Papillary thyroid cancer is the most common type of thyroid cancer and, although this cancer generally has a very good survival rate/prognosis, thyroid surgery is still needed in most cases. Most papillary thyroid cancers are ‘low risk’, meaning that they are small (< 4 cm in diameter), are completely contained within the thyroid and do not spread into neighboring tissues or to distant body sites. There are two surgery choices for people diagnosed with low risk papillary thyroid cancer: 1) removal of just that part of the thyroid that contains the thyroid cancer (this is called a hemithyroidectomy or partial thyroidectomy) or 2) removal of the whole thyroid gland (this is called a total thyroidectomy).
There are two advantages of hemithyroidectomy. First, the part of the thyroid that is left in place (is not surgically removed) will continue to make thyroid hormone, which is the normal job of the thyroid and is needed for controlling how the body uses energy (metabolism). For this reason, many people who undergo hemithyroidectomy do not need to take a thyroid hormone replacement pill. On the other hand, people who have had all of their thyroid tissue removed (total thyroidectomy) must take this pill every day following surgery. Second, hemithyroidectomy is a smaller surgery than is total thyroidectomy and, for this reason, the risk of complications from surgery are also smaller. Recent studies also suggest that, because hemithyroidectomy is a smaller surgery than total thyroidectomy and with a lower risk of complications, overall quality of life after surgery may be better for people who undergo a hemithyroidectomy.
Hemithyroidectomy does have disadvantages, however. First, the thyroid tissue that is not surgically removed generally must be monitored over time for formation of new thyroid cancer and, if this does happen, another surgery might be needed to remove this cancer. Second, it can be more difficult for doctors to tell if a thyroid cancer recurs (comes back) if the whole thyroid gland is not removed.
The purpose of the study reviewed here was to compare quality of life for people who underwent a hemithyroidectomy for low risk papillary thyroid cancer to quality of life for people who underwent total thyroidectomy.