ArticleScientific reports2026
Comparison of cancer-specific survival between total thyroidectomy and lobectomy in tall cell variant of papillary thyroid carcinoma.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The tall cell variant of papillary thyroid carcinoma (TCV-PTC) is an aggressive subtype with a poorer prognosis. Controversy persists regarding the surgical strategy for TCV-PTC. Using the SEER database (2005–2017), we analyzed 1,463 patients with pathologically confirmed TCV-PTC who underwent either total thyroidectomy (TT) (n = 1,369) or lobectomy (n = 94). Propensity score matching (PSM) was used to address confounding biases. The primary endpoint was cancer-specific survival (CSS), assessed using Kaplan-Meier analysis and Cox regression. After PSM (n = 376), TT demonstrated superior CSS compared to lobectomy (p = 0.019). The 5-year and 10-year CSS for TT were 97.8% and 95.0% versus 90.7% and 89.1% for lobectomy in the matched cohort. This survival benefit of TT persisted regardless of radioiodine therapy (RAI) (p < 0.05). Multivariable analysis identified lobectomy, tumor size > 40 mm, extrathyroidal extension, and lymph node metastasis as independent risk factors for reduced CSS. Total thyroidectomy is associated with improved CSS compared to lobectomy in TCV-PTC, independent of RAI. Greater caution should be considered in selecting lobectomy for TCV patients, especially for patients with tumors > 40 mm, lymph node metastasis, or extrathyroidal extension. Completion thyroidectomy may be beneficial for patients diagnosed with TCV-PTC after lobectomy.
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