Thyroidectomy for Papillary Thyroid Carcinoma

Papillary thyroid carcinoma is the most common endocrine malignancy and accounts for the overwhelming majority of thyroid carcinoma. This recent dramatic increase in incidence is almost exclusively attributed to the incidental detection of small papillary thyroid carcinoma or microcarcinoma. Surgical management of thyroid carcinoma has been evolving to avoid overtreating patients by adopting the appropriate risk-based approach including the recommendation of hemithyroidectomy for low-risk carcinoma, the avoidance of routine prophylactic central nodal dissections, a higher threshold in using postoperative radioiodine ablation after total thyroidectomy, and the active observation or surveillance of papillary microcarcinoma as a viable alternative option instead of immediate surgical treatment.