title: Thyroid lobectomy for treatment of well differentiated intrathyroid malignancy.
abstract: BACKGROUND
  There remains controversy over the type of surgery appropriate for T1T2N0 well differentiated thyroid cancers (WDTC). Current guidelines recommend total thyroidectomy for all but the smallest lesions, despite previous evidence from large institutions suggesting that lobectomy provides similar excellent results. The objective of this study was to report our experience of T1T2N0 WDTC managed by either thyroid lobectomy or total thyroidectomy.
  
  
  METHODS
  Eight hundred eighty-nine patients with pT1T2 intrathyroid cancers treated surgically between 1986 and 2005 were identified from a database of 1810 patients with WDTC. Total thyroidectomy was carried out in 528 (59%) and thyroid lobectomy in 361 (41%) patients. Overall survival (OS), disease-specific survival (DSS) and recurrence-free survival (RFS) were determined by the Kaplan-Meier method. Factors predictive of outcome by univariate and multivariate analysis were determined using the log rank test and Cox proportional hazards method respectively.
  
  
  RESULTS
  With a median follow-up of 99 months, the 10-yr OS, DSS, and RFS for all patients were 92%, 99%, and 98% respectively. Univariate analysis showed no significant difference in OS by extent of surgical resection. Multivariate analysis showed that age over 45 yr and male gender were independent predictors for poorer OS, whereas T stage and type of surgery were not. Comparison of the thyroid lobectomy group and the total thyroidectomy group showed no difference in local recurrence (0% for both) or regional recurrence (0% vs 0.8%, P = .96).
  
  
  CONCLUSIONS
  Patients with pT1T2 N0 WDTC can be safely managed by thyroid lobectomy alone.
authors: Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors: Iain J
authors: IJ
authors: Nixon
authors: Ian
authors: I
authors: Ganly
authors: Snehal G
authors: SG
authors: Patel
authors: Frank L
authors: FL
authors: Palmer
authors: Monica M
authors: MM
authors: Whitcher
authors: Robert M
authors: RM
authors: Tuttle
authors: Ashok
authors: A
authors: Shaha
authors: Jatin P
authors: JP
authors: Shah
mesh_terms: D018249:Adenoma, Oxyphilic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D013961:Thyroid Gland / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy; D055815:Young Adult