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Related Experiment Video

Updated: Jun 6, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Surgery for papillary thyroid carcinoma: is lobectomy enough?

Abie H Mendelsohn1, David A Elashoff, Elliot Abemayor

  • 1Division of Head and Neck Surgery, Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, CA 90095, USA. Amendelsohn@mednet.ucla.edu

Archives of Otolaryngology--Head & Neck Surgery
|November 17, 2010
PubMed
Summary

Papillary thyroid carcinoma (PTC) treatment may not require total thyroidectomy for all patients, as lobectomy shows similar survival rates. External beam radiation therapy for PTC should also be reevaluated due to poor survival outcomes.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Epidemiology

Background:

  • Papillary thyroid carcinoma (PTC) is a common endocrine malignancy.
  • Current treatment guidelines often recommend total thyroidectomy, but evidence supporting this for all cases requires further investigation.
  • Understanding survival outcomes based on surgical approach and adjuvant therapies is crucial for optimizing patient care.

Purpose of the Study:

  • To analyze the impact of surgical extent (total thyroidectomy vs. lobectomy) on survival in papillary thyroid carcinoma patients.
  • To evaluate the influence of tumor characteristics and adjuvant therapies on disease-specific survival (DSS) and overall survival (OS).
  • To inform current treatment recommendations for papillary thyroid carcinoma.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) Program database.

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Last Updated: Jun 6, 2026

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  • Included patients who underwent surgery for papillary thyroid carcinoma between 1988 and 2001.
  • Performed multivariate analysis to assess survival differences, controlling for tumor size, extrathyroidal extent, nodal status, and age.

    • Main Results:

    • No significant survival difference was found between total thyroidectomy and lobectomy when controlling for tumor size.
    • Increased tumor size, extrathyroidal extent, positive nodal status, and older age were associated with significantly worse DSS and OS.
    • Radioactive iodine therapy showed poorer DSS but improved OS, while external beam radiation therapy was linked to significantly worse DSS and OS.

    Conclusions:

    • The findings suggest a need to re-evaluate the standard recommendation of total thyroidectomy for all papillary thyroid carcinoma patients, particularly based on tumor size.
    • The current use of external beam radiation therapy in PTC treatment warrants critical reexamination due to its association with adverse survival outcomes.
    • Further research is needed to refine surgical and adjuvant treatment strategies for papillary thyroid carcinoma to improve patient survival.