{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T20:06:44Z","timestamp":1789330004727,"version":"build-2803163510"},"reference-count":31,"publisher":"Harborside Press, LLC","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Medullary thyroid cancer (MTC) is a rare thyroid malignancy, with 70% to 80% of cases being sporadic (sMTC). Current guidelines recommend total thyroidectomy (TT) for all preoperatively suspicious sMTC, though there has been increasing support for reducing the surgical extent in recent years. However, relevant data are limited. This study aimed to comprehensively evaluate the safety of hemithyroidectomy (HT) in sMTC. <jats:bold>Patients and Methods:<\/jats:bold> This study included 797 patients with MTC who received curative-intent initial surgery at 19 participating referral centers. Genetic testing was performed to identify disease heredity. We evaluated the safety of HT in sMTC across 5 aspects: (1) prevalence of occult bilateral foci, (2) prevalence of contralateral lobe recurrence, (3) biochemical response, (4) structural recurrence-free survival (SRFS), and (5) overall survival (OS). <jats:bold>Results:<\/jats:bold> Of the 797 patients, 648 were genetically confirmed as having sMTC. HT and TT were performed as the index surgery in 232 (35.8%) and 416 (64.2%) patients, respectively. In the TT group, bilateral foci were found in 34 (8.2%) patients, of whom only 10 (2.4%) had sonographically occult foci, and of these, only 3 (0.72%) had a maximal tumor size \u22642 cm. In the HT group, only 1.7% (4\/232) had recurrence in the preserved lobe, with only 1 (0.43%) having a maximal tumor size \u22642 cm. After propensity score matching, 230 pairs of patients were included in further analysis. No significant differences were found in OS (log-rank: <jats:italic>P<\/jats:italic>=.484; Cox regression: <jats:italic>P<\/jats:italic>=.380), SRFS (log-rank: <jats:italic>P<\/jats:italic>=.914; Cox regression: <jats:italic>P<\/jats:italic>=.309), or biochemical response (chi-square: <jats:italic>P<\/jats:italic>=.744; logistic regression: <jats:italic>P<\/jats:italic>=.818) between the 2 groups. Subgroup analyses showed that HT conferred comparable structural and biochemical outcomes with TT in small (\u22642 cm) sMTCs, even for patients with high-risk factors such as high preoperative calcitonin, multifocal disease, lymph node metastases, <jats:italic>RET<\/jats:italic><jats:sup>M918T<\/jats:sup> mutation, and desmoplasia. <jats:bold>Conclusions:<\/jats:bold> For small unilateral sMTCs, HT may be considered an alternative treatment that does not compromise prognosis while avoiding additional complications associated with TT.<\/jats:p>","DOI":"10.6004\/jnccn.2024.7088","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T20:13:46Z","timestamp":1738959226000},"page":"105-112","source":"Crossref","is-referenced-by-count":21,"title":["Hemithyroidectomy Versus Total Thyroidectomy for Sporadic Medullary Thyroid Cancer: A Chinese Nationwide Large-Scale Cohort Study"],"prefix":"10.6004","volume":"23","author":[{"given":"Xiao","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cenkai","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuqiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Affiliated Hospital of Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zimeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqi","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoting","family":"Sun","sequence":"additional","affiliation":[{"name":"Westlake Center for Intelligent Proteomics, Westlake Laboratory of Life Sciences and Biomedicine, Research Center for Industries of the Future, School of Medicine, School of Life Sciences, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Westlake Center for Intelligent Proteomics, Westlake Laboratory of Life Sciences and Biomedicine, Research Center for Industries of the Future, School of Medicine, School of Life Sciences, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naisi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanqing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyu","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Hospital of Dalian Medical University, Dalian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiannan","family":"Guo","sequence":"additional","affiliation":[{"name":"Westlake Center for Intelligent Proteomics, Westlake Laboratory of Life Sciences and Biomedicine, Research Center for Industries of the Future, School of Medicine, School of Life Sciences, Westlake University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghai","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Thyroid","first-page":"567","article-title":"Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma","volume":"25","author":"Wells SA","year":"2015","unstructured":"Wells SA, Asa SL, Dralle H,  Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. 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Surgery 2001;130:1044\u20131049."},{"key":"B25","series-title":"Ann R Coll Surg Engl","first-page":"433","article-title":"Medullary thyroid carcinoma\u2013update and present management controversies","volume":"88","author":"Al-Rawi M","year":"2006","unstructured":"Al-Rawi M, Wheeler MH. Medullary thyroid carcinoma\u2013update and present management controversies. Ann R Coll Surg Engl 2006;88:433\u2013438."},{"key":"B26","series-title":"World J Surg","first-page":"3954","article-title":"Static prognostic factors and appropriate surgical designs for patients with medullary thyroid carcinoma: the second report from a single-institution study in Japan","volume":"42","author":"Ito Y","year":"2018","unstructured":"Ito Y, Miyauchi A, Kihara M,  Static prognostic factors and appropriate surgical designs for patients with medullary thyroid carcinoma: the second report from a single-institution study in Japan. World J Surg 2018;42:3954\u20133966."},{"key":"B27","series-title":"Endocr Rev","first-page":"934","article-title":"Medullary thyroid cancer: updates and challenges","volume":"44","author":"Gild ML","year":"2023","unstructured":"Gild ML, Clifton-Bligh RJ, Wirth LJ, Robinson BG. Medullary thyroid cancer: updates and challenges. Endocr Rev 2023;44:934\u2013946."},{"key":"B28","series-title":"Br J Surg","first-page":"695","article-title":"Prediction of biochemical cure in patients with medullary thyroid cancer","volume":"107","author":"Machens A","year":"2020","unstructured":"Machens A, Lorenz K, Dralle H. Prediction of biochemical cure in patients with medullary thyroid cancer. Br J Surg 2020;107:695\u2013704."},{"key":"B29","series-title":"Thyroid","first-page":"368","article-title":"Survival and long-term biochemical cure in medullary thyroid carcinoma in Denmark 1997\u20132014: a nationwide study","volume":"29","author":"Mathiesen JS","year":"2019","unstructured":"Mathiesen JS, Kroustrup JP, Vestergaard P,  Survival and long-term biochemical cure in medullary thyroid carcinoma in Denmark 1997\u20132014: a nationwide study. Thyroid 2019;29:368\u2013377."},{"key":"B30","series-title":"J Clin Endocrinol Metab","first-page":"2655","article-title":"Biomarker-based risk stratification for previously untreated medullary thyroid cancer","volume":"95","author":"Machens A","year":"2010","unstructured":"Machens A, Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab 2010;95:2655\u20132663."},{"key":"B31","series-title":"J Clin Oncol","first-page":"96","article-title":"International medullary thyroid carcinoma grading system: a validated grading system for medullary thyroid carcinoma","volume":"40","author":"Xu B","year":"2022","unstructured":"Xu B, Fuchs TL, Ahmadi S,  International medullary thyroid carcinoma grading system: a validated grading system for medullary thyroid carcinoma. J Clin Oncol 2022;40:96\u2013104."}],"container-title":["Journal of the National Comprehensive Cancer Network"],"original-title":[],"link":[{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/23\/3\/article-p105.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/23\/3\/article-p105.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/23\/3\/article-p105.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T13:13:33Z","timestamp":1741785213000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/23\/3\/article-p105.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":31,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.6004\/jnccn.2024.7088","relation":{},"ISSN":["1540-1405","1540-1413"],"issn-type":[{"value":"1540-1405","type":"print"},{"value":"1540-1413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}