Papillary thyroid cancer
ICD-10 C73 · ICD-11 2D10.1

Treatment of Papillary Thyroid Carcinoma ≤4 cm, Limited to the Thyroid — No Lymph Node or Distant Metastasis (cT1–cT2, cN0, cM0)

Clinical Scenario

This protocol applies to papillary thyroid carcinoma that measures 4 cm or less, is confined to the thyroid gland without gross extrathyroidal extension (cT1 or cT2), and shows no regional cervical lymph node involvement (cN0) and no distant metastasis (cM0) — a localised, low-risk presentation.

Surgical Approach

For this localised stage, surgical resection centred on the involved lobe is a primary consideration — the full structured protocol defines the precise indications and conditions under which a broader operation may be selected instead.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1177/10507256251363120

When resection is performed for patients with thyroid cancer ≤2 cm without gross extra-thyroidal extension (cT1) and without metastases (cN0M0), the initial surgical procedure should be a thyroid lobectomy unless there are bilateral cancers or other indications to remove the contralateral lobe.

For patients with low risk, unilateral thyroid cancer >2 and ≤4 cm (cT2N0M0), thyroid lobectomy may be the preferred initial surgical treatment due to significantly lower risk and side effects.

However, the patient and treatment team may adopt total thyroidectomy to enable RAI administration and/or enhance follow-up based on disease features, suspicious contralateral nodularity, and/or patient preferences.

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