Total thyroidectomy is the recommended treatment for all Papillary Thyroid Carcinoma (PTC).
Surgical treatment of well differentiated carcinomas of the thyroid gland remains a discussed topic and there is still no evidence of global and total harmony in the appropriate surgical procedure to be applied in the approach of these tumors. The major unresolved debate concerning the ideal surgical management of PTC focuses on the extent of thyroidectomy. The most common recommended options range from thyroid lobectomy to a total extracapsular thyroidectomy. Controversy concern not only the extent of thyroidectomy but also the indications for, and the extent of cervical lymph node dissection. To date, there are no controlled prospective trials comparing the results of different surgical treatments of PTC. There are, however, several large retrospective reports that have addressed the extent of thyroidectomy in the management of patients with PCT1. The purpose of this review article is to demonstrate that total thyroidectomy seems to be the optimal treatment for most patients with clinically significant PTC. We also emphasize that the ability to perform thyroid surgery safely is of paramount importance with an excellent long-term prognosis. To determine the ideal treatment surgeons must weigh the risk-complications of a more aggressive surgical resection (total thyroidectomy) versus the risk of morbidity, mortality, recurrence rates and difficulty in following patients who undergo less gland resection (lobectomy). It is mandatory to expand efforts to identify high-risk patients more accurately, thereby facilating more rational approaches to treatment.
Santini
J
J
Dept. of Otolaryngology, Head and Neck Surgery, C.H.U. Pasteur, Nice, France.
Haddad
A
A
D002291:Carcinoma, Papillary / Q000601:surgery*; D006801:Humans; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods