Thyroidectomy and Lymph Node Dissection in Papillary Thyroid Carcinoma

Table 1

Indication for total thyroidectomy for patients with papillary carcinoma in various guidelines and in our department.

Kuma Hospital	All patients except T1N0M0 or microcarcinoma extending only to muscles mucosal layer of the esophagus and recurrent laryngeal nerve
JSTS/JAES	Strongly recommended −−−−−−−−→ Tumor size >5 cm, extrathyroid extension to the trachea or esophagus, large number of clinical lymph node metastasis, lymph node metastasis >3 cm, and distant metastasis; Moderately recommended −−−−−−−−→ Tumor size >4 cm, clinical lymph node metastasis
ATA	All patients except low-risk microcarcinoma
BTA	Most patients, especially for those with tumor size >1 cm, multifocal disease, extrathyroid extension, familial disease, clinical lymph node metastasis, and radiation history
NCCN	Age <15 yrs or >45 yrs, radiation history, distant metastasis, bilateral nodularity, extrathyroidal extension, Tumor size >4 cm, clinical lymph node metastasis, and aggressive variant (however, also for other cases, total thyroidectomy is the most common)