Total thyroidectomy versus lobectomy: surgical approach to T1-T2 papillary thyroid cancer

The incidence of papillary thyroid carcinoma, which accounts for 80-90% of all thyroid cancers, has recently been increasing. The current study aimed to compare the oncological and functional outcomes of total thyroidectomy (TT) and thyroid lobectomy (TL). To this end, a retrospective single-centre cohort study involving a tertiary care institution was conducted. Data regarding demographics, clinicopathology and postoperative complications from 586 patients with papillary thyroid cancer treated in a single institution were collected. Cox proportional-hazards models were utilised to determine differences in outcomes strati- ed according to propensity score. Our data suggested no signicant difference in the risk for locoregional recurrence or distant metastasis between TL and TT among patients with pT1-2 pN0 papillary carcinoma. TT plays an important role in improving prognosis among patients with metastatic lymph nodes in the central neck compartment (pN1a) (p=0.001). Moreover, TT had signicantly higher rates of postoperative hypocalcaemia and recurrent laryngeal nerve paralysis compared to TL (p<0.001 and p=0.02, respectively).