{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:02:34Z","timestamp":1787162554474,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012829","name":"Guangdong Provincial Hospital of Traditional Chinese Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hashimoto\u2019s thyroiditis (HT) is often associated with papillary thyroid carcinoma (PTC) and increases the difficulty of thyroidectomy. The clinical outcomes of applying the transoral approach and the transthoracic approach\u2014the two most widely practiced endoscopic thyroid surgery techniques\u2014in patients with PTC complicated by HT remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This study is a single-center retrospective design. Clinical data on 500 patients with PTC who underwent endoscopic thyroidectomy between January 2016 and December 2022 were collected. Patients voluntarily chose either the transoral endoscopic thyroidectomy via a vestibular approach (TOETVA) or endoscopic thyroidectomy via a chest-breast approach (ETCB), were grouped accordingly, and were further subdivided into HT and non-HT groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 500 patients included, 140 had HT and 360 did not. The proportion of patients with stage T1 tumors was larger in the HT group than in the non-HT group. All endoscopic thyroidectomies (202 ETCBs and 298 TOETVAs) completed successfully without conversion to open surgery. The total number of retrieved lymph nodes was larger in the HT group than in the non-HT group, but the number of positive lymph nodes was smaller. Among patients treated by ETCB, the operative time was longer and the incidence of complications (transient hypoparathyroidism and transient recurrent laryngeal nerve injury) was greater in the HT group than in the non-HT group. For patients treated by TOETVA, the operative time and incidence of complications did not differ significantly between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HT appears to be associated with less aggressive tumor characteristics. TOETVA could represent a preferable option compared with ETCB for managing PTC with concomitant HT, although further prospective studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1623966","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:17:51Z","timestamp":1761106671000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of Hashimoto\u2019s thyroiditis on endoscopic thyroidectomy in patients with papillary thyroid carcinoma"],"prefix":"10.3389","volume":"15","author":[{"given":"Zhen-Xin","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Bao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng-Shun","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan-Hong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Hong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Wan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu-Ping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02207-6","article-title":"Thyroid cancer: incidence and mortality trends in China, 2005-2015","volume":"68","author":"Wang","year":"2020","journal-title":"Endocrine"},{"key":"B2","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1038\/s41574-019-0263-x","article-title":"Geographic influences in the global rise of thyroid cancer","volume":"16","author":"Kim","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s004649900476","article-title":"Endoscopic right thyroid lobectomy","volume":"11","author":"Huscher","year":"1997","journal-title":"Surg Endosc"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-009-1825-6","article-title":"Transoral endoscopic thyroidectomy: Part 2: Surgical technique","volume":"81","author":"Benhidjeb","year":"2010","journal-title":"Chirurg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.3366","article-title":"Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach","volume":"153","author":"Anuwong","year":"2018","journal-title":"JAMA Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000932","article-title":"Transoral endoscopic thyroidectomy vestibular approach versus endoscopic thyroidectomy via areola approach for patients with unilateral papillary thyroid carcinoma: A retrospective study","volume":"31","author":"Zhang","year":"2021","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0234","article-title":"Changed presentation of Hashimoto\u2019s thyroiditis in North-Eastern Sicily and Calabria (Southern Italy) based on a 31-year experience","volume":"18","author":"Benvenga","year":"2008","journal-title":"Thyroid"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0554","article-title":"Hashimoto\u2019s thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records","volume":"23","author":"Caturegli","year":"2013","journal-title":"Thyroid"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-0903","article-title":"The association between papillary thyroid carcinoma and histologically proven Hashimoto\u2019s thyroiditis: a meta-analysis","volume":"168","author":"Lee","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1955.01270080137023","article-title":"Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland","volume":"70","author":"Dailey","year":"1955","journal-title":"AMA Arch Surg"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/endocr\/bqaa062","article-title":"IL-10 restores MHC class I expression and interferes with immunity in papillary thyroid cancer with hashimoto thyroiditis","volume":"161","author":"Lu","year":"2020","journal-title":"Endocrinology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-022-00857-6","article-title":"Papillary thyroid cancer with Hashimoto\u2019s thyroiditis attenuates the tumor aggressiveness through the up-regulation of E-cadherin and TGF-beta expression","volume":"23","author":"Kim","year":"2023","journal-title":"Clin Exp Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.7150\/jca.38330","article-title":"IL-2 enhanced MHC class I expression in papillary thyroid cancer with Hashimoto\u2019s thyroiditis overcomes immune escape in