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Video

Head and Neck Surgery

(A571) Less-Than-Total versus Total Thyroidectomy for Non-High Risk Differentiated Thyroid Cancers: A Systematic Review and Meta-Analysis

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Fatemeh Akbarpoor, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM)
    Dubai, Dubai, United Arab Emirates

  • KA

    Khadeeja Aakef, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), Dubai, United Arab Emirates

  • DA

    Deena Alshirawi, MBBS

    Medical Student.
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), Dubai, United Arab Emirates

  • JM

    Jonathan Mokhtar, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM)
    Dubai, Dubai, United Arab Emirates

  • MA

    Maral Azarayesh, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), Dubai, United Arab Emirates

  • MA

    Maryam Alabdullah, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), Dubai, United Arab Emirates

  • ZA

    Zainab Alabdullah, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), United States

  • Emma Ann Finnegan

    Medical Student
    Trinity College Dublin
    Dublin , Dublin, Ireland

  • HA

    Hend Alahmed, MBBS

    Medical Student
    Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine (MBRU-CoM), United States

    • Senior Author(s)

  • PL

    Peter Loizou, BSc (Hons), BM, DOHNS, MRCS(Eng), MEd, DIC, FRCS (ORL-HNS)

    Consultant ENT, Head & Neck Surgeon
    Mediclinic Middle East, Dubai, United Arab Emirates

    • Presenting Author(s)

  • GF

    Guilherme Franceschini Machado

Disclosure(s):
Fatemeh Akbarpoor, MBBS: No relevant relationships to disclose.
Emma Ann Finnegan: No relevant relationships to disclose.


Introduction: Differentiated thyroid cancer (DTC) is the most common thyroid malignancy. The 2015 American Thyroid Association (ATA) guidelines recommend either total thyroidectomy (TT) or less-than-total thyroidectomy (LTT) for low-risk patients, but their comparative outcomes remain unclear. This systematic review and meta-analysis evaluates LTT versus TT in low-risk DTC.

Methods: This study implemented a systematic review and meta-analysis where a comprehensive search was conducted across PubMed, Cochrane Library, Scopus, and Web of Science to identify studies published between 2015 and 2024. Studies comparing LTT and TT in adult patients with low-risk DTC were included. Outcomes assessed were recurrence rate, distant metastasis, reoperation, disease-specific mortality, and post-operative complications, including hypocalcemia, recurrent laryngeal nerve (RLN) injury, and hematoma. Statistical analyses were conducted using R version 4.4.0, with heterogeneity assessed using the I² statistic and a random-effects model applied.

Results: Twenty-four studies involving 28,933 patients were included. Of these, 10,757 (37.2%) underwent LTT, and 18,176 (62.8%) underwent TT. Mean age ranged from 35 to 70 years, with follow-up durations of 6–144 months. LTT was associated with a higher recurrence rate (OR 2.40; 95% CI 1.65–3.48; p < 0.001; I² = 39%) and reoperation rate (OR 15.4; 95% CI 2.05–115; p = 0.008; I² = 67%), but no significant differences were observed in distant metastasis (OR 0.739; 95% CI 0.16–3.33; p = 0.694; I² = 0%) or disease-specific mortality (OR 0.87; 95% CI 0.58–1.30; p = 0.48; I² = 4%). LTT had lower transient hypocalcemia (OR 0.195; 95% CI 0.066–0.573; p = 0.003; I² = 74%) and RLN injury rates (OR 0.681; 95% CI 0.489–0.948; p = 0.023; I² = 18%), with no difference in hematoma rates (OR 0.856; 95% CI 0.525–1.40; p = 0.532; I² = 0%).

Conclusions: TT significantly reduces recurrence but increases the risk of postoperative complications compared to LTT. Surgical decisions for patients with low-risk DTC should consider patient-specific risks and preferences.