Trends in thyroid surgery in Japan from 2014 to 2023: report on the National Clinical Database

Surg Today. 2025 Nov 17. doi: 10.1007/s00595-025-03126-7. Online ahead of print.

ABSTRACT

PURPOSE: Endocrine surgery encompasses various organ systems, but thyroid surgery represents the major component. The Japanese Association of Thyroid Surgeons published nationwide data on thyroid cancer surgery until 2005, since when no further reports have been published. Thus, we analyzed thyroid surgery trends using data from the National Clinical Database (NCD) from 2014 to 2023.

METHODS: We analyzed cases of thyroid surgery, for malignant and benign conditions, recorded in the NCD. A detailed analysis of papillary thyroid carcinoma (PTC) cases was conducted in 2014, 2019, and 2023 to assess TNM classification, surgical procedures, complications, and outcomes.

RESULTS: The number of thyroid surgery facilities and the number of thyroid surgeries being performed have both declined since 2020. A trend toward more hemithyroidectomies and fewer total thyroidectomies for PTC is evident. The number of surgeries for cancers < 1 cm and lateral node dissection for PTC have also decreased. Endoscopically assisted surgery has increased continuously, accounting for > 4% of thyroid operations in 2020. The incidence of permanent hypoparathyroidism has decreased and perioperative mortality is rare.

CONCLUSION: The changes in surgical trends are aligned with guideline updates and shifts in surgical practice. Future efforts will refine data collection and utilize the NCD to improve thyroid surgical quality and research.

PMID:41247462 | DOI:10.1007/s00595-025-03126-7