, Volume 34, Issue 6, pp 1291-1293
Date: 17 Feb 2010

Managing Patients with a Preoperative Diagnosis of AJCC/UICC Stage I (T1N0M0) Papillary Thyroid Carcinoma: East Versus West, Whose Policy is Best?

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Since 1993 Ito et al. [13] have followed a cohort of 346 papillary thyroid microcarcinoma (PTM) patients, on whom they did not perform immediate surgery at diagnosis. After 5 years of observation [3], only 7% of this cohort showed tumor enlargement of 3 mm or more, and only 1.4% had developed lateral compartment nodal metastasis (NM). From 1993 through 2002 they diagnosed a total of 751 patients with PTM and submitted 600 (80%) to their “classic strategy” of surgery whereby 54% had “subtotal or more limited thyroidectomy,” all 600 had central compartment nodal dissection (CCND), and 319 (53%) also had modified radical dissection (MRD) of the lateral compartment [1]. In this series of 600 surgically treated PTM patients, 2.2% showed recurrence in NM or residual thyroid and none developed distant metastases or died of PTM [3].

In this issue, Ito et al. [4] educate us further about surgery for treating low-risk papillary thyroid cancer (PTC) at the Kuma Hospital. They describe the present