Thyroid Lobectomy as an Initial Treatment Option on 1-4 cm Papillary Cancer

ABSTRACT

Recently, the early diagnosis and treatment of differentiated thyroid cancer has significantly increased the proportion of thyroid lobectomy rather than total thyroidectomy. Thyroid lobectomy is recommended for less than 1 cm and total thyroidectomy for more than 4 cm except in unusual cases. There are still controversies in papillary cancer, which size from 1 to 4 cm. There are some reports that the indiscriminate expansion of thyroid lobectomy results in inferior results on the recurrence rate and survival rate compared to total thyroidectomy. But several other studies revealed that the recurrence after lobectomy could be diagnosed, it would not increase the rate of locoregional recurrence and mortality. It is necessary to make efforts to completely remove the cancer and lymph node metastasis, even in unilateral multiple papillary cancers, microscopic or gross invasion to the strap muscles (T3b), even in patients with lateral metastasis, or microscopic central lymph node metastasis. Although the proportion of these patients is nearly half of all 1-4 cm patients with papillary cancer, thyroid lobectomy may be considered as an alternative treatment to total thyroidectomy for patients with 1-4 cm papillary cancer.