lobectomy for papillary thyroid cancer

The included studies compared two groups of patients with PTC: the total thyroidectomy (TT) group and the lobectomy (LT) group. Total thyroidectomy versus lobectomy for intermediate-risk papillary thyroid carcinoma: A single-institution matched-pair analysis. (A) including all group of patients; (B) in patients with tumors ≤1.0 cm; (C) in patients with tumors >1 cm; (D) after exclusion of contralateral lobe recurrence. Lobectomy in patients with differentiated thyroid cancer: indications and follow-up. Background: 2019 Nov;136(6):481-487. doi: 10.1016/j.anorl.2018.07.010. A lobectomy is an operation that removes the lobe containing the cancer, usually along with the isthmus (the... Thyroidectomy. 8600 Rockville Pike For long-term management (starting at a point to be determined by your doctor and you) Persistent disease TSH <.1. Papillary Thyroid Cancer: Is Surgery Always Necessary? Epub 2015 Apr 22. In 2009, the American Thyroid Association (ATA) updated its guidelines to recommend defining thyroid lobectomy as cancers ≤ 1.5 cm. (A) Including all group of patients; (B) in patients with tumors ≤1.0 cm; (C): in patients with 1.0 to 2.0 cm tumors; (D) in patients with 2.0 to 4.0 cm tumors. JAMA 2006;295:2164–7. Lobectomy is not advocated for papillary thyroid carcinoma (PTC) with high-risk features, although there is no high-level evidence showing that this is an inferior strategy. The cases of 1,088 PTC patients who underwent thyroid lobectomy with curative intent at Ito Hospital between 1986 and 1995 were analyzed retrospectively in this study. More importantly, LT was associated with higher mortality in PTC patients with 2.0 to 4.0 cm tumors. We sought to study whether the extent of thyroidectomy (TT vs thyroid lobectomy [TL]) influences overall and disease-specific survival in children with localized PTC. The long-term clinical outcome of the PTC patients who had been treated by lobectomy without RAI ablation was excellent. 2 The levothyroxine dose was titrated to maintain thyroid-stimulating hormone (TSH) levels according to the indications given in different years by authoritative international guidelines, 26, 27 and after the publication of the 2015 … -, Koike A, Naruse T. Incidence of thyroid cancer in Japan. This systematic review and meta-analysis collected data for evaluating the effect of surgical extent on overall survival (OS) and recurrence-free survival (RFS) in patients with papillary thyroid cancer (PTC). Liu J, Zhang Z, Huang H, Xu S, Liu Y, Liu S, Wang X, Xu Z. Risk factors for hypothyroidism and thyroid hormone replacement after hemithyroidectomy in papillary thyroid carcinoma. Adam MA, Pura J, Gu L, et al. Accessibility In 2015, the American Thyroid Association issued updated guidelines for the management of differentiated thyroid cancer. Recent American Thyroid Association Guidelines recommend either near‐total/total thyroidectomy or lobectomy for patients with a thyroid nodule suspicious for papillary thyroid cancer (PTC) on fine‐needle aspiration (FNA) biopsy (Bethesda V). Oral Oncol. 2021 Apr 5. doi: 10.1007/s40477-021-00576-w. Online ahead of print. Papillary thyroid cancer, which is the most common type of thyroid cancer, makes up about 80% of all cases of thyroid cancer. -, Surgery. Total thyroidectomy versus lobectomy as initial operation for small unilateral papillary thyroid carcinoma: A meta-analysis. to remove all or part of the thyroid and possibly nearby lymph nodes. Flow diagram of the literature search and individual studies identified for this systematic review and meta-analysis. In the subgroup analysis, both the ≤1 cm group and >1 cm group that underwent TT were associated with better RFS. OS = overall survival, RFS = recurrence-free survival. Total thyroidectomy versus lobectomy as initial operation for small unilateral papillary thyroid carcinoma: A meta-analysis. Arch Otolaryngol Head Neck Surg 2010; 136:1055. Online ahead of print. doi: 10.1530/ERC-19-0085. Thyroid Lobectomy for Low-Risk Papillary Thyroid Cancer: A National Survey of Low- and High-Volume Surgeons | springermedizin.de Skip to main content Clinical features, treatment, and long-term outcome of papillary thyroid cancer in children and adolescents without radiation exposure. … 2019 Mar;90:17-22. doi: 10.1016/j.oraloncology.2019.01.010. Background: In the subgroup analysis, the combined HR of the ≤1 cm group and the 1.0 to 2.0 cm group showed that