Management of Small Papillary Thyroid Cancers

Surg Clin North Am. 2024 Aug;104(4):725-740. doi: 10.1016/j.suc.2024.02.003. Epub 2024 Mar 19.

Abstract

Thyroid cancer is the most common endocrine malignancy. With increasing imaging utilization, there has been an increase in the recognition of small, indolent cancers that would otherwise go undiagnosed. Historically, the surgical recommendation for all patients with thyroid cancer was a total thyroidectomy. However, over the last 20 years, there have been numerous studies evaluating the de-escalation of interventions for low-risk thyroid cancers, transitioning from total thyroidectomy to thyroid lobectomy or active surveillance when indicated. Here, we review the current literature and recommendations with each of these treatment options.

Keywords: Active surveillance; Differentiated thyroid cancer; Low-risk thyroid cancer; Papillary thyroid cancer; Surgery; Thyroid cancer; Thyroid lobectomy; Thyroidectomy.

Publication types

  • Review

MeSH terms

  • Humans
  • Thyroid Cancer, Papillary* / diagnosis
  • Thyroid Cancer, Papillary* / pathology
  • Thyroid Cancer, Papillary* / surgery
  • Thyroid Cancer, Papillary* / therapy
  • Thyroid Neoplasms* / diagnosis
  • Thyroid Neoplasms* / surgery
  • Thyroid Neoplasms* / therapy
  • Thyroidectomy* / methods
  • Watchful Waiting