A Temporal Analysis of Surgical Management and Outcomes Following ATA Guideline Updates in Papillary Thyroid…

Cohort studyThyroid : official journal of the American Thyroid Association· Jun 2026

A Temporal Analysis of Surgical Management and Outcomes Following ATA Guideline Updates in Papillary Thyroid Carcinoma: A Real-World Cohort Study of 31,861 Patients in South Korea.

Jae Sang Ryu, Eun Jin Kim, In A Lee … Jandee Lee

SurgeryCohort studyClinical practiceQ1IF 5.3

Permanent hypocalcemia fell sharply after American Thyroid Association guideline-driven surgical de-escalation for papillary thyroid carcinoma.

A Temporal Analysis of Surgical Management and Outcomes Following ATA Guideline Updates in Papillary Thyroid Carcinoma: A Real-World Cohort Study of 31,861 Patients in South Korea.

Jae Sang Ryu … Jandee Lee

Thyroid · Jun 2026 · Q1 in General Medicine

Background

The American Thyroid Association (American Thyroid Association) guideline revisions in 2009 and 2015 encouraged a shift toward less extensive surgery and reduced use of radioactive iodine (radioactive iodine) in the management of patients with low-risk papillary thyroid carcinoma (papillary thyroid carcinoma).

Purpose

The aim of this study was to evaluate the real-world impact of these guideline changes on treatment patterns, complications, and oncologic outcomes.

Methods

In this retrospective cohort study conducted at a high-volume tertiary center in South Korea, we analyzed 31,861 patients treated for PTCs measuring ≤4 cm during 2004-2020.

n = 31,861 patients

Results

permanent low calcium became rare after de-escalation

More results

After guideline implementation, total thyroidectomies and radioactive iodine use significantly declined.

However, 5-year DFS and restricted mean survival time comparisons revealed no significant differences.

“

Conclusion

American Thyroid Association guideline-driven de-escalation strategies were successfully implemented in real-world practice in this study, reducing overtreatment and surgical morbidity without compromising short-term oncologic outcomes.

A Temporal Analysis of Surgical Management and Outcomes Following ATA Guideline Updates in Papillary Thyroid Carcinoma: A Real-World Cohort Study of 31,861 Patients in South Korea.

A Temporal Analysis of Surgical Management and Outcomes Following ATA Guideline Updates in Papillary Thyroid Carcinoma: A Real-World Cohort Study of 31,861 Patients in South Korea.

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