Extent of Surgery for Low-Risk Differentiated Thyroid Cancer - 27/06/19

Doi : 10.1016/j.suc.2019.04.003

Alexandria D. McDow, MD ^a, Susan C. Pitt, MD, MPHS ^b,^⁎
^a Section of Endocrine Surgery, Department of Surgery, Indiana University, 545 Barnhill Drive EH 537, Indianapolis, IN 46202, USA
^b Division of Endocrine Surgery, Department of Surgery, University of Wisconsin-Madison, 600 Highland Avenue, CSC K4/738, Madison, WI 53792-7375, USA

^∗Corresponding author.

Résumé

Although the incidence of thyroid cancer is increasing, survival remains unchanged. Due to concern for overtreatment, surgical management of thyroid cancer has evolved. Papillary thyroid microcarcinoma measuring 1 cm or smaller are considered very low risk and can be managed with either thyroid lobectomy or active surveillance. Total thyroidectomy is no longer recommended for these cancers unless there is evidence of metastasis, local invasion, or aggressive disease. Recommendations for low-risk differentiated thyroid cancer measuring 1 cm to 4 cm remain controversial. This article explores the controversies over the extent of surgery for patients with very low-risk and low-risk differentiated thyroid cancer.

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Keywords : Thyroid cancer, Thyroidectomy, Thyroid lobectomy, Surgery, Extent of resection, Low-risk thyroid cancer, Differentiated thyroid cancer, Active surveillance