Total thyroidectomy versus lobectomy for intermediate-risk papillary thyroid carcinoma: A single-institution matched-pair analysis

The Effect of Prophylactic Central Neck Dissection During Hemithyroidectomy on Locoregional Recurrence in Patients With Papillary Thyroid Carcinoma: A Meta-Analysis

“…In the study by Ebina et al [8], the extent of hemithyroidectomy was unclear and many subtotal thyroidectomies were included. In the study by Liu et al [9], 62.8% of patients exhibited lateral neck metastasis, and it appeared that the researchers applied different indications from what is generally accepted (Fig. 1).…”

“…The abstract and full text of 66 records were screened, and 14 were included in the quantitative analysis. The articles published by Ebina et al [8] and Liu et al [9] reported follow-up data for patients who underwent hemithyroidectomy with central neck dissection, but were excluded. In the study by Ebina et al [8], the extent of hemithyroidectomy was unclear and many subtotal thyroidectomies were included.…”

Thyroid cancer histological subtypes based on tumor size: National perspective

“…6 These recommendations are supported by evidence from multiple studies that demonstrated a minimal survival advantage exists in relation to extent of the initial surgery in patients with DTC. [8][9][10][11]15,16 With the "less is adequate" approach to thyroid surgery, it is important to acknowledge the risk of suboptimally treating smaller tumors with pathological features not evident on initial evaluation. Additionally, there is a risk of misdiagnosing tumors other than DTC, such as MTC.…”

“…provides similar outcomes compared with TT in terms of overall survival, disease-free survival, and recurrence rates. [8][9][10][11][12][13][14][15][16] Furthermore, studies have shown that the few recurrences that do develop in the long-term are readily detectable and could be treated with completion thyroidectomy, without affecting overall survival rate. 12,17,18 The 2015 ATA guidelines emphasize the importance of a thorough initial workup in patients presenting with a thyroid nodule, because even for tumors with low risk for aggressive behavior such as <4 cm papillary thyroid cancer, they may present with pathological features that warrant more extensive surgery.…”

“…Although it was once considered the standard of care to perform a total thyroidectomy (TT) in patients with thyroid tumors >1 cm, 7 it is now appropriate to consider thyroid lobectomy for well‐differentiated thyroid tumors ranging from 1 to 4 cm when no extrathyroidal extension (ETE) or clinically evident nodal metastases are present 6 . These recommendations are based on evidence that thyroid lobectomy provides similar outcomes compared with TT in terms of overall survival, disease‐free survival, and recurrence rates 8‐16 . Furthermore, studies have shown that the few recurrences that do develop in the long‐term are readily detectable and could be treated with completion thyroidectomy, without affecting overall survival rate 12,17,18 …”