TT had no advantage with regard to OS compared to LT. Surgery for papillary thyroid carcinoma: is lobectomy enough? Liu J, Zhang Z, Huang H, Xu S, Liu Y, Liu S, Wang X, Xu Z. -. World J Surg. Thyroid 2002;12:141–9. These guidelines have been criticized as aggressive, especially for early-stage PTC, as it likely does not influence patient survival and results in life-long thyroid hormone replacement. These guidelines have been criticized as aggressive, especially for early-stage PTC, as it likely does not influence patient survival and results in life-long thyroid hormone replacement. This study evaluates the … Please enable it to take advantage of the complete set of features! Total thyroidectomy versus lobectomy for papillary thyroid cancer: A systematic review and meta-analysis Medicine (Baltimore). Papillary and follicular thyroid cancers are the most common types, and are known as differentiated thyroid cancers because they process iodine similarly to normal thyroid tissue. Low risk TSH 0.1 - 0.5. Mendelsohn AH, Elashoff DA, Abemayor E, St John MA. Undergoing a lobectomy for thyroid nodules suspicious for papillary thyroid cancer on fine-needle aspiration was more cost effective and was associated with greater effectiveness compared with total thyroidectomy, according to the results of a study presented at the 2016 Clinical Congress of the American College of Surgeons, held October 16–20 in Washington, DC. Remember that 30%-40% of patients with papillary thyroid cancer will have multifocal disease. Cancer Epidemiol 2015;39:511–8. Comparison of histopathological features and prognosis of classical and follicular variant papillary thyroid carcinoma. Thyroid lobectomy (TL) has been proposed as definitive surgical treatment for papillary thyroid cancers (PTC) up to 4 cm. The TT and LT groups had similar OS results (HR = 1.04; 95% CI: 0.90-1.21; P = .60). 11 Ablation therapy using a low dose of radioiodine may be sufficient in low- to intermediate-risk patients with follicular variant papillary thyroid carcinoma Novel robot-assisted thyroidectomy by a transaxillary gas-insufflation approach (TAGA): a preliminary report. This site needs JavaScript to work properly. J Surg Res. The primary therapy for differentiated (papillary and follicular) thyroid cancer is surgery. After receiving a diagnosis of papillary thyroid cancer, intuitively, the thought has been that surgery is the next step. LT = lobectomy, OS = overall survival, PTC = papillary thyroid cancer, TT = total thyroidectomy. Flow diagram of the literature search and individual studies identified for this systematic…, Forest plot of studies comparing TT with LT for OS in patients with…, Forest plot of studies comparing TT with LT for RFS in patients with…, Funnel plots used to assess the effects of publication bias on the OS…, National Library of Medicine Optimal extent of surgery, however, remains controversial. Cell Death Dis. 2021 May 10. doi: 10.1007/s00423-021-02189-7. High risk w/ no recurrence TSH 0.1 - 0.5 for 5-10 years. (2014) Thyroid Lobectomy for Papillary Thyroid Cancer Long-Term Follow-Up Study of 1,088 Cases. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2015 Jun;24(2):117-22. doi: 10.1016/j.suronc.2015.04.005. Ann Oncol 2011;22:957–63. Thyroid Lobectomy for Low to Intermediate Risk Differentiated Thyroid Cancer 6 November 2020 | Cancers, Vol. Back to the future with thyroid lobectomy AT THE ASA ANNUAL MEETING BOSTON – Extensive surgery beyond lobectomy offers no survival advantage for small papillary thyroid cancers, according to a large database analysis. Attitudes about the use of lobectomy for these patients are lacking, particularly from low-volume surgeons who perform the majority of thyroidectomies in the US. World Journal of Surgery, 38, 68-79. The funnel plots revealed no apparent evidence of publication bias. In this analysis, we aim to assess the cost‐effectiveness of lobectomy in comparison to total thyroidectomy. 2019. Clipboard, Search History, and several other advanced features are temporarily unavailable. Tunca F, Sormaz IC, Iscan Y, Senyurek YG, Terzioglu T. J Endocrinol Invest. This study was designed to investigate the long-term clinical outcome of PTC patients who had undergone thyroid lobectomy and to elucidate the indications of lobectomy as initial surgery. 