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Hemi-Thyroidectomy versus Total Thyroidectomy in Patients
with Low-Risk Papillary Thyroid Carcinoma Sized 2 cm or Less
Int J Thyroidol
Published online November 15, 2019
© 2019 Korean Thyroid Association.

Han Song Park1, Hyoung Shin Lee2, Jung Hwa Sung2, Hyun Jung Hwang2 and Kang Dae Lee2

Department of Medicine1 and Otolaryngology-Head and Neck Surgery2, Kosin University College of Medicine, Busan, Korea
Correspondence to:
Kang Dae Lee, MD, Department of Otolaryngology-Head and Neck Surgery, Kosin University College
of Medicine, 262, Gamcheon-ro, Seo-gu, Busan 49267, Korea
Tel: 82-51-990-6470, Fax: 82-51-245-8539, E-mail:
Received August 26, 2019; Revised September 19, 2019; Accepted October 12, 2019.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background and Objectives: The controversy over the optimal extent of thyroidectomy for papillary thyroid
carcinoma (PTC) has been around for long time. Particularly, there is a lack of consensus in low-risk PTC sized
>1 cm and ≤2 cm. In this retrospective study, we analyzed the oncologic outcomes between
hemi-thyroidectomy and total thyroidectomy in patients with low-risk PTC sized 2 cm or less. Materials and
Methods: A retrospective chart review of 1107 patients who was diagnosed as unilateral low-risk PTC with
maximal tumor size 2 cm or less and underwent either hemi-thyroidectomy (n=550) or total thyroidectomy
(n=557) as initial treatment was conducted. All patients underwent ipsilateral prophylactic central neck
dissection. Patients had no evidence of gross extrathyroidal extension or lymph node metastasis.
Clinicopathologic factors and recurrence rate were compared according to the surgical extent and factors
correlated to recurrence was analyzed. Results: While total thyroidectomy group had more aggressive
clinicopathologic factors such as minimal extrathyroidal extension, multifocality, and lymph node metastasis,
recurrence rate was higher in the hemi-thyroidectomy group (p=0.006). However, when the contralateral lobe
recurrence was excluded there was no difference in recurrence between the two groups (p=0.597). In patients
with tumor sized >1 cm and ≤2 cm there was no significant difference in recurrence between the two groups
(p=0.100). Conclusion: Total thyroidectomy may not decrease recurrence in patients with PTC presented with
unilateral tumor sized >1 cm and ≤2 cm. Hemi-thyroidectomy could be considered as a treatment of choice
in these patients when they are presented as low-risk group.
Keywords :
Thyroid, Papillary thyroid carcinoma, Recurrence, Thyroidectomy, Low risk group

November 2019, 12 (2)