{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:57:27Z","timestamp":1787068647885,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["grant number: RS-2025-00515073"],"award-info":[{"award-number":["grant number: RS-2025-00515073"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal surgical extent for isthmus-confined papillary thyroid carcinoma (PTC) remains unclear. We aimed to evaluate the clinicopathological characteristics, surgical complications, and recurrence rates based on the extent of resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included 345 patients who underwent thyroidectomy for solitary isthmus-confined PTC at two affiliated tertiary centers from 2013 to 2022. Patients were excluded if they had multifocal PTC with lobar involvement, large tumors (&gt;4 cm), suspected extrathyroidal extension (ETE), clinically positive lymph nodes (LNs), or aggressive histological subtypes. Clinicopathological features, surgical complication rates, and recurrence rates were compared among the total thyroidectomy (TT), lobectomy (L), and isthmusectomy (I) groups. This retrospective cohort study used propensity score matching (PSM), resulting in two groups of 85 patients: TT\/L and I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 345 included patients, 89 underwent TT, 30 underwent L, and 226 underwent I. After PSM, 170 patients were analyzed. The mean age was 48.2 years, and the mean tumor size was 0.8 cm. Microcarcinoma accounted for 71.8% of cases. The rates of ETE (65.3%), multifocality (9.4%),\n                      <jats:italic toggle=\"yes\">BRAF<\/jats:italic>\n                      mutation (75.3%), and Hashimoto\u2019s thyroiditis (19.4%) were observed without significant differences between the TT\/L and I groups. Risk stratification for central LN metastasis showed no significant difference (high-risk: 21.2% vs. 27.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.353). No recurrence or distant metastasis was observed in either group during a median follow-up of 4.3 years. Median follow-up was longer in the TT\/L group (6.1 years [interquartile range (IQR): 4.0\u20138.5] vs. 3.6 years [IQR: 2.1\u20134.9],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Major complications were more frequent in TT\/L group: transient\/permanent hypocalcemia (14.1%\/1.2% vs. 0%\/0%) and transient vocal cord palsy (3.5% vs. 0%). Levothyroxine dependency was significantly higher in the TT\/L group in terms of usage (90.6% vs. 34.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), average administered dose (85.5 \u00b1 45.1 \u00b5g vs. 21.9 \u00b1 33.2 \u00b5g,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and duration (5.2 \u00b1 3.1 years vs. 0.9 \u00b1 1.3 years,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Newly noted thyroid lesions occurred more frequently in the I group (1.3% vs. 10.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Isthmusectomy may be considered for carefully selected patients with isthmus-confined PTC. Validation in long-term prospective studies is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251382600","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T14:01:56Z","timestamp":1759154516000},"page":"1322-1330","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative Study of Clinical Outcomes for Total Thyroidectomy\/Lobectomy and Isthmusectomy in Patients with Isthmic Papillary Thyroid Carcinoma"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1370-2733","authenticated-orcid":false,"given":"Seungho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5511-3596","authenticated-orcid":false,"given":"Su-jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea."},{"name":"Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Young","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea."},{"name":"Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanhee","family":"Park","sequence":"additional","affiliation":[{"name":"Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayoun","family":"Kim","sequence":"additional","affiliation":[{"name":"Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Lim","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0615-0563","authenticated-orcid":false,"given":"Woochul","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Won","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Jun","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Boramae Medical Center and College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea."},{"name":"Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul, 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