Objective The aim of this study was to validate the predictors of peropertive computed tomography imaging parameters for sternotomy in patients with substernal goiter.
Methods We retrospectively reviewed complete clinical and computed tomography data of 37 patients who had substernal goiter and underwent surgery from January 2010 to February 2019. The patients were divided into two groups based on whether or not underwent sternotomy surgery. The maximum length and width, length behind sternum of tumors were measured on preoperative computed tomography images, the volume above and below sternum, and total volume of tumors was calculated. Logstic regression model and receiver operating characteristic curve analysis were performed to identify siginificant predictors associated with sternotomy.
Results Out of a total of 37 patients, 4 patients (10.8%) underwent sternotomy. The length, width and length behind sternum, as well as the volume below sternum and the total volume of tumors were significantly greater in patients with sternotomy compared to those without sternotomy (all P<0.05). The length behind sternum (OR 1.152, 95% CI: 1.012-1.312, P = 0.033) of tumors was the simple and convenient predictor for sternotomy in substernal goiter. The optimal cut-off value of length behind sternum was 46.7 mm (area under the curve: 0.962, 95% CI: 0.896-1.028, P ≤ 0.01), and the sensitivity and specificity was 100% and 87.9%, respectively.
Conclusion Computed tomography examination plays an important role in determining the surgery need for substernal goiter. The length behind sternum of tumor is a convenient and independent predictor of sternotomy for substernal goiter.