Intermediate-sized follicular thyroid cancer surgical trends before and after the 2015 American thyroid association guideline changes

In 2015, the ATA updated the guidelines to advocate for a lobectomy for tumors <1.0 ​cm and total thyroidectomy for tumors >4.0 ​cm. Treatment for tumors of intermediate size 1.0-4.0 ​cm is dependent on high-risk characteristics. There is limited research comparing the impact of the updated ATA guidelines on clinical practice on intermediate-sized tumors. In this study, the impact of the 2015 ATA guidelines on the surgical treatment of intermediated-sized FTC will be evaluated using the Surveillance, Epidemiology, and End Results (SEER) database. A total of 9983 patients were included; 7769 patients (74.1 ​%) were diagnosed pre-ATA guidelines and 2709 patients (25.9 ​%) post-ATA guidelines. The mean rate of lobectomy for intermediate-sized tumors was 22.1 ​% which increased to 33.4 ​% post-ATA updates. The results of the logistic regression showed the rate of lobectomy increased significantly in the post-ATA changes period (p ​< ​0.001). Future research could benefit from evaluating how these trends impact patient outcome measures.