CQ17. Does Total (or Near Total) Thyroidectomy Improve the Prognosis of Papillary Carcinoma Patients Compared to Lobectomy or Lobectomy Isthmectomy

In Western guidelines, total (or near total) thyroidectomy is recommended for overt clinical carcinoma (Recommendation rating A) [1, 2]. It is also confirmed that total thyroidectomy is most likely to be performed based on the results of the carcinoma registry in the United States and questionnaires in Europe and United States [3, 4]. In Japan, however, lobectomy with isthmectomy is the most widely adopted method for papillary carcinoma regardless of the perceived level of carcinoma risk. In Western countries, the general strategy is a combination of total thyroidectomy and RAI therapy followed by TSH suppression and constant thyroglobulin measurement. However, in Japan, it is practically impossible to perform RAI therapy routinely. As indicated below, data with a high evidence level for the superiority of total thyroidectomy are lacking. Therefore, the committee developed a consensus for the appropriate extent of surgery based on the current Japanese situation.