2011 Oct 1;117(19):4439-46 If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well. The D-RFS and CSS rates were both significantly lower in the group of patients who were aged 45 years old or older, the group whose tumors were larger than 40 mm, and the group with extrathyroidal invasion. Average tumor size was 9.5 ± 6 mm. The surgeon may also remove some of the lymph nodes in the neck to check whether any cancer cells have spread. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2015 Apr 22. Background: The 2015 American Thyroid Association guidelines endorsed lobectomy for patients with low-risk papillary thyroid cancer (PTC) measuring 1-4 cm. When 264 thyroid cancer surgeons were asked how they would treat a hypothetical patient with papillary thyroid cancer, about half said they would opt for a thyroid lobectomy … Epub 2019 Jan 31. Surgery is the initial treatment for papillary or follicular thyroid cancers. 1983 Jun;56(6):1131-8 Surg Oncol. Dynamic risk stratification has been accepted in recent years as an integral part of differentiated thyroid cancer (DTC) management and follow-up. Most cancers are treated with removal of the thyroid gland (thyroidectomy), although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor (lobectomy). Background: Thyroid lobectomy (TL) has been proposed as definitive surgical treatment for papillary thyroid cancers (PTC) up to 4 cm. 2019 Jul;26(7):R381-R393. Enomoto Y, Enomoto K, Uchino S, Shibuya H, Watanabe S, Noguchi S. World J Surg. One-hundred sixty-seven patients met the inclusion criteria. We performed subgroup analysis according to different tumor sizes. Background Total thyroidectomy is well accepted as initial surgery for papillary thyroid cancer (PTC), but the extent of the thyroidectomy remains a matter of controversy. Although these findings could be attributed to the lag between scientific evidence and clinical practice, further work is warranted to explore any additional patient and provider factors that may explain this lack of change. Privacy, Help Methods: A new risk factor indicator for papillary thyroid cancer based on immune infiltration. This site needs JavaScript to work properly. Results: Epub 2015 Aug 18. It is the most common surgery for thyroid cancer. Recent trends in incidence, geographical distribution, and survival of papillary thyroid cancer in France. Thyroid lobectomy for papillary thyroid cancer: long-term follow-up study of 1,088 cases. 2019 Mar;90:17-22. doi: 10.1016/j.oraloncology.2019.01.010. Low risk TSH 0.3 - 2.0. Each dot represents a separate study. Careers. All clinical outcomes, including recurrence and death as a result of PTC or other reasons, were evaluated. Can shear wave elastography determine remnant thyroid tissue in the early postoperative period in patients with differentiated thyroid carcinoma? Prevention and treatment information (HHS). Introduction. FOIA -, Endocr Pract. Long-term outcomes of total thyroidectomy versus thyroid lobectomy for papillary thyroid microcarcinoma: comparative analysis after propensity score matching. 2020 Feb;99(6):e19073. Thyroid cancer is a malignant tumor of the thyroid gland. The long-term clinical outcome of the PTC patients who had been treated by lobectomy without RAI ablation was excellent. Lee SJ, Song CM, Ji YB, Choi YY, Sohn YS, Park JH, Kim DS, Tae K. Langenbecks Arch Surg. Conclusion: The incidence of total thyroidectomy has not decreased despite recommendations encouraging consideration of lobectomy for patients with small papillary thyroid cancers. (A) funnel plot to assess publication bias effect on the OS; (B) funnel plot to assess publication bias on the RFS. Papillary thyroid microcarcinoma (PTMC) is a carcinoma less than or equal to 1 cm. Study Design. Epub 2019 Jun 10. An epidemic of diagnosis largely through incidental finding on imaging, as well as question of clinical relevance, has kept the management debate lively. -, J Clin Endocrinol Metab. Your papillary thyroid cancer is located in other sites of your body other than your neck (this is distant spread of your cancer or distant metastases) You had a papillary thyroid cancer and you underwent removal of half of your thyroid gland -called a thyroid lobectomy. Patients with PTC treated over 5 years (2013–2017 inclusive) and meeting the ATA criteria for lobectomy were identified from the prospectively developed database of a high‐volume, university department of endocrine surgery. Please enable it to take advantage of the complete set of features! Patients were grouped into two groups. Eur Ann Otorhinolaryngol Head Neck