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For low-risk thyroid cancer, guidelines favor the less extensive thyroid lobectomy — but total thyroidectomy is still the most common choice. A new study finds that which surgery a patient receives often comes down to which surgeon they see, with surgeon-level total thyroidectomy rates ranging from 38% to 87%. Lobectomy use is rising, but significant variation in guideline adherence remains a concern.
For patients with low-risk thyroid cancer, the surgery they receive may have less to do with their disease and more to do with their doctor. A new study in the Journal of Surgical Research found that total thyroidectomy — the more extensive removal of the entire thyroid — was still performed in two-thirds of low-risk cases, despite guidelines since 2015 supporting the less invasive thyroid lobectomy as a safe alternative.
The retrospective study tracked 2,615 Michigan patients treated by 297 surgeons across 80 facilities between 2015 and 2022. While lobectomy rates nearly doubled over that period, total thyroidectomy rates dropped but remained dominant. Crucially, stable completion thyroidectomy rates suggest lobectomy isn't leading to more follow-up surgeries — reinforcing its appropriateness for low-risk patients.
By the Numbers:
Why it matters: Wide surgeon-level variation suggests that guideline adherence — not just patient factors — is driving treatment decisions. Experts say addressing this gap, potentially through molecular tumor profiling and better physician education, could reduce unnecessary surgeries and their associated risks.
