Purposes: The recent trend is towards reducing the extent of surgery considering the good prognosis of thyroid cancer and quality of life of patients. But there is still controversy about the appropriate extent of surgery for thyroid cancer located in the isthmus. In order to find the appropriate extent of surgery for thyroid cancer located in the isthmus, we compared clinical findings according to the extent of surgery and tumor size.
Methods: Between January 1997 and August 2017, a retrospective analysis was performed on all patients who underwent thyroid surgery for thyroid solitary cancer located in the isthmus. Finally 197 patients were included in this study.
Results: Median follow-up period was 54.4 months, recurrence rate was 0.5% (1 out of 197 patients). 41 patients (20.8%) underwent less than total thyroidectomy, 156 patients (79.2%) underwent total thyroidectomy, there was no statistically significant difference in recurrence rate. (p-value: 0.208) Groups with tumors larger than 1 cm had significantly increased microscopic extrathyroidal extension and gross extrathyroidal extension compared to groups smaller than 1 cm. (p-value: 0.032, 0.009, respectively)
Conclusions: There is no difference in recurrence rate according to the extent of surgery. Therefore, hemithyroidectomy should be actively considered in thyroid cancer located in the isthmus, especially in a solitary nodule smaller than 1 cm. Isthmusectomy is also an option.