Abstract

The management of differentiated thyroid cancer has undergone a significant paradigm shift from aggressive surgical intervention toward a more individualized and conservative approach. The 2025 American Thyroid Association (ATA) Guidelines reinforce the principle of “less is more,” emphasizing risk-adapted, patient-centered care while minimizing overtreatment in low risk disease. This commentary reviews the evolving surgical strategies in thyroid cancer, including the expanding role of thyroid lobectomy, selective use of radioactive iodine, avoidance of routine prophylactic central neck dissection, acceptance of active surveillance for low-risk papillary thyroid microcarcinoma, molecular profiling, and a more cautious approach to completion thyroidectomy. Furthermore, the article highlights the growing importance of minimally invasive techniques such as transoral endoscopic thyroidectomy and emerging applications of artificial intelligence in thyroid surgery that are not incorporated in recent ATA Guidelines. Collectively, these advances reflect a transition toward safer, less invasive, and more personalized management of thyroid cancer while preserving excellent oncologic outcomes.

Key words: Differentiated Thyroid Cancer, American Thyroid Assosiation, Total Thyroidectomy, Lobectomy, Active surveillance