Our Summary

The American Thyroid Association (ATA) updated its guidelines in 2016 about how to manage thyroid nodules and thyroid cancers in adults. The new advice suggested that a surgical procedure called a lobectomy might be a good choice for low-risk patients. Researchers wanted to see if this new guidance changed the number of more extensive surgeries (called completion thyroidectomies) that were being performed. They looked at over 48,000 cases from the past six years, both before and after the new guidelines were published. The results showed that the rate of these surgeries dropped from 51.8% before the guidelines to 43.1% after. This suggests that more medical centers around the world are following the new guidelines and opting for less invasive surgeries when possible.

FAQs

  1. What new guidelines did the American Thyroid Association (ATA) release in 2016 regarding the management of thyroid nodules and cancers?
  2. What surgical procedure is suggested by the ATA’s new guidelines for low-risk patients with thyroid nodules or cancers?
  3. Did the introduction of the ATA’s new guidelines in 2016 impact the rate of completion thyroidectomies performed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to discuss the possibility of a lobectomy as a treatment option, especially for low-risk patients. This less invasive surgery may have fewer complications and a quicker recovery time compared to a full thyroidectomy. It is important to have a thorough discussion with your healthcare provider about the best treatment plan for your individual situation.

Suitable For

Patients who may be recommended for thyroidectomy include:

  1. Patients with thyroid cancer: Thyroidectomy is often recommended for patients with thyroid cancer to remove the cancerous tissue and prevent it from spreading to other parts of the body.

  2. Patients with large or symptomatic thyroid nodules: Thyroidectomy may be recommended for patients with large nodules that are causing symptoms such as difficulty breathing or swallowing.

  3. Patients with hyperthyroidism: Thyroidectomy may be recommended for patients with hyperthyroidism that cannot be controlled with medication or radioactive iodine therapy.

  4. Patients with Graves’ disease: Thyroidectomy may be recommended for patients with Graves’ disease who do not respond to other treatments or who have severe symptoms.

  5. Patients with multinodular goiter: Thyroidectomy may be recommended for patients with a multinodular goiter that is causing symptoms such as difficulty breathing or swallowing.

  6. Patients with recurrent thyroid nodules: Thyroidectomy may be recommended for patients who have recurrent thyroid nodules or who are at high risk for thyroid cancer.

  7. Patients with a family history of thyroid cancer: Thyroidectomy may be recommended for patients with a family history of thyroid cancer or a genetic predisposition to the disease.

It is important for patients to discuss their individual case with their healthcare provider to determine if thyroidectomy is the best treatment option for them.

Timeline

Before thyroidectomy:

  • Patient may experience symptoms such as difficulty swallowing, hoarseness, fatigue, weight gain, and/or a visible lump on the neck
  • Patient undergoes diagnostic tests such as ultrasound, fine needle aspiration biopsy, and blood tests to determine the need for surgery
  • Patient consults with an endocrinologist and/or surgeon to discuss treatment options and risks
  • Patient may need to undergo pre-operative testing and preparation before the surgery, such as thyroid hormone replacement therapy and counseling on potential complications

After thyroidectomy:

  • Patient undergoes the surgical procedure to remove part or all of the thyroid gland
  • Patient may need to stay in the hospital for a day or longer depending on the extent of the surgery and any complications
  • Patient may experience temporary or permanent changes in hormone levels, requiring lifelong thyroid hormone replacement therapy
  • Patient may need to follow up with their healthcare provider regularly for monitoring of hormone levels and any potential complications
  • Patient may need to make lifestyle changes, such as adjusting diet and exercise habits, to manage weight and overall health post-surgery.

What to Ask Your Doctor

  1. What are the risks and benefits of a thyroidectomy in my specific case?
  2. Are there any alternative treatment options to consider before undergoing a thyroidectomy?
  3. How experienced are you in performing thyroidectomies?
  4. What is the expected recovery time and potential complications after the surgery?
  5. Will I need to take thyroid hormone replacement medication after the procedure?
  6. How often will I need follow-up appointments and monitoring after the surgery?
  7. How will a thyroidectomy impact my daily life, including diet, exercise, and overall health?
  8. Are there any long-term effects or risks associated with a thyroidectomy?
  9. What can I expect in terms of scarring or changes to my appearance after the surgery?
  10. Are there any specific guidelines or recommendations I should follow before and after the thyroidectomy procedure?

Reference

Authors: Soibelman D, Ronen O. Journal: Clin Otolaryngol. 2025 Mar;50(2):205-219. doi: 10.1111/coa.14262. Epub 2024 Nov 26. PMID: 39587912