Related Experiment Video
Updated: Jan 9, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Total thyroidectomy versus lobectomy for unilateral papillary thyroid cancer and lateral lymph node metastasis: A
Shuang Wu1, Yue Zhao1, Hancong Li1
1Division of Thyroid Surgery, Department of General Surgery and Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background:
The optimal surgical approach for unilateral papillary thyroid cancer with lateral lymph node metastasis remains a subject of ongoing debate. This systematic review and meta-analysis aims to provide available evidence to facilitate clinical decision-making.
Methods:
This study was registered in PROSPERO (CRD420251049050). Indexed databases (PubMed, The Cochrane Library, Embase, and Web of Science) were searched from 2010 to 2025 comparing lobectomy and total thyroidectomy in patients with unilateral papillary thyroid cancer and lateral lymph node metastasis. The primary outcomes include recurrence-free survival, recurrence rate, and postoperative complications. The risk of bias was assessed using the Newcastle-Ottawa Scale. Data were pooled by using the fixed-effects model. Heterogeneity was assessed using the I2 statistic and sensitivity analysis.
Results:
Six studies with 1,894 participants were included. The mean duration of follow-up was 76.9 months. The results indicated that lobectomy has a lower risk of complications (risk ratio: 0.21, 95% confidence interval: 0.06-0.70, P = .01) compared with total thyroidectomy, especially for transient hypoparathyroidism (risk ratio: 0.01, 95% confidence interval: 0.00-0.05, P < .00001), permanent hypoparathyroidism (risk ratio: 0.06, 95% confidence interval: 0.01-0.26, P = .0002), and transient recurrent laryngeal nerve injury (risk ratio: 0.49, 95% confidence interval: 0.26-0.91, P = .02). Furthermore, lobectomy and total thyroidectomy showed similar effects on 5-year recurrence-free survival (hazard ratio: 1.03, 95% confidence interval: 0.68-1.56, P = .91) and recurrence rate (risk ratio = 1.10, 95% confidence interval: 0.77-1.58, P = .61).
Conclusion:
After excluding gross extrathyroidal extension and aggressive subtypes, this meta-analysis suggests that lobectomy is a preferred surgical approach for unilateral papillary thyroid cancer with lateral lymph node metastasis, providing comparable oncologic outcomes with significantly lower complication rates versus total thyroidectomy. Further validation through prospective cohorts is recommended.
