Completion thyroidectomy in a patient with low-risk papillary cancer

Recent adoption of a new thyroid cytopathology reporting system (the Bethesda system) and current clinical practice guidelines have led to a large number of patients with indeterminate thyroid nodules undergoing diagnostic thyroid lobectomy. If such patients are found to have papillary thyroid cancer on final pathology, the question of completion thyroidectomy is often raised. In general, patients who have undergone a lobectomy in this situation and are found to have thyroid cancer will typically have low-risk disease. In such cases, there is little compelling evidence to recommend completion thyroidectomy, to either decrease recurrence rates or allow radioiodine remnant ablation. Therefore, for patients with low-risk thyroid cancer who have undergone lobectomy, follow-up without additional surgery, using serum thyroglobulin measurements and neck ultrasound to monitor for recurrence, is recommended.