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Invited Commentary
November 15, 2010

Extent of Surgery for Papillary Thyroid Carcinoma: The Debate Continues: Comment on “Surgery for Papillary Thyroid Carcinoma”

Arch Otolaryngol Head Neck Surg. 2010;136(11):1061-1063. doi:10.1001/archotol.136.11.1061

Mendelsohn and colleagues have written an interesting article. The subtitle “Is Lobectomy Enough?” is intriguing. The answer is simple. Yes, lobectomy is enough in a select group of low-risk patients with intrathyroidal well-differentiated thyroid cancer.

After the publication of the American Thyroid Association guidelines in 2006 and revised guidelines in 2009,1 the debate with regard to the extent of thyroid surgery for well-differentiated thyroid carcinoma seemed to have ended. There was a strong reference in the American Thyroid Association guidelines to a publication from Bilimoria and colleagues2 with regard to National Cancer Database (NCDB) data analysis. Several shortcomings of the article by Bilimoria et al were noted in an article by Shah.3 With the large number of patients for whom the NCDB showed data, the arguments by Bilimoria et al appeared to be convincing that total thyroidectomy would be the best choice of treatment for papillary thyroid carcinoma.

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