor volume doubling time in active surveillance of papillary thyroid microcarcinoma: a multicenter cohort study in Korea. Thyroid 2021;31:1491501. https://doi.org/10.1089/thy.2021.0094
  • 25. Sciuto R, Romano L, Rea S, Marandino F, Sperduti I, Mainin CL. Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution. Ann of Oncol 2009;20:1728-1735. https://doi.org/10.1093/annonc/mdp050
  • 26. Benkhaudoura M, Taktuk S, Alobedi R. Recurrent laryngeal nerve injury and hypoparathyroidism rates in reoperative thyroid surgery. Turk. J Surg 2017;33:14-17. https://doi.org/10.5152/UCD.2017.3369
  • 27. Colombo C, Leo SD, Di Stefano M, et al. Total thyroidectomy versus lobectomy for thyroid cancer: single-center data and literature review. Ann Surg Oncol 2021;28;4334-4342. https://doi.org/10.1245/s10434-020-09481-8
  • 28. Medas F, Tuveri M, Canu GL, Erdas E, Calo PG. Complications after reoperative thyroid surgery: retrospective evaluation of 152 consecutive cases. Updates Surg 2019;71:705-710. https://doi.org/10.1007/s13304-019-00647-y
  • 29. Young S, Harari A, Smooke Praw S, Ituarte PH, Yeh M. Effect of reoperation on outcomes in papillary thyroid cancer. Surgery 2013;154:1354-1362. https://doi.org/10.1016/j.surg.2013.06.043
  • 30. Yim JH, Kim WB, Kim EY, et al. The outcomes of first reoperation for locoregionally recurrent/persistent papillary thyroid carcinoma in patients who initially underwent total thyroidectomy and remnant ablation. J Clin Endoc Met 2011;96:2049-2056. https://doi.org/10.1210/jc.2010-2298
  • 31. Bojoga A, Koot A, Bonenkamp J, et al. The impact of the extent of surgery on the long-term outcomes of patients with low-risk differentiated non-medullary thyroid cancer: a systematic meta-analysis. J Clin Med 2020;9:2316-2326. https://doi.org/10.3390/jcm9072316
  • 32. Lee EK, Kang YE, Park YJ, et al. A multicenter, randomized, controlled trial for assessing the usefulness of suppressing thyroid stimulating hormone target levels after thyroid lobectomy in low to intermediate risk thyroid cancer patients (master): a study protocol. Thyroid Endocrinol Metab 2021;36:574-581. https://doi.org/10.3803/EnM.2020.943
  • 33. Carhill AA, Litofsky DR, Ross DS, et al. Long-term outcomes following therapy in differentiated thyroid carcinoma: NTCTCS registry analysis 1987–2012. Endocrinol Metab 2015;100:3270-3279. https://doi.org/10.1210/JC.2015-1346
  • 34. Petersen K, Bengtsson C, Lapidus L, Lindstedt G, Nyström E. Morbidity, mortality, and quality of life for patients treated with levothyroxine. Arch Intern Med 1990;150:2077-2081. https://doi.org/10.1001/archinte.1990.00390210063015
  • 35. Kandil EV, Noureldin SI, Abbas A, Tufano RP. The impact of surgical volume on patient outcomes following thyroid surgery. Surgery 2013;154:1346-1353. https://doi.org/10.1016/j.surg.2013.04.068
  • 36. Minuto MN, Reina S, Monti E, Ansaldo GL, Varaldo E. Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients. Endocrinol Invest 2019;42:1291-1297. https://doi.org/10.1007/s40618-019-01064-z
  • 37. Patel KN, Yip L, Lubitz CC, et al. The American association of endocrine surgeons guidelines for the definitive surgical management of thyroid disease in adults. Ann Surg 2020;271:21-93. https://doi.org/10.1097/SLA.0000000000003580
  • 38. Kluijfhout WP, Pasternak JD, Drake FT, et al. Application of the new American Thyroid Association guidelines leads to a substantial rate of completion total thyroidectomy to enable adjuvant radioactive iodine. Surgery 2017;161:127-133. https://doi.org/10.1016/j.surg.2016.05.056
  • 39. Dhir M, McCoy KL, Ohori NP, et al. Correct extent of thyroidectomy is poorly predicted preoperatively by the guidelines of the American Thyroid Association for low and intermediate risk thyroid cancers. Surgery 2018;163:81-87. https://doi.org/10.1016/j.surg.2017.04.029
  • 40. DiMarco AN, Wong MS, Jayasekara J, et al. Risk of needing completion thyroidectomy for low-risk papillary thyroid cancers treated by lobectomy. BJS Open 2019;3:299-304. https://doi.org/10.1002/bjs5.50137
  • 41. Mammen JS, Cooper DS. Lobectomy versus total thyroidectomy in suspicious or malignant thyroid nodules. Transoral Neck Surgery 2020:63-67. https://doi.org/10.1007/978-3-030-30722-6_6
  • 42. Kim K, Kim M, Lim W, Kim BH, Park SK. The concept of economic evaluation and its application in thyroid cancer research. Endocrinol Metab 2021;36:725-736. https://doi.org/10.3803/EnM.2021.1164
  • 43. Kahaly GJ, Dietlein M. Cost estimation of thyroid disorders in Germany. Thyroid 2002;12:909-914. https://doi.org/10.1089/105072502761016548
Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kalp ve Damar Cerrahisi
Bölüm Derleme
Yazarlar