vitro","volume":"11","author":"Hu","year":"2020","journal-title":"J Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1273498","article-title":"Prevalence and Impact of BRAF mutation in patients with concomitant papillary thyroid carcinoma and Hashimoto\u2019s thyroiditis: a systematic review with meta-analysis","volume":"14","author":"Janicki","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1055\/a-2065-0845","article-title":"Does the association of Hashimoto\u2019s thyroiditis with differentiated thyroid cancer really have a protective role","volume":"55","author":"Demir","year":"2023","journal-title":"Horm Metab Res"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2012.09.017","article-title":"Is thyroidectomy in patients with Hashimoto thyroiditis more risky","volume":"178","author":"McManus","year":"2012","journal-title":"J Surg Res"},{"key":"B17","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12893-018-0447-7","article-title":"May predictors of difficulty in thyroid surgery increase the incidence of complications? Prospective study with the proposal of a preoperative score","volume":"18","author":"D\u2019Orazi","year":"2019","journal-title":"BMC Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"49","DOI":"10.11138\/gchir\/2015.36.2.049","article-title":"Difficult thyroidectomies","volume":"36","author":"Pellizzo","year":"2015","journal-title":"G Chir"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-019-01071-0","article-title":"Classifying pain in transoral endoscopic thyroidectomy","volume":"42","author":"Zhang","year":"2019","journal-title":"J Endocrinol Invest"},{"key":"B20","doi-asserted-by":"publisher","first-page":"387062","DOI":"10.4061\/2011\/387062","article-title":"Clinical and pathological implications of concurrent autoimmune thyroid disorders and papillary thyroid cancer","volume":"2011","author":"Cunha","year":"2011","journal-title":"J Thyroid Res"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2017.00053","article-title":"Association between Hashimoto\u2019s thyroiditis and thyroid cancer in 64,628 patients","volume":"7","author":"Resende de Paiva","year":"2017","journal-title":"Front Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.801925","article-title":"Hashimoto\u2019s thyroiditis: A \u201cDouble-edged sword\u201d in thyroid carcinoma","volume":"13","author":"Xu","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e2118526","DOI":"10.1001\/jamanetworkopen.2021.18526","article-title":"Prevalence of Hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes","volume":"4","author":"Xu","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-017-1401-7","article-title":"Thyroid autoimmune antibodies in patients with papillary thyroid carcinoma: a double-edged sword","volume":"58","author":"Shen","year":"2017","journal-title":"Endocrine"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-018-9540-9","article-title":"Papillary thyroid carcinoma emerging from hashimoto thyroiditis demonstrates increased PD-L1 expression, which persists with metastasis","volume":"29","author":"Lubin","year":"2018","journal-title":"Endocr Pathol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1309","article-title":"Differentiated thyroid cancer is associated with less aggressive disease and better outcome in patients with coexisting Hashimotos thyroiditis","volume":"98","author":"Dvorkin","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e2674","DOI":"10.1097\/MD.0000000000002674","article-title":"The effects of hashimoto thyroiditis on lymph node metastases in unifocal and multifocal papillary thyroid carcinoma: A retrospective chinese cohort study","volume":"95","author":"Zhu","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000864","article-title":"Transoral endoscopic thyroidectomy vestibular approach (TOETVA) in thyroiditis","volume":"31","author":"Dinc","year":"2020","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e26793","DOI":"10.1016\/j.heliyon.2024.e26793","article-title":"The impact of coexisting Hashimoto\u2019s thyroiditis on the feasibility of endoscopic thyroidectomy in papillary thyroid carcinoma","volume":"10","author":"Wang","year":"2024","journal-title":"Heliyon"},{"key":"B30","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1186\/s12893-022-01707-8","article-title":"Safety and feasibility of the transoral endoscopic thyroidectomy vestibular approach with neuroprotection techniques for papillary thyroid carcinoma","volume":"22","author":"Chen","year":"2022","journal-title":"BMC Surg"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-06841-8","article-title":"Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases","volume":"34","author":"Ahn","year":"2020","journal-title":"Surg Endosc"},{"key":"B32","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00423-024-03377-x","article-title":"Transoral endoscopic thyroidectomy submental vestibular approach for early-stage papillary thyroid carcinoma: a systematic review and meta-analysis","volume":"409","author":"Hindawi","year":"2024","journal-title":"Langenbecks Arch Surg"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/07435800.2025.2556056","article-title":"Development of painless thyroiditis after thyroid lobectomy in patients with Hashimoto\u2019s thyroiditis","author":"Sato","year":"2025","journal-title":"Endocr Res"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-17842-4","article-title":"Hashimoto\u2019s thyroiditis shows sex- and age-dependent inverse associations with papillary thyroid carcinoma progression: A propensity score-matched analysis of 6963 surgical cases","volume":"32","author":"Ma","year":"2025","journal-title":"Ann Surg Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1623966\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:17:52Z","timestamp":1761106672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1623966\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":34,"alternative-id":["10.3389\/fonc.2025.1623966"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1623966","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]},"article-number":"1623966"}}