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Objective:

To examine the association between the extent of surgery and overall survival in a large contemporary cohort of patients with papillary thyroid cancer (PTC).

Background:

Guidelines recommend total thyroidectomy for PTC tumors> 1 cm, based on older data demonstrating an overall survival advantage for total thyroidectomy over lobectomy.

Methods:

Adult patients with PTC tumors 1.0–4.0 cm undergoing thyroidectomy in the National Cancer Database, 1998–2006, were included. Cox proportional hazards models were applied to measure the association between the extent of surgery and overall survival while adjusting for patient demographic and clinical factors, including comorbidities, extrathyroidal extension, multifocality, nodal and distant metastases, and radioactive iodine treatment.

Results:

Among 61,775 PTC patients, 54,926 underwent total thyroidectomy and 6849 lobectomy. Compared with …