Surgical treatment of thyroid papillary carcinoma: current controversies

Papillary cancer is the most frequent thyroid cancer occurring in all age groups with a good prognosis. Surgery is commonly recognized as the primary treatment of PC, but controversy concerning the type of resection continues. We are still waiting for the best predictors of tumor aggressiveness which would help us to select patients for the type of surgery according to the tumor prognosis. We currently recommend total thyroidectomy in all cases leading to eradicate all tumoral tissue specially in multicentric disease, to optimize the effect of postoperative Iodine-131 therapy and to allow thyroglobulin levels to be reliably used as a marker of recurrence. We advocate lymphnode dissection only if chain nodes are palpable. Total thyroidectomy should be made by experienced surgeon in order to minimize post-operative morbidity.