To compare robot vs open thyroid surgery using inverse probability of treatment weighting (IPTW) with regard to oncologic safety in papillary thyroid carcinoma (PTC) patients.

We enrolled 722 patients with PTC who underwent a total thyroidectomy with central compartment node dissection (CCND) at the Asan Medical Center in Korea from January 2009 to December 2010. These patients were classified into open thyroid surgery (n = 610) or robot thyroid surgery (n= 112) groups. We verified the impact of robot thyroid surgery on clinical recurrence and ablation/control-stimulated thyroglobulin (sTg) levels predictive of non-recurrence using weighted logistic regression models with IPTW.

Age, sex, thyroid weight, extent of CCND, and TNM stage were significantly different between the two groups (p < 0.05); however, there was no significant difference in the recurrence rate between the open and robot groups (1.5 vs 2.7%; p = 0.608). The proportion of patients with ablation sTg < 10.0 ng/mL and control sTg < 1.0 ng/mL was comparable between the two groups (p > 0.05). Logistic regression with IPTW using the propensity scores estimated by adjusting all of the parameters demonstrated that robot thyroid surgery did not influence the clinical recurrence (OR: 0.784; 95% CI: 0.150–3.403; p = 0.750), ablation sTg (OR: 0.950; 95% CI: 0.361–2.399; p = 0.914), and control sTg levels (OR: 0.498; 95% CI: 0.190–1.189; p = 0.130).

Robot thyroid surgery is comparable to open thyroid surgery with regard to oncologic safety in PTC patients.