Isthmusectomy in selected patients with well‐differentiated thyroid carcinoma

BACKGROUND: Isthmusectomy in the treatment of well-differentiated thyroid carcinoma (WDTC) is controversial. In this study, we analyze the outcomes of WDTC managed by isthmusectomy alone. METHODS: Forty-three patients treated with isthmusectomy alone were identified from an institutional database of 6259 surgically treated patients with WDTC. Patient and tumor characteristics were analyzed. Disease-specific survival (DSS) and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. RESULTS: The pT classification was T1 for 41 and T2 for two patients. All were clinical N0, but 10 pts were pN1a. Using the American Thyroid Association risk stratification system, 9 patients were low-risk and 22 were intermediate-risk. One patient developed local recurrence, and two developed regional lymph node metastases; the 5- and 10-year DSS was 100.0%. The 5- and 10-year RFS was 93.1%. CONCLUSIONS: Isthmusectomy alone is an acceptable procedure in selected patients with low- and intermediate-risk WDTC limited to the isthmus.