Skip to content

Cancer Health Center

Font Size

Stage I and II Papillary and Follicular Thyroid Cancer

    Surgery is the therapy of choice for all primary lesions. Surgical options include total thyroidectomy or lobectomy. The choice of procedure is influenced mainly by the age of the patient and the size of the nodule. Survival results may be similar; the difference between them lies in the rates of surgical complications and local recurrences.[1,2,3,4,5,6,7]

    Standard treatment options:

    Recommended Related to Cancer

    Treatment Option Overview

    The management of patients with gastrointestinal stromal tumors (GIST) is a multidisciplinary effort involving close collaboration between pathologists, medical oncologists, surgeons, and imaging experts.[1] Treatment may involve surgery and/or the use of tyrosine kinase inhibitors (TKI) depending on the extent of disease and tumor sensitivity to TKI. Although recurrence is common for patients with high-risk tumors (see Table1), complete resection of localized tumors may be associated with long-term...

    Read the Treatment Option Overview article > >

    1. Total thyroidectomy.
    2. Lobectomy.

    Total Thyroidectomy

    This procedure is advocated because of the high incidence of multicentric involvement of both lobes of the gland and the possibility of dedifferentiation of any residual tumor to the anaplastic cell type.

    From the National Cancer Center Data Base (NCDB) registry of 52,173 patients, 43,227 (82.9%) underwent total thyroidectomy, and 8,946 (17.1%) underwent lobectomy. For a papillary thyroid cancer measuring less than 1 cm, the extent of surgery did not impact recurrence or survival (P = .24 and P = .83, respectively).[8] For tumors measuring 1 cm or larger, lobectomy resulted in higher risk of recurrence and death (P = .04 and P = .009, respectively). To minimize the influence of larger tumors, 1-cm to 2-cm lesions were examined separately; lobectomy again resulted in a higher risk of recurrence and death (P = .04 and P = .04, respectively). In this study, total thyroidectomy resulted in lower recurrence rates and improved survival for patients with papillary thyroid cancer measuring 1 cm or larger compared with lobectomy.[8][Level of evidence: 3iiA]

    Furthermore, in a pattern of care study, using the NCDB registry from 1985 to 2003, 57,243 papillary thyroid cancer patients with tumors measuring 1 cm or larger underwent total thyroidectomy or lobectomy. Trends in the extent of surgery were examined for patients wtih papillary thyroid cancer over 2 decades. Logistic regression was used to identify factors that predict the use of total thyroidectomy compared with lobectomy. Use of total thyroidectomy increased from 70.8% in 1985 to 90.4% in 2003 (P < .0001). Patients treated at high-volume medical facilities or academic centers were more likely to undergo total thyroidectomy than were patients examined at low-volume medical facilities or community hospitals (P < .0001).[9][Level of evidence: 3i]

      1|2|3|4

      Today on WebMD

      Colorectal cancer cells
      A common one in both men and women.
      Lung cancer xray
      See it in pictures, plus read the facts.
       
      sauteed cherry tomatoes
      Fight cancer one plate at a time.
      Ovarian cancer illustration
      Do you know the symptoms?
       
      Jennifer Goodman Linn self-portrait
      Blog
      what is your cancer risk
      HEALTH CHECK
       
      colorectal cancer treatment advances
      Video
      breast cancer overview slideshow
      SLIDESHOW
       
      prostate cancer overview
      SLIDESHOW
      lung cancer overview slideshow
      SLIDESHOW
       
      ovarian cancer overview slideshow
      SLIDESHOW
      Actor Michael Douglas
      Article