Hasan Acar 0000-0001-6435-8720

Arkın Akalın 0000-0001-7161-1480

Erken Görünüm Tarihi 24 Temmuz 2023
Yayımlanma Tarihi 1 Ekim 2023
Gönderilme Tarihi 4 Temmuz 2023
Kabul Tarihi 24 Temmuz 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 16 Sayı: 4

Kaynak Göster

APA Acar, H., & Akalın, A. (2023). The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs. Pamukkale Medical Journal, 16(4), 736-741. https://doi.org/10.31362/patd.1322477
AMA Acar H, Akalın A. The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs. Pam Tıp Derg. Ekim 2023;16(4):736-741. doi:10.31362/patd.1322477
Chicago Acar, Hasan, ve Arkın Akalın. “The Effects of Reoperations Due to Inadequate Treatment in Differentiated Thyroid Cancers on Morbidity, Mortality and Costs”. Pamukkale Medical Journal 16, sy. 4 (Ekim 2023): 736-41. https://doi.org/10.31362/patd.1322477.
EndNote Acar H, Akalın A (01 Ekim 2023) The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs. Pamukkale Medical Journal 16 4 736–741.
IEEE H. Acar ve A. Akalın, “The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs”, Pam Tıp Derg, c. 16, sy. 4, ss. 736–741, 2023, doi: 10.31362/patd.1322477.
ISNAD Acar, Hasan - Akalın, Arkın. “The Effects of Reoperations Due to Inadequate Treatment in Differentiated Thyroid Cancers on Morbidity, Mortality and Costs”. Pamukkale Medical Journal 16/4 (Ekim 2023), 736-741. https://doi.org/10.31362/patd.1322477.
JAMA Acar H, Akalın A. The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs. Pam Tıp Derg. 2023;16:736–741.
MLA Acar, Hasan ve Arkın Akalın. “The Effects of Reoperations Due to Inadequate Treatment in Differentiated Thyroid Cancers on Morbidity, Mortality and Costs”. Pamukkale Medical Journal, c. 16, sy. 4, 2023, ss. 736-41, doi:10.31362/patd.1322477.
Vancouver Acar H, Akalın A. The effects of reoperations due to inadequate treatment in differentiated thyroid cancers on morbidity, mortality and costs. Pam Tıp Derg. 2023;16(4):736-41.
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