Dis. Papillary thyroid microcarcinoma is generally managed with less extensive surgery, often only a thyroid lobectomy. -, Dal Maso L, Lise M, Zambon P, et al. Most papillary thyroid cancers can be treated with surgery and radioactive iodine therapy. Bethesda, MD 20894, Copyright Endocr Relat Cancer. Lymph node removal. See this image and copyright information in PMC. 2001 May-Jun;7(3):202-20 Background: Low-risk patients with differentiated thyroid cancer can be treated with thyroid lobectomy. Tumor size, clinical lymph node metastasis, and extrathyroidal invasion were significantly associated with the L-RFS rate. -. This study sought to establish the expected rate of completion thyroidectomy in patients with papillary thyroid cancer (PTC) treated by lobectomy. Attitudes about the use of lobectomy for these patients are lacking, particularly from low-volume surgeons who perform the majority of thyroidectomies in the US. The combined hazard ratio (HR) was calculated. This study sought to establish the expected rate of completion thyroidectomy in patients with papillary thyroid cancer (PTC) treated by lobectomy. The incidence of papillary thyroid cancer has increased in the past 25 years without a clear increase in thyroid cancer deaths. 8600 Rockville Pike In the 2.0 to 4.0 cm group, TT provided better OS than LT (HR = 0.88; 95% CI: 0.79-0.99; P = .03). 2021 Feb;10(2):678-689. doi: 10.21037/gs-20-712. Thyroid lobectomy in patients with differentiated thyroid cancer: an analysis of the clinical outcomes in a nationwide multicenter study. This study aimed to examine the association between the extent of surgery and … Prevention and treatment information (HHS). This study was designed to investigate the long-term clinical outcome of PTC patients who had undergone thyroid lobectomy and to elucidate the indications of lobectomy as initial surgery. Surgical resection is the cornerstone of therapy. Haigh PI, Urbach DR, Rotstein LE. Forest plot of studies comparing TT with LT for OS in patients with PTC. Would you like email updates of new search results? Lee J, Park JH, Lee CR, Chung WY, Park CS. The CT scan of the neck for papillary thyroid cancer is an x-ray test that produces detailed cross-sectional images of your body from the bottom of your brain to the middle of your chest. Controversies remain about the ideal risk-based surgical approach for differentiated thyroid cancer (DTC). 2006 Jan-Feb;12(1):63-102 However, unlike many other cancers, papillary cancer has a generally excellent outlook, even if It tends to grow slowly and often spreads to lymph nodes in the neck. 2012 Jun;36(6):1241-6. doi: 10.1007/s00268-012-1558-4. Most cancers are treated with removal of the thyroid gland (thyroidectomy), although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor (lobectomy). To establish the indications for lobectomy as initial surgery for PTC, the potential risk factors, such as age, sex, primary tumor size, extrathyroidal invasion, and clinical lymph node metastasis at the time of the initial surgery, were assessed statistically for associations with recurrence and disease-related death. Gland Surg. 2013 Nov;23(11):1408-15. doi: 10.1089/thy.2012.0463. Díez JJ, Alcázar V, Iglesias P, Romero-Lluch A, Sastre J, Corral BP, Zafón C, Galofré JC, Pamplona MJ. Lobectomy Compared to Total Thyroidectomy for Low-Risk Papillary Thyroid Cancer: A Systematic Review. The cause-specific survival (CSS) rate at 25 years was 95.2%. This study was designed to investigate the long-term clinical outcome of PTC patients who had undergone thyroid lobectomy and to elucidate the indications of lobectomy as initial surgery. Results: Di Filippo L, Giugliano G, Tagliabue M, Gandini S, Sileo F, Allora A, Grosso E, Proh M, Basso V, Scaglione D, Manzoni MF, Ansarin M. Acta Otorhinolaryngol Ital. Papillary thyroid cancer is the most common type of thyroid cancer, making up to 80% of all thyroid cancers. Unable to load your collection due to an error, Unable to load your delegates due to an error. 