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Initial Total Thyroidectomy Versus Lobectomy with Intraoperative Frozen Section for Thyroid Nodules That Are “Suspicious for PTC”

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Difficult Decisions in Endocrine Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

The optimal surgical management for a thyroid nodule that is ‘suspicious for papillary thyroid carcinoma (PTC)’ remains unclear. Surgical options include (1) lobectomy with intraoperative frozen section or (2) initial total thyroidectomy. To help address this clinical question we employ the GRADE approach. The current literature was reviewed, and outcomes were assessed for their impact on clinical decision-making as related to thyroid surgery. Based on our review of the literature, it is clear that there is currently a paucity of high-to-moderate quality evidence regarding the treatment of patients with thyroid nodules that are ‘suspicious for PTC’. Important aspects to consider in the decision-making process are (1) accuracy of diagnosis and (2) relative risk of surgery. When considering the available evidence, assuming relatively low complication rates by experienced surgeons, initial total thyroidectomy may be recommended.

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Authors and Affiliations

  1. Department of Surgery, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA

    Jason A. Glenn

  2. Department of Surgery, Division of Surgical Oncology, Section of Endocrine Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Tracy S. Wang

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  1. Jason A. Glenn
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  2. Tracy S. Wang
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Correspondence to Tracy S. Wang .

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Editors and Affiliations

  1. Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA

    Peter Angelos

  2. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Raymon H. Grogan

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Glenn, J.A., Wang, T.S. (2018). Initial Total Thyroidectomy Versus Lobectomy with Intraoperative Frozen Section for Thyroid Nodules That Are “Suspicious for PTC”. In: Angelos, P., Grogan, R. (eds) Difficult Decisions in Endocrine Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-92860-9_9

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  • DOI: https://doi.org/10.1007/978-3-319-92860-9_9

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