Prognostic factors in mortality and morbidity in patients with differentiated thyroid cancer - Original Article

Ear, Nose & Throat Journal, Dec, 2002 by Robert L. Witt, Ann Marie McNamara

In conclusion, women younger than 45 years who have a papillary thyroid cancer smaller than 4cm that is limited clinically to one lobe and who have no nodal or distant metastasis or other extrathyroidal spread are considered to be at low risk for mortality and morbidity with thyroid lobectomy. Total thyroidectomy, in the hands of an experienced surgeon whose postsurgical rates of hypocalcemia and recurrent laryngeal nerve paralysis are low, provides women with T2N0M0 papillary thyroid cancer a potentially lower incidence of recurrence.

An unambiguous advantage of total thyroidectomy is that it allows for precise follow-up with thyroglobulin and radioactive iodine scanning. Every patient's case is unique, of course, so therapeutic decisions should be made in consultation with the patient's endocrinologist, internist, or family physician.