Effect and long-term outcome of hemithyroidectomy for patients with low-risk papillary thyroid carcinoma.

Background Although the incidence of papillary thyroid carcinoma (PTC) has increased during the recent years, most of the PTCs are slow growing and considered as low-risk tumors with an excellent prognosis. This observed increase in small tumors leads to many controversies regarding the optimal surgical approach, and the extent of surgery for low-risk PTC is still the subject of debate. Recently, there is a trend toward utilizing a less-aggressive surgical approach, including the option of hemithyroidectomy for small PTCs up to 4 cm. Patients and methods This study included 60 patients with a proven diagnosis of PTC. According to the guidelines of the British Thyroid Association, the American Thyroid Association, and the American Joint Committee on Cancer, these patients would have low-risk PTCs and considered eligible for hemithyroidectomy (total lobectomy with isthmusectomy) as an initial treatment and followed up for about 5 years to detect recurrence and survival rate. Results Hemithyroidectomy was performed as an initial treatment. Completion thyroidectomy (CTx) was performed in five (8.33%) patients in the postoperative period within 1 week after the initial operation owing to identifying high-risk features in the final histopathology. During the follow-up period of the 60 patients, there was no locoregional recurrence. Recurrence was observed in three (5%) patients in the contralateral thyroid lobe within 3-4 years and was treated with a second surgery in the form of CTx. The overall rate of CTx was eight (13.33%) of 60 patients. The prognosis and the 5-year survival rate were excellent (100%). Conclusion Hemithyroidectomy in appropriately selected patients is an optimal surgical approach for treating low-risk PTC, and if recurrence occurs in the contralateral lobe, it can be treated safely by CTx, which yielded excellent curative results. [ABSTRACT FROM AUTHOR]