The Role of Thyroidectomy in the Management of Thyroglossal Duct Carcinoma: A Systematic Review

OBJECTIVE: The extent of surgical management of thyroglossal duct-associated differentiated thyroid carcinoma remains controversial. This study aims to evaluate the role of total thyroidectomy in patients with thyroglossal duct-associated differentiated thyroid carcinoma and provide insights to support individualized, evidence-based care. DATA SOURCES: A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Google Scholar from inception to January 2025. REVIEW METHODS: Screening was performed independently by two reviewers. Studies were included if they reported treatment details for patients with thyroglossal duct carcinoma, and excluded if they were letters, abstracts, reviews, or meta-analyses. The primary outcome consisted of recurrent disease. Secondary outcomes were presence of synchronous thyroid cancer, surgical treatments, and mortality. The study protocol was registered in PROSPERO (CRD-42023489730). RESULTS: Three hundred thirteen studies (243 case reports, 70 case series; range 1-26 patients per study) were included compromising 645 patients with differentiated thyroid carcinoma. Notably, no cohort studies were found. Recurrent disease occurred in 24/436 (5.5%) patients with reported follow-up (median, 35.5 months [12.0-80.0]). Among patients without preoperative suspicion for synchronous cancer in the thyroid, recurrence rates did not differ significantly between the Sistrunk-only group (n = 3/92 (3.3%), median follow-up 24 months [IQR, 12-48]) and the Sistrunk plus thyroidectomy group (n = 6/101 (5.9%), median follow-up 24 months [IQR, 12-69]; P = .502). CONCLUSIONS: The Sistrunk procedure alone may be sufficient in appropriately selected patients with thyroglossal duct carcinoma. The decision to perform total thyroidectomy should be individualized based on tumor characteristics and thorough thyroid assessment.