Thyroid cancer is the commonest endocrine cancer. It is increasingly diagnosed both due to the diagnosis of previously undiagnosed subclinical lesions as well as due to a lesser true increase in incidence. Surgery is the only treatment modality that can cure thyroid cancer and has a key role in the multidisciplinary treatment of the malignancy. The combination of the rarity of the disease and broad spectrum of clinical outcomes has hindered the accumulation of level 1 evidence in the management of thyroid cancer with inevitable controversies regarding the surgical and adjuvant treatment of all types of thyroid cancer and its variants.
The controversies and growing consensus towards an optimal extent of thyroid surgery and the role of lymph node dissection tailored to the disease type and risk group are discussed. The data regarding the value of surgical specialisation on thyroid surgery are also reviewed.