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Updated: May 15, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

How many contralateral papillary thyroid carcinomas can be missed?

Kwan Ju Lee¹, Yun Jung Cho, Jeong Goo Kim

¹Department of Surgery, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, 520-2, Daeheung-dong, Jung-gu, Daejeon, South Korea.

World Journal of Surgery

|January 18, 2013

Summary

Bilateral papillary thyroid cancer (PTC) occurs in 29.8% of patients. Large tumors and multifocality increase the risk of bilateral disease, with contralateral cancer often missed preoperatively.

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

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Published on: November 28, 2025

Area of Science:

Endocrinology
Surgical Oncology
Thyroid Cancer Research

Background:

Papillary thyroid carcinomas (PTCs) require consideration of contralateral cancer during lobectomy.
Determining the incidence and characteristics of bilateral PTCs (bPTCs) is crucial.
Assessing the rate of missed preoperative diagnoses for bPTCs is important.

Purpose of the Study:

To determine the incidence of bilateral PTCs (bPTCs).
To analyze the characteristics of bPTCs.
To evaluate the rate of preoperative detection of contralateral tumors in bPTC patients.

Main Methods:

A cohort of 466 PTC patients treated with total thyroidectomy between January 2007 and May 2011 was analyzed.
Patients were categorized into unilateral and bilateral PTC groups.
bPTC patients were specifically assessed for preoperative detection of the contralateral tumor.

Main Results:

The incidence of bilaterality in PTC patients was 29.8%.
Tumor size (≥ 1 cm) and multifocality were significantly associated with bilaterality (p = 0.014 and p < 0.001, respectively).
Preoperative detection of contralateral cancer was missed in 15.8% of bPTCs and 4.7% of unilateral PTCs.

Conclusions:

Tumor size and multifocality are key predictors of bilaterality in PTC.
Total thyroidectomy is recommended for patients with multifocal or large PTC.
A significant percentage of contralateral PTCs (4.7-5.5%) are missed preoperatively.