What are the benefits of total thyroidectomy for the treatment of papillary thyroid carcinoma (PTC)?

Updated: Jun 18, 2020
  • Author: Ponnandai S Somasundar, MD, MPH, FACS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Total thyroidectomy is considered by many to be the surgical treatment of choice for papillary tumors of the thyroid, for a number of reasons. Papillary foci involving both lobes are found in some 60-85% of patients. About 5-10% of patients who have had a lobectomy develop recurrences in the remaining lobe. Also, at 20 years after initial surgery, patients who had undergone total thyroidectomy had a recurrence rate of 8%, whereas those who had received lobectomy only had a recurrence rate of 22%. Survival rates were, however, comparable.

Total thyroidectomy also facilitates earlier detection and treatment of recurrent or metastatic carcinoma. This surgical option is mandatory in patients with papillary carcinoma discovered on postoperative histology (ie, if a very well-differentiated tumor is discovered) after a lobectomy, with or without isthmectomy.


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