Hemithyroidectomy Eligibility Under ATA 2015 and 2025 Criteria: A Reclassification Cohort Study
In brief
ATA 2025 criteria raise hemithyroidectomy eligibility to 81% from 60% under 2015
In a cohort of 86 differentiated thyroid cancer patients, eligibility for hemithyroidectomy rose from 60.5% with the 2015 ATA guidelines to 81.4% with the 2025 update, while recommended completion thyroidectomy fell from 44% to 29%. Yet, about 41% still underwent completion surgery, indicating that factors beyond the guidelines influence real-world practice.
- Journal
- The Laryngoscope (Q1)
- Published
- 19 August 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Muhammer Ergenç, Pelin Metin, Bayram Demirbağ, M Ümit Uğurlu
- PMID
- 42615792
- DOI
- 10.1002/lary.70843
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 22 August 2026): Hemithyroidectomy eligibility under ATA criteria
Abstract
OBJECTIVE: To compare hemithyroidectomy eligibility and completion thyroidectomy recommendations under the ATA 2015 and ATA 2025 criteria within the same patient cohort (primary aim) and, as a secondary descriptive analysis, to assess the concordance between these guideline-based classifications and the operations actually performed. METHODS: Retrospective cohort study of adult patients who underwent primary hemithyroidectomy for differentiated thyroid carcinoma at a tertiary center (January 2015-November 2025). NIFTP and tumors of uncertain malignant potential were excluded from the comparative analysis. Each case was independently reclassified by ATA 2015 and ATA 2025 criteria using final histopathology (a retrospective, hindsight reclassification that could not have informed preoperative decisions); paired comparisons used the McNemar test. RESULTS: Of 98 patients, 86 were eligible for comparative analysis. Hemithyroidectomy eligibility increased from 60.5% (52/86) under ATA 2015 to 81.4% (70/86) under ATA 2025 (absolute increase 20.9 points; 95% CI 12.3-29.5; p < 0.001). Completion thyroidectomy indications decreased from 44.2% (38/86) to 29.1% (25/86) (absolute reduction 15.1 points; 95% CI 7.5-22.7; p < 0.001). Despite this reduction, completion was actually performed in 40.7% (35/86) of the comparative cohort (vs. 35.7% overall; the difference reflects exclusion of NIFTP and tumors of uncertain malignant potential). CONCLUSION: The ATA 2025 criteria substantially expand hemithyroidectomy eligibility and reduce completion thyroidectomy indications compared with ATA 2015. Real-world completion rates nonetheless exceeded guideline-based projections, suggesting that additional pathological and clinical factors may influence individualized surgical decision-making. These findings characterize the guideline update's impact on surgical strategy and do not address long-term oncologic outcomes, which were beyond this study's scope.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.