背景：对于伴有对侧结节的单侧乳头状甲状腺癌（PTC），最佳外科手术范围仍不清楚。本研究评估了一大群接受半甲状腺切除术的患者的长期结局，这些患者患有单侧PTC和对侧可疑低到中度结节。 方法：这项回顾性队列研究包括在韩国阿山医学中心在2016年1月至2017年12月期间接受半甲状腺切除术的单侧PTC患者。患者分为两组，术中有和术中没有对侧结节的组：有结节组和无结节组。评估了术前和随访期间观察到的所有对侧结节。 结果：研究队列共包含1761名患者（1879个结节），其中有700名（39.8%）有对侧结节，1061名（60.2%）没有对侧结节。对侧结节的中位数大小为0.5厘米。随访中位数为59个月后，有结节组对侧结节的中位增长为0.1厘米（范围为-3.4-4.7厘米）。术中存在的对侧结节中，54.7%保持不变，缩小或消失；而14.8%增大≥0.3厘米。在700名有对侧结节的患者中，有20名（2.9%）被诊断为对侧PTC。有结节组和无结节组的5年对侧PTC无病生存率分别为98.2%和99.3% （P = 0.003），而这两组的5年无复发生存率无显著差异。在接受术后补全甲状腺切除术的39名患者中，有2名（5.1%）出现了永久性低钙血症。 结论：对于患有单侧低风险PTC和对侧可疑低到中度结节的患者，半甲状腺切除术可能是一种安全且可行的初步治疗选择。

Background The optimal extent of surgery for unilateral papillary thyroid carcinoma (PTC) with contralateral nodules remains unclear. This study evaluated the long-term outcomes in a large cohort of patients with unilateral PTC and contralateral low-to-intermediate suspicious nodules who underwent lobectomy. Methods This retrospective cohort study included patients with unilateral PTC who underwent lobectomy between January 2016 and December 2017 at Asan Medical Center in Korea. Patients were divided into two groups, those with and without contralateral nodules at the time of lobectomy: the Present group and the Absent group. All contralateral nodules observed at the time of surgery and during follow-up were evaluated. Results The study cohort consisted of 1761 patients (1879 nodules), including 700 (39.8%) with and 1061 (60.2%) without contralateral nodules. The median size of the contralateral nodules was 0.5 cm. After a median follow-up of 59 months, the median growth of the contralateral nodules in the Present group was 0.1 cm (range, -3.4-4.7 cm). Of the contralateral nodules present at the time of lobectomy, 54.7% remained unchanged, decreased in size or disappeared; whereas 14.8% increased ≥0.3 cm. Of the 700 patients with contralateral nodules, 20 (2.9%) were diagnosed with contralateral PTC. The 5-year contralateral PTC disease-free survival rates in patients with and without contralateral nodules were 98.2% and 99.3% (P = 0.003), respectively, whereas the 5-year recurrence-free survival rates did not differ significantly in these two groups. Of the 39 patients who underwent completion thyroidectomy, two (5.1%) experienced permanent hypocalcemia. Conclusions Lobectomy may be a safe and feasible initial treatment option for patients with unilateral low-risk PTC and contralateral low-to-intermediate suspicious nodules.