{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:36:12Z","timestamp":1791995772680,"version":"4.4.0"},"reference-count":121,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Thyroid lobectomy has gained increasing popularity over the past decade as a treatment for differentiated thyroid cancer, largely due to a rise in the diagnosis of low-risk cancers and evidence showing no benefit from radioiodine in low-risk disease. Multiple studies have confirmed lobectomy as an effective and safe option. Its advantages over total thyroidectomy include lower complication rates and a reduced need for lifelong levothyroxine (LT4) therapy. Recent research has broadened the indications for lobectomy, extending its use to patients with contralateral benign nodules and several \u201cadverse\u201d histological features, such as minimal extrathyroidal extension, small lymph node metastases, or multifocality\u2014provided these are of minimal size. For patients with follicular thyroid carcinoma, who typically undergo surgery for Bethesda III-IV cytology, minimally invasive disease should be treated with lobectomy alone. In patients with angioinvasion, the risk of metastasis increases with the number of vessels involved (&amp;gt;2-3 vessels), larger tumor size, and advanced patient age. Following surgery, current evidence supports a TSH target within the normal range, reducing the need for LT4 treatment to only 30% of patients. Follow-up is based on neck ultrasound because thyroglobulin levels have limited value in detecting recurrence. In cases where further treatment is required, completion thyroidectomy is as safe as upfront total thyroidectomy. Overall, lobectomy is the preferred treatment option for many, if not most, differentiated thyroid cancer patients with low to low-intermediate risk disease, offering lower complication rates, reduced need for LT4 therapy, and excellent long-term outcomes.<\/jats:p>","DOI":"10.1210\/clinem\/dgae903","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T17:17:04Z","timestamp":1735838224000},"page":"e2327-e2337","source":"Crossref","is-referenced-by-count":14,"title":["Approach to the Patient With Thyroid Cancer: Selection and Management of Candidates for Lobectomy"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-4212","authenticated-orcid":false,"given":"Eyal","family":"Robenshtok","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism Institute and Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 49100 ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel Aviv University , Tel Aviv 6997801 ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Bachar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Beilinson Hospital, Rabin Medical Center, Petah Tikva 49100 ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel Aviv University , Tel Aviv 6997801 ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0581-5500","authenticated-orcid":false,"given":"Amit","family":"Ritter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Beilinson Hospital, Rabin Medical Center, Petah Tikva 49100 ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel Aviv University , Tel Aviv 6997801 ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"issue":"1","key":"2025062421164149200_dgae903-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"issue":"5","key":"2025062421164149200_dgae903-B2","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1001\/jamaoto.2018.0042","article-title":"Thyroidectomy practice after implementation of the 2015 American Thyroid Association guidelines on surgical options for patients with well-differentiated thyroid carcinoma","volume":"144","author":"Hirshoren","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"2025062421164149200_dgae903-B3","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1056\/NEJMoa2111953","article-title":"Thyroidectomy without radioiodine in patients with low-risk thyroid cancer","volume":"386","author":"Leboulleux","year":"2022","journal-title":"N Engl J Med"},{"issue":"3","key":"2025062421164149200_dgae903-B4","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1210\/jc.2018-01933","article-title":"Thyroid ultrasound and the increase in diagnosis of low-risk thyroid cancer","volume":"104","author":"Haymart","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2025062421164149200_dgae903-B5","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1245\/s10434-018-6550-2","article-title":"Impact of extent of surgery on tumor recurrence and survival for papillary thyroid cancer patients","volume":"25","author":"Gartland","year":"2018","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"2025062421164149200_dgae903-B6","doi-asserted-by":"crossref","first-page":"5087","DOI":"10.1097\/JS9.0000000000001556","article-title":"The preferred surgical choice for intermediate-risk papillary thyroid cancer: total thyroidectomy or lobectomy? 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