Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer

ABSTRACT Objectives The 2015 American Thyroid Association (ATA) guidelines recommended lobectomy for management of low‐risk differentiated thyroid carcinomas (DTC), aiming to mitigate overtreatment. The primary objective of this study was to assess the impact of the 2015 ATA guidelines on the rates...

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Main Authors: Akash S. Halagur, Jeffrey D. Huynh, Uchechukwu C. Megwalu
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.70175
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author Akash S. Halagur
Jeffrey D. Huynh
Uchechukwu C. Megwalu
author_facet Akash S. Halagur
Jeffrey D. Huynh
Uchechukwu C. Megwalu
author_sort Akash S. Halagur
collection DOAJ
description ABSTRACT Objectives The 2015 American Thyroid Association (ATA) guidelines recommended lobectomy for management of low‐risk differentiated thyroid carcinomas (DTC), aiming to mitigate overtreatment. The primary objective of this study was to assess the impact of the 2015 ATA guidelines on the rates of lobectomy versus total thyroidectomy for the treatment of low‐risk DTC, using the Surveillance, Epidemiology, and End Results (SEER) 17 database. Our secondary objectives were to examine the modifying effects of tumor size on the change in the rates of lobectomy between the pre‐ and post‐guideline periods and to identify factors that are associated with the use of lobectomy in the post‐guideline period. Methods A retrospective cohort analysis of adults diagnosed with low‐risk DTC from 2011 to 2020 was conducted using the SEER 17 database. Logistic regression assessed the likelihood of lobectomy and total thyroidectomy before and after guideline implementation, including size‐stratified and post‐guideline subgroup analyses. Results Among 61,078 patients, lobectomy rates increased from 16% pre‐guideline to 25% post‐guideline (aOR 1.81, 95% CI 1.74–1.89). Lobectomy increased across both T1 and T2 tumors; post‐guideline subgroup analysis indicates T2 tumors were less likely to receive lobectomy than T1 tumors. Conclusions The use of lobectomy for treatment of low‐risk DTC has significantly increased since the publication of the 2015 ATA guidelines. However, total thyroidectomy remains the predominant treatment. Level of Evidence Level 3.
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spelling doaj-art-e3b768244a9a4d77856586dc4517aff92025-08-20T03:30:04ZengWileyLaryngoscope Investigative Otolaryngology2378-80382025-06-01103n/an/a10.1002/lio2.70175Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid CancerAkash S. Halagur0Jeffrey D. Huynh1Uchechukwu C. Megwalu2Department of Otolaryngology—Head and Neck Surgery Stanford University School of Medicine Stanford California USADepartment of Otolaryngology—Head and Neck Surgery Stanford University School of Medicine Stanford California USADepartment of Otolaryngology—Head and Neck Surgery Stanford University School of Medicine Stanford California USAABSTRACT Objectives The 2015 American Thyroid Association (ATA) guidelines recommended lobectomy for management of low‐risk differentiated thyroid carcinomas (DTC), aiming to mitigate overtreatment. The primary objective of this study was to assess the impact of the 2015 ATA guidelines on the rates of lobectomy versus total thyroidectomy for the treatment of low‐risk DTC, using the Surveillance, Epidemiology, and End Results (SEER) 17 database. Our secondary objectives were to examine the modifying effects of tumor size on the change in the rates of lobectomy between the pre‐ and post‐guideline periods and to identify factors that are associated with the use of lobectomy in the post‐guideline period. Methods A retrospective cohort analysis of adults diagnosed with low‐risk DTC from 2011 to 2020 was conducted using the SEER 17 database. Logistic regression assessed the likelihood of lobectomy and total thyroidectomy before and after guideline implementation, including size‐stratified and post‐guideline subgroup analyses. Results Among 61,078 patients, lobectomy rates increased from 16% pre‐guideline to 25% post‐guideline (aOR 1.81, 95% CI 1.74–1.89). Lobectomy increased across both T1 and T2 tumors; post‐guideline subgroup analysis indicates T2 tumors were less likely to receive lobectomy than T1 tumors. Conclusions The use of lobectomy for treatment of low‐risk DTC has significantly increased since the publication of the 2015 ATA guidelines. However, total thyroidectomy remains the predominant treatment. Level of Evidence Level 3.https://doi.org/10.1002/lio2.70175American Thyroid Association guidelineslobectomylow‐risk differentiated thyroid carcinomaSEER databasetotal thyroidectomy
spellingShingle Akash S. Halagur
Jeffrey D. Huynh
Uchechukwu C. Megwalu
Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
Laryngoscope Investigative Otolaryngology
American Thyroid Association guidelines
lobectomy
low‐risk differentiated thyroid carcinoma
SEER database
total thyroidectomy
title Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
title_full Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
title_fullStr Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
title_full_unstemmed Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
title_short Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low‐Risk Thyroid Cancer
title_sort impact of the 2015 american thyroid association guidelines on treatment of low risk thyroid cancer
topic American Thyroid Association guidelines
lobectomy
low‐risk differentiated thyroid carcinoma
SEER database
total thyroidectomy
url https://doi.org/10.1002/lio2.70175
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AT uchechukwucmegwalu impactofthe2015americanthyroidassociationguidelinesontreatmentoflowriskthyroidcancer