Outcome of Hemithyroidectomy in Patients with Low-Risk Papillary Thyroid Cancer

Author(s): Vinod Kumar Singhal, Nufra Senopher Mohamed Sarfra, Adil Mohammed Suleman, Tazeen Burhan.

Background: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, with low-risk tumors generally exhibiting an indolent course. Hemithyroidectomy (HT) has emerged as a conservative surgical approach for appropriately selected low-risk PTC patients, offering favorable oncologic outcomes while minimizing complications. Aim of the study: To evaluate the clinical, surgical, and oncologic outcomes of hemithyroidectomy in patients with low-risk PTC and identify factors associated with recurrence. Methods: A cross-sectional study was conducted at the Department of ENT & Head and Neck Surgery, [Name of Institution], including 150 adult patients with histologically confirmed low-risk PTC who underwent hemithyroidectomy between July 2024 and June 2025. Patients were followed for a minimum of 24 months. Demographic, clinical, surgical, and follow-up data were collected. Primary outcomes included recurrence, disease-free survival (DFS), and overall survival (OS); secondary outcomes included postoperative complications, hypothyroidism, operative time, and hospital stay. Statistical analysis included univariate and multivariate logistic regression to identify predictors of recurrence. Result: The mean age was 43.2 ± 11.8 years, and 68% of patients were female. Mean tumor size was 1.15 ± 0.46 cm; 13.3% were multifocal, and 4% demonstrated extrathyroidal extension. Symptom relief was achieved in 93.3% of patients. Postoperative hypothyroidism occurred in 18.7%, while transient hypocalcemia and transient recurrent laryngeal nerve (RLN) palsy occurred in 6.7% and 2.7%, respectively, with no permanent complications. Over a mean follow-up of 50.2 ± 12.5 months, recurrence occurred in 4% of patients, all locoregional. Five-year DFS and OS were 96% and 99.3%, respectively. Multivariate analysis identified multifocality (OR 6.78, p=0.038) and extrathyroidal extension (OR 16.7, p=0.012) as independent predictors of recurrence. Conclusion: Hemithyroidectomy is a safe and effective treatment for low-risk PTC, providing excellent clinical outcomes and low recurrence rates. Careful patient selection, particularly considering multifocality and extrathyroidal extension, is essential to optimize oncologic outcomes.