68 - 79 CrossRef View Record in Scopus Google Scholar Study design: The National Cancer Database was interrogated for adult patients having TL for T1b-T2 PTC between 2004 and 2014. Thyroid lobectomy for papillary thyroid cancer: long-term follow-up study of 1,088 cases World J Surg , 38 ( 2014 ) , pp. Methods: Papillary thyroid cancer. Ann Surg Oncol 2005; 12:81. The first one underwent thyroid lobectomy (242) and the second underwent total thyroidectomy (3449). Caution is warranted when LT is performed in this group of patients. Accessibility About 95% of thyroid cancers are either papillary thyroid cancer or follicular thyroid cancer. Papillary thyroid cancer is the most common neoplasm of the thyroid gland. -, Colonna M, Uhry Z, Guizard AV, et al. Results. The median follow-up period was 17.6 years. Endocr Pract. In fact, it is the 8th most common cancer among women overall and the most common cancer in women younger than 25. Papillary thyroid microcarcinoma (PTMC) has a good prognosis and a long survival time, surgery is the common treatment including total thyroidectomy (TT) and unilateral lobectomy (LT), but recent studies showed that TT does not show an advantage over LT for PTMC in preventing cancer recurrence and reducing mortality. Methods. LT = lobectomy, OS = overall survival, PTC = papillary thyroid cancer, TT = total thyroidectomy. … Thyroid. The 2016 ATA guidelines state that thyroid lobectomy alone may be sufficient treatment for low-risk papillary and follicular carcinomas. It is one of the fastest growing cancer types with over 20,000 new cases a year. National Library of Medicine There are four types of thyroid cancer. Current guidelines recommend total thyroidectomy (TT) and radioablation for most papillary thyroid cancer (PTC) in children. In patients with tumors ≤1 cm, the combined HR was 0.85 (95% CI: 0.66–1.09; P = .21; Fig. Privacy, Help We evaluated the 5-year overall survival of patients using the log-rank test. Treatment for stage I papillary and follicular thyroid cancer: Stage I thyroid cancer is the most treatable stage and has good prognosis, the treatment methods for stage I of differentiated thyroid cancers are: Near or total thyroidectomy with or without radioiodine therapy. 2015 Jun;24(2):117-22. doi: 10.1016/j.suronc.2015.04.005. We retrieved data of 3691 patients diagnosed with papillary thyroid cancer in 2010. 12. Treatment protocols for thyroid cancer are provided below. Based on the above results, we concluded that lobectomy is a valid alternative to total thyroidectomy for the treatment of PTC patients who are younger than aged 45 years, whose tumor diameter is 40 mm or less, and who do not have clinical lymph node metastasis or extrathyroidal invasion. A lobectomy (hemithyroidectomy) alone is sufficient treatment for many small thyroid cancers while for other patients it is better to remove the whole gland. Total thyroidectomy was associated with improved survival in patients with 2.0-3.9 cm conventional papillary thyroid cancer, and should be considered for 2.0-3.9 cm papillary thyroid cancers when preoperative molecular analysis is not used to distinguish conventional from follicular-variant. It accounts for the majority (~70%) of all thyroid neoplasms and 85% of all thyroid cancers 2,4. doi: 10.1097/MD.0000000000019073. (1) and later validated in multiple studies as well as endorsed by the 2015 American Thyroid Association (ATA) guidelines (2-8), is based on data collected within the first 1 to 2 years after initial therapy with total Surgery for Thyroid Cancer Lobectomy. Considerable controversy exists about how much thyroid tissue should be removed at the initial operation, and there are no prospective randomized clinical trials to provide guidance for selection of the optimal operation. Extent of thyroidectomy is not a major determinant of survival in low- or high-risk papillary thyroid cancer. Epub 2019 Jan 31. A survey was mailed to 1000 surgeons stratified by specialty (500 general … Conclusions: This study examined the risk of survival in patients with small thyroid cancers that were treated total … We searched the PubMed, Embase, and Cochrane Library databases. -, Davies L, Welch HG. Local lymph node recurrence after central neck dissection in papillary thyroid cancers: A meta analysis. Would you like email updates of new search results? Careers. 