Hemithyroidectomy for Differentiated Thyroid Cancer

Abstract

There has been a renewed interest in minimalistic, initial management options for low-risk thyroid cancer over the last several years. Recent guidelines endorse a much more risk-adapted surgical management approach, allowing hemithyroidectomy as an alternative to total thyroidectomy for intrathyroidal, well-differentiated thyroid cancer tumors up to 4 cm in maximal diameter. In this chapter, we describe a clinical framework to classify patients as ideal, appropriate, or inappropriate for a hemithyroidectomy, which takes into account three major domains—tumor and imaging results; patient characteristics and preferences; and disease management team characteristics and treatment philosophy—in the pre-operative, intra-operative, and post-operative periods.