The Extent of Thyroidectomy in Differentiated Thyroid Cancers – Revisited with Evidence

Abstract

Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy, with papillary thyroid carcinoma accounting for the majority of cases. Although the incidence of DTC has increased worldwide, mortality has remained relatively stable, raising concerns regarding overdiagnosis and overtreatment. The extent of thyroidectomy remains a matter of debate, particularly for low-risk tumors measuring 1–4 cm. This review summarizes the available evidence comparing thyroid lobectomy and total thyroidectomy, discussing recurrence, survival, complications, radioactive iodine therapy, completion thyroidectomy, and the role of molecular testing. The authors conclude that treatment should be individualized using a risk-based approach as recommended by the American Thyroid Association, balancing adequate oncologic treatment with avoidance of unnecessary morbidity.