Thyroid Lobectomy Versus Total Thyroidectomy for Papillary Thyroid Cancer

Classical papillary thyroid cancer (PTC) is the most common well-differentiated tumor of the thyroid gland and generally has a very favorable prognosis. Historically, standard-of-care for all PTCs was total thyroidectomy and radioactive iodine (RAI) therapy. Consensus guidelines in the past decade have de-escalated surgical therapy from total thyroidectomy to thyroid lobectomy without postoperative RAI in select low-risk PTCs. This shift in surgical practice may result in equivalent rates of recurrence and overall survival while reducing rates of recurrent laryngeal nerve injury, hypoparathyroidism, and the need for life-long thyroid hormone replacement. Thoughtful patient selection remains critical for choosing between thyroid lobectomy and total thyroidectomy.