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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. Hemithyroidectomy may be sufficient for some PTMC cases, as completion surgery is not always necessary.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Papillary thyroid microcarcinoma (PTMC) is defined as papillary cancer ≤1 cm.
- Thyroid cancer incidence has risen over the past 30 years.
- Increased awareness and improved diagnostic methods contribute to higher detection rates.
Purpose of the Study:
- To evaluate the rising incidence of PTMC.
- To determine if hemithyroidectomy is sufficient treatment for PTMC.
- To assess the necessity of completion surgery for PTMC.
Main Methods:
- Retrospective analysis of 462 patients undergoing thyroidectomy (2000-2015).
- Data collected included surgical procedure, histopathology, complications, follow-up, and mortality.
- All cases underwent ultrasound (USG) and fine-needle aspiration cytology (FNAC).
Main Results:
- PTMC incidence increased significantly from 44.6% (2000-2007) to 74.4% (2008-2015) (p<0.001).
- Of 22 PTMC patients needing completion surgery, 40 were managed with hemithyroidectomy alone.
- No recurrence was observed in patients treated with hemithyroidectomy.
Conclusions:
- The rising incidence of PTMC is linked to increased pathological and radiological awareness.
- Completion surgery is not always necessary for PTMC, particularly incidental findings.
- Hemithyroidectomy may be adequate for managing select PTMC cases, avoiding overtreatment.
