<p><b>BACKGROUND: </b>The American Thyroid Association (ATA) recommends thyroid lobectomy for 1 to 4 cm tumors without adverse features. We studied the prevalence of adverse pathological features in patients eligible for unilateral lobectomy.</p><p><b>METHODS: </b>We conducted a retrospective study of patients who underwent total thyroidectomy. Patients with differentiated thyroid cancer (DTC) with tumors measuring 1 to 4 cm with no known preoperative adverse features were included in this study. Patients with nodal and distant metastasis, tumors <1 cm to > 4 cm, age < 17 years old, and gross extrathyroidal extension were excluded. Patients with bilateral nodularity on imaging were excluded from the final analysis on adverse features.</p><p><b>RESULTS: </b>There were 59.1% of patients undergoing thyroidectomy with tumors measuring 1 to 4 cm and no preoperatively known adverse features who were eligible for lobectomy under current ATA guidelines who would have needed a completion thyroidectomy after pathological analysis of the index tumor.</p><p><b>CONCLUSION: </b>Two thirds of the patients may require a completion thyroidectomy if unilateral lobectomy is done in tumors measuring 1 to 4 cm based on adverse pathological features.</p>
S. P. Murthy, Balasubramanian, D., Subramaniam, N., Nair, G., Babu, M. J. C., Rathod, P. V., Thankappan, K., Iyer, S., Vijayan, S. Nalumackal, Prasad, C., and Nair, V., “Prevalence of adverse pathological features in 1 to 4 cm low-risk differentiated thyroid carcinoma.”, Head Neck, vol. 40, no. 6, pp. 1214-1218, 2018.