The Ongoing Debate Regarding Completion Thyroidectomy Versus Primary Thyroid Surgery for Low and Intermediate Differentiated Thyroid Carcinoma: A Meta-Analysis

Lobectomy is increasingly performed for low-risk differentiated thyroid cancer (DTC) and papillary thyroid microcarcinoma (PTMC). However, there is a continuous controversy about completion thyroidectomy (CT) following lobectomy. The current meta-analysis aimed to assess the outcomes of the initial surgical procedure versus CT performed for low/intermediate-risk thyroid carcinoma. Six hundred and sixty-one articles were retrieved, and only 15 full texts fulfilled the inclusion and exclusion criteria. There were 15 studies, including 17,143 patients; twelve were retrospective, two prospective studies, and a controlled trial. Seven articles were from Asia, four from the USA, two from Europe, while two were published in Canada. The studies showed no difference between lobectomy and primary thyroid surgery regarding post-surgery complications. CT was not different from the initial surgical procedure in terms of complications for DTC. The study was limited by the retrospective studies included, the outcomes assessed were not uniform, and significant heterogeneity was observed. Further, well-controlled, more specific trials are needed.