1984 Dec;96(6):957-71 Other guidelines have recommended thyroid lobectomy as a safe option for the treatment of papillary thyroid cancers ≤ 4 cm in size. 2019 Oct;242:244-251. doi: 10.1016/j.jss.2019.04.036. The incidence of thyroid cancer has been increasing sharply in both the United States and Japan [ 1 , 2 ], and the most common subtype of thyroid Thyroid Lobectomy for Papillary Thyroid Cancer: Long-term Follow-up Study of 1,088 Cases | springermedizin.de A response to therapy (RTT) system, first proposed in 2010 by Tuttle et al. Total thyroidectomy is well accepted as initial surgery for papillary thyroid cancer (PTC), but the extent of the thyroidectomy remains a matter of controversy. Yang Z, Wei X, Pan Y, Xu J, Si Y, Min Z, Yu B. Patients who underwent TT had a better RFS outcome than those who underwent LT (HR = 0.56; 95% CI: 0.41-0.77; P < .0001). Background: The 2015 American Thyroid Association (ATA) guidelines called for consideration of thyroid lobectomy (TL) as an acceptable surgical treatment for small and less aggressive papillary thyroid cancers (PTC) with no clinical evidence of metastasis or extrathyroidal extension. It is more common in women with an M:F ratio of 1:2.5 (range 1:1.6-3:1) 2. Surg Oncol. The remaining 5% are medullary thyroid cancer and anaplastic thyroid cancer, which can be more aggressive and may require more extensive treatment. Based on the above findings, we classified the patients into four groups according to age <45 or ≥ 45 years, tumor size ≤ 40 or >40 mm, whether clinical lymph node metastasis was present, and whether extrathyroidal invasion was present. Gland Surg. The remnant-thyroid recurrence-free survival (RT-RFS) rate, the regional- lymph-node recurrence-free survival (L-RFS) rate, and the distant-recurrence-free survival (D-RFS) rate as of 25 years after surgery were 93.5, 90.6, and 93.6%, respectively. Every case is unique, though. Patients with these cancers typically have a good prognosis. Total thyroidectomy versus lobectomy: surgical approach to T1-T2 papillary thyroid cancer. It can help determine the location and size of thyroid cancers, whether the cancer has invaded into any nearby structures, and whether they have spread to … Eur Ann Otorhinolaryngol Head Neck Dis. The authors have no conflicts of interest to disclose. This study aimed to examine the association between the extent of surgery and … Serial measurements of serum thyroglobulin (Tg) are recommended for surveillance, but the cutoff values indicating recurrence are not known. This study evaluates the use and appropriateness of TL for T1b and T2 PTC. Matsuzu, K., et al. None of the patients had received postoperative radioactive iodine (RAI) ablation therapy. Forest plot of studies comparing TT with LT for RFS in patients with PTC. 2015 Dec;38(12):1327-34. doi: 10.1007/s40618-015-0376-6. Thirteen studies were included in the present study. Epub 2019 May 16. For initial management after thyroid cancer diagnosis: High risk and intermediate risk TSH <0.1. 12, No. Patients who should have undergone total thyroidectomy (TT) instead of lobectomy … 2020 Oct;9(5):1267-1277. doi: 10.21037/gs-20-450. Our meta-analysis suggested that LT increased the risk of recurrence in PTC patients with tumors ≤1.0 cm and in PTC patients with tumors >1.0 cm. These include a general treatment approach, [1, 2, 3] as well as treatment recommendations for the three categories of thyroid cancer: differentiated (Hürthle cell, papillary, and follicular), anaplastic (undifferentiated), and medullary thyroid cancer. Total thyroidectomy versus lobectomy for intermediate-risk papillary thyroid carcinoma: A single-institution matched-pair analysis. Methods The cases of … Epub 2013 Jul 17. Matsuzu K, Sugino K, Masudo K, et al. Burgess JR. Temporal trends for thyroid carcinoma in Australia: an increasing incidence of papillary thyroid carcinoma (1982–1997). Conclusions: 13. Thyroidectomy: Surgeons remove most or all of the thyroid gland. Indeed, recent reports have questioned the need for total thyroidectomy for cancers smaller than 4 cm. Trisha D. Cubb, MD Weill Cornell Medical College Houston Methodist Academic Institute Houston, TX May 20, 2021 . The surgeon may also remove some of the lymph nodes in the neck to check whether any cancer cells have spread. None of the patients without any of these four risk factors died of PTC. On the other hand, 22 patients who died of PTC were positive for one or more of these four factors. Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients. The American Thyroid Association recommends a lobectomy, surgery to remove one lobe of the thyroid instead of the entire gland, for people in stage I or II of papillary cancer and for very small and/or very low-risk thyroid cancer. 2014;38(1):68-79. A lobectomy (hemithyroidectomy) alone is sufficient treatment for many small thyroid cancers while for other patients it is better to remove the whole gland.

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