[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-375963-105":59,"doc-detail-375963-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","the-landmark-series-extent-of-surgery-for-low-risk-differentiated-thyroid-cancer","The Landmark Series - Extent of Surgery for Low-Risk Differentiated Thyroid Cancer","","Management of differentiated thyroid cancer (DTC) in patients with low risk for progression or relapse remains controversial despite excellent disease-specific survival. Minimizing treatment impact on quality of life is emphasized as surgical practice has shifted toward less extensive procedures. The review summarizes influential studies over two decades, focusing on trends such as lobectomy rather than total thyroidectomy, reduced or omitted prophylactic central lymphadenectomy, and more personalized, patient-centered decision-making.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-landmark-series-extent-of-surgery-for-low-risk-differentiated-thyroid-cancer/375963/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-landmark-series-extent-of-surgery-for-low-risk-differentiated-thyroid-cancer/375963.png","ImageObject",300,407,{"name":92,"@type":93},"Sarah ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is the extent of surgery controversial for low-risk differentiated thyroid cancer?","Question",{"text":112,"@type":113},"Low-risk DTC patients generally have excellent disease-specific survival, so the goal is to limit harm to quality of life. Evidence has driven shifts in practice, but consensus criteria and benefits of additional treatments remain debated.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the review define “low-risk” thyroid cancer?",{"text":117,"@type":113},"Low-risk thyroid cancers are papillary, follicular, or oncocytic carcinomas smaller than 4 cm and entirely confined to the thyroid, with no clinical or radiographic evidence of gross extrathyroidal extension, regional or distant metastases, or local invasion.",{"name":119,"@type":110,"acceptedAnswer":120},"What major trend in surgery does the review describe over recent years?",{"text":121,"@type":113},"Surgical resection has moved from total thyroidectomy toward thyroid lobectomy, and away from prophylactic central compartment lymphadenectomy, with consideration of omitting surgery altogether in some situations.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},375963,1790441459,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962085320529,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Ann Surg Oncol (2025) 32:3119–3125  \n[https://doi.org/10.1245/s10434-025-17063-9](https://doi.org/10.1245/s10434-025-17063-9)  \nREVIEW ARTICLE – ENDOCRINE TUMORS  \nThe Landmark Series: Extent of Surgery for Low‑Risk Differentiated Thyroid Cancer  \nTimothy M. Ullmann, MD1, and Julie A. Sosa, MD, MA, FACS, FSSO2  \n1Department of Surgery, Albany Medical College, Albany, NY; 2Department of Surgery, University of California San Francisco (UCSF), San Francisco, CA  \nABSTRACT The management of patients with differentiated thyroid cancers (DTCs) at low risk for disease progression or relapse after treatment remains controversial. These patients have excellent disease-specific survival. Therefore, minimizing the impact of treatments on patients’ quality of life is particularly important. For these reasons, the pendulum has swung in recent years to favor less extensive surgery toward lobectomy instead of total thyroidectomy, away from prophylactic (central compartment) lymphadenectomy, and even in some cases, omitting surgery altogether. This review discusses several of the influential studies from the past two decades that have had an impact on the management for these patients, including a shift toward more personalized care.  \nThyroidectomy is the standard-of-care treatment for the majority of patients with differentiated thyroid cancer (DTC), including those considered to be at low risk for recurrent or progressive disease. Although there is no consensus on the specific criteria to define “low-risk” thyroid cancers, in this review we define low-risk thyroid cancers as papillary, follicular, or oncocytic thyroid carcinomas smaller than 4 cm and entirely confined to the thyroid (no clinical or radiographic evidence of gross extrathyroidal extension, regional or distant metastases, or local invasion) . The treatment for these tumors remains controversial and continues to evolve.  \n© The Author(s) 2025  \nFirst Received: 28 December 2024  \nAccepted: 7 February 2025  \nPublished online: 26 February 2025  \nJ. A. Sosa, MD, MA, FACS, FSSOe-mail: [julie.sosa@ucsf.edu](julie.sosa@ucsf.edu)  \nIn recent years, the extent of surgical resection for lowrisk tumors has seen a transition from total thyroidectomy to thyroid lobectomy and away from prophylactic central neck compartment lymphadenectomy. 1 These shifts came after key studies demonstrating equivalent survival for patients treated with thyroid lobectomy and those treated with total thyroidectomy2 ,3 and a lack of benefit from radioactive iodine (RAI) treatment for these patients.4 Small trials also have failed to demonstrate a benefit of prophylactic central neck dissection.5,6  \nA growing body of research has found a low rate of disease progression during active surveillance7 or after ablation of small low-risk cancers.8 Current treatment focuses on a patient-centered approach; especially when evidential equipoise exists between treatment options.9, 10 Advances such as better understanding of the molecular mechanisms that drive aggressive tumor behavior may allow further personalization in the future.11  \nThis review aims to summarize and assess some of the key studies that have influenced current guidelines regarding the surgical management of low-risk differentiated thyroid cancers in four areas: lobectomy versus total thyroidectomy, use of adjuvant radioactive iodine, prophylactic central neck dissection, and active surveillance and ablative techniques for tumors smaller than 1 cm.  \nLITERATURE SEARCH  \nA literature search was performed using the EMBASE and MEDLINE databases for “extent of surgery low-risk thyroid cancer” for English language articles published from 2010 through October 2024. Results were filtered for“controlled trial,” “clinical trial,” “randomized controlled trial,” “controlled clinical trial,” or “comparative study.”Selected studies were chosen by the authors based on their relevance to the topic of this review and influence on current  \nguidelines. Additional studie","cbCaihmbXmo71hWW","https://ap.wps.com/l/cbCaihmbXmo71hWW","pdf",486989,"English","# The Landmark Series: Extent of Surgery for Low-Risk Differentiated Thyroid Cancer\n## Abstract and low-risk definition\n## Surgical extent: lobectomy versus total thyroidectomy\n## Literature search and study selection\n## Adjuvant radioactive iodine\n## Prophylactic central neck dissection\n## Active surveillance and ablative techniques","[{\"question\":\"Why is the extent of surgery controversial for low-risk differentiated thyroid cancer?\",\"answer\":\"Low-risk DTC patients generally have excellent disease-specific survival, so the goal is to limit harm to quality of life. Evidence has driven shifts in practice, but consensus criteria and benefits of additional treatments remain debated.\"},{\"question\":\"How does the review define “low-risk” thyroid cancer?\",\"answer\":\"Low-risk thyroid cancers are papillary, follicular, or oncocytic carcinomas smaller than 4 cm and entirely confined to the thyroid, with no clinical or radiographic evidence of gross extrathyroidal extension, regional or distant metastases, or local invasion.\"},{\"question\":\"What major trend in surgery does the review describe over recent years?\",\"answer\":\"Surgical resection has moved from total thyroidectomy toward thyroid lobectomy, and away from prophylactic central compartment lymphadenectomy, with consideration of omitting surgery altogether in some situations.\"}]","The Landmark Series - Extent of Surgery for Low-Risk Differentiated Thyroid Cancer | PDF",1790216835,18]