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Updated: Mar 18, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
The rising incidence of papillary thyroid microcarcinoma and is completion surgery necessary or not?
Oğuz Kuşcu1, Övsen Önay2, Bahar Kayahan2
1Hacettepe University Faculty of Medicine Department of Otorhinolaryngology.
Abstract:
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary cancer that is 1 cm or less in its maximal diameter. The incidence of thyroid cancer has increased during the past 30 years. The aim of this study is to evaluate the rising incidence of PTMC (papillary thyroid microcarcinoma) and whether is lobectomy enough or not. The data of 462 consecutive patients who underwent thyroidectomy (hemithyroidectomy and total thyroidectomy) at the Hacettepe University Hospitals Department of ENT from 2000 to 2015 were analyzed. Surgical procedure, histopathologic examinations, postoperative complications, follow-up time and mortality were recorded. USG and FNAC were performed on all cases. Of the 344 patients with thyroid malignancy and 118 patients underwent total laryngectomy with thyroidectomy. 364 patients with TT and 98 patients with HT. The first group included 204 patients (Surgery time 2000-2007), 91 of them ( 44.6%) had PTMC. The second group included 258 patients, 192of them (74,4%) had PTMC (p<0.001). 22 Patients with PTMC underwent completion surgery and 40 of them just followed by hemithyroidectomy. There was no recurrence. PTMC has been rising incidence because of ,pathological and radiological, increased awareness and completion surgery is not necessary for all PTMC cases especially incidental PTMC.
Insights
The incidence of papillary thyroid microcarcinoma (PTMC) is rising due to increased awareness. Completion surgery is often unnecessary for PTMC, especially incidental cases, with no recurrence observed after hemithyroidectomy.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- The incidence of thyroid cancer has notably increased over the past three decades.
- Papillary thyroid microcarcinoma (PTMC), defined as papillary cancer ≤1 cm, is a significant contributor to this rise.
- Evaluating the rising PTMC incidence and the adequacy of hemithyroidectomy is crucial for patient management.
Purpose of the Study:
- To investigate the increasing incidence of papillary thyroid microcarcinoma (PTMC).
- To determine if hemithyroidectomy (lobectomy) is a sufficient surgical treatment for PTMC.
- To assess the necessity of completion surgery for PTMC cases.
Main Methods:
- Retrospective analysis of 462 patients who underwent thyroidectomy (hemithyroidectomy or total thyroidectomy) between 2000 and 2015.
- Inclusion of surgical procedure details, histopathology, complications, follow-up, and mortality data.
- Utilized ultrasound (USG) and fine-needle aspiration cytology (FNAC) for all cases.
Main Results:
- A significant increase in PTMC incidence was observed, rising from 44.6% in 2000-2007 to 74.4% in 2008-2015 (p<0.001).
- Of 22 PTMC patients requiring completion surgery, 40 were managed with hemithyroidectomy alone.
- No recurrence was reported in any PTMC patient, regardless of surgical approach.
Conclusions:
- The rising incidence of PTMC is attributed to increased pathological and radiological detection and awareness.
- Completion surgery is not universally necessary for all PTMC cases, particularly incidental findings.
- Hemithyroidectomy appears to be an adequate treatment for select PTMC cases, with no observed recurrence.
