{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:09:43Z","timestamp":1790885383210,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The 2015 American Thyroid Association guidelines recommend risk\u2010stratified management of papillary thyroid cancer (PTC). Debate continues on whether upfront total thyroidectomy versus lobectomy confers improved survival in intermediate\u2010risk PTC. This study aims to synthesize recurrence and survival data for optimal surgical management in risk\u2010stratified PTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, and Cochrane Library.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Two independent reviewers searched and screened, from January 1, 2015, to April 26, 2025, articles comparing the prognostic outcomes of lobectomy or total thyroidectomy for PTC. Pooled analyses were performed where feasible, in recurrence\u2010based outcomes across low\u2010to\u2010intermediate\u2010risk cohorts. Additional sensitivity analyses were conducted. Qualitative analysis covered recurrence and mortality outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2670 identified records, 10 studies (n\u2009=\u200917,082) were included. Meta\u2010analysis of intermediate\u2010risk PTC (n\u2009=\u20093881) demonstrated comparable 5\u2010year recurrence\u2010free survival between lobectomy (96% [95% CI: 89%\u201099%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200983.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and total thyroidectomy (95% [95% CI: 91%\u201097%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200985.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001; hazard ratio [HR] 1.19 [95% CI: 0.69\u20102.04],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200933.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.2096). Pooled analysis of low\u2010to\u2010intermediate\u2010risk cohorts (n\u2009=\u20091119) showed similar raw recurrence rates\u2014lobectomy: 3% ([95% CI: 2%\u20107%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.5777) versus total thyroidectomy: 4% ([95% CI: 1%\u201014%],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200992.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Systematic review of disease\u2010specific survival (n\u2009=\u20093081) demonstrated no mortality benefit for total thyroidectomy across all risk groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thyroid lobectomy is sufficient in managing low\u2010to\u2010intermediate\u2010risk PTC, reducing morbidity associated with upfront total thyroidectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70009","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T11:46:45Z","timestamp":1756813605000},"page":"1099-1110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Lobectomy Versus Total Thyroidectomy Across 2015 American Thyroid Association Low\u2010to\u2010Intermediate\u2010Risk Papillary Thyroid Carcinoma"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8711-7510","authenticated-orcid":false,"given":"Ryan Seng Hong","family":"Wong","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trishan Manav","family":"Sri Ram","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5449-5582","authenticated-orcid":false,"given":"Yuelin","family":"Xia","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Han","family":"Heng","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanth","family":"Jayabaskaran","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yau Hua","family":"Lim","sequence":"additional","affiliation":[{"name":"College of Humanities and Sciences National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Sheng Yep","family":"Yeo","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"See","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Singapore General Hospital  Singapore"},{"name":"Academic Clinical Programme Surgery Duke\u2010NUS Medical School  Singapore"},{"name":"Division of Surgery and Surgical Oncology National Cancer Centre Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chwee Ming","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Singapore General Hospital  Singapore"},{"name":"Academic Clinical Programme Surgery Duke\u2010NUS Medical School  Singapore"},{"name":"Division of Surgery and Surgical Oncology National Cancer Centre Singapore  Singapore"},{"name":"Si, Department of Clinical Translational Research Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00035-3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04090"},{"key":"e_1_2_9_4_1","unstructured":"Thyroid cancer\u2014cancer stat facts. Accessed May 19 2025.https:\/\/seer.cancer.gov\/statfacts\/html\/thyro.html"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.3.272"},{"key":"e_1_2_9_6_1","unstructured":"Thyroid cancer survival rates. American Cancer Society. Accessed May 19 2025.https:\/\/www.cancer.org\/cancer\/types\/thyroid-cancer\/detection-diagnosis-staging\/survival-rates.html"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2021.11.009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30360"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25356"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.08.016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000925"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2017-00067"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2024.06.003"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31814697d9"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-004-1165-1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.181"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21504"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3846-8"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006674"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.01.010"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.060410"},{"key":"e_1_2_9_25_1","unstructured":"Ottawa Hospital Research Institute. Accessed May 19 2025.https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.5781"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14020432"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14112757"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.01.049"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-022-06813-5"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001945"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.3860"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102912"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs-24-178"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26983"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019073"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001556"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0356"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.1060"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2017.07.004"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2111953"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs-20-430"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70009","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70009","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:15:29Z","timestamp":1790244929000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ohn.70009"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70009","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]},"assertion":[{"value":"2025-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}