Total Thyroidectomy vs. Lobectomy in Papillary Thyroid Microcarcinoma: A Contested Gold Standard

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Papillary thyroid microcarcinoma (PTMC) incidence is rising due to advanced diagnostics.
• Optimal PTMC management strategies remain controversial, ranging from surveillance to surgery.

Purpose of the Study:

• To analyze surgical decision-making and outcomes for PTMC.
• To identify factors influencing PTMC treatment and postoperative results.

Main Methods:

• Retrospective analysis of 130 PTMC patients undergoing thyroid surgery over five years.
• Data collection included clinical, cytological, and pathological information.
• Surgical options included total thyroidectomy or hemithyroidectomy with lymph node dissection; follow-up was clinical and biochemical.

Main Results:

• Total thyroidectomy was the predominant procedure (89.3%).
• Multifocality (26.1%) and occult lymph node metastases (14.6% central, 3.8% lateral) were noted.
• 90.7% of patients were disease-free at follow-up; multifocality and nodal status influenced surgical planning.

Conclusions:

• A risk-adapted surgical approach for PTMC is supported, favoring total thyroidectomy for suspicious or multifocal disease.
• Total thyroidectomy is a safe and effective strategy for selected PTMC cases.
• Further multicenter studies are required to refine PTMC management guidelines.