Abstract
Background Surgical resection is the key to management of thyroid cancer, but determining the optimal surgical procedure for individual cases has been controversial. Methods The author reviews several large data bases that allow examination of prognostic criteria for long-term outcomes. Results Patients can be classified into good- or poor-risk groups that assist defining the optimal surgical procedure. Routine use of total thyroidectomy in all patients with thyroid cancer is best avoided; however, patients with medullary cancer generally need total thyroidectomy. Conclusions The definition of risk groups has clarified the options regarding choice of primary surgical therapy for differentiated thyroid cancer.