title: Review of survival rates 20-years after conservative surgery for papillary thyroid carcinoma.
abstract: BACKGROUND
  A less extensive thyroidectomy could be used for patients in the low risk group.
  
  
  OBJECTIVE
  To perform a critical follow-up after lobectomy with isthmusectomy for the treatment of papillary thyroid carcinoma in patients with a single nodule limited to the periphery of the lobe.
  
  
  METHODS
  Thirty-one patients with thyroid papillary carcinoma operated on till 1993 were selected. They had undergone lobectomy with isthmusectomy. This is a retrospective cohort study in which the oncological outcome (contralateral and regional recurrence) and the reoperation complications (recurrent nerve paralysis/paresis and hypoparathyroidism) were evaluated. Descriptive analysis was employed.
  
  
  RESULTS
  In the last decade (2003-2013), 6 (20%) contralateral recurrences were observed in the remaining lobe and in 1 of these cases (3%), contralateral lymph node metastases were noted. A completion thyroidectomy plus lymphadenectomy was performed, without modification of global survival.
  
  
  CONCLUSIONS
  Because of the rate of 20% of contralateral recurrence after a 20-year follow-up, we suggest modification of the surgical paradigm for total thyroidectomy as an initial therapy.
authors.affiliation: Department of Surgery, Medicine School, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Department of Health, Hospital Heliópolis, São Paulo, SP, Brazil.
authors.forename: Abrão
authors.initials: A
authors.lastname: Rapoport
authors.affiliation: Lusíada Foundation (UNILUS), São Paulo, SP, Brazil; Department of Head and Neck Surgery and Otorhinolaryngology, Hospital Heliópolis, São Paulo, SP, Brazil.
authors.forename: Otávio Alberto
authors.initials: OA
authors.lastname: Curioni
authors.affiliation: Lusíada Foundation (UNILUS), São Paulo, SP, Brazil; Department of Head and Neck Surgery and Otorhinolaryngology, Hospital Heliópolis, São Paulo, SP, Brazil.
authors.forename: Ali
authors.initials: A
authors.lastname: Amar
authors.affiliation: Larynx Group, Department of Head and Neck Surgery, Hospital das Clínicas, Medicine School, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Electronic address: dedivitis@usp.br.
authors.forename: Rogério Aparecido
authors.initials: RA
authors.lastname: Dedivitis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000601:surgery*; D002291:Carcinoma, Papillary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D013997:Time Factors
keywords: Carcinoma papilar; Glândula tireoide; Neoplasias da glândula tireoide; Papillary carcinoma; Thyroid gland; Thyroid neoplasms; Thyroidectomy; Tireoidectomia