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

  • Tsuneo Imai
  • Hiroya Kitano
  • Iwao Sugitani
  • Nobuyuki Wada


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.


Total Thyroidectomy Papillary Carcinoma Recurrent Laryngeal Nerve Paralysis Remnant Thyroid High Evidence Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Tsuneo Imai
    • 1
  • Hiroya Kitano
    • 2
  • Iwao Sugitani
    • 3
  • Nobuyuki Wada
    • 4
  1. 1.Department of Breast & Endocrine SurgeryNagoya UniversityNagoyaJapan
  2. 2.Division of Otolaryngology, Head & Neck Surgery, Department of Sensory and Motor Organ, Faculty of MedicineTottori UniversityTottoriJapan
  3. 3.Division of Head and NeckCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  4. 4.Department of SurgeryYokohama City UniversityYokohamaJapan

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