Chan S, Karamali K, Kolodziejczyk A, et al. - With trends towards treatment de-escalation and recent guidelines from the American Thyroid Association and British Thyroid Association endorsing hemithyroidectomy (HT) alone for low-risk differentiated thyroid cancer (DTC) of 1–4 cm, researchers systematically appraised the literature to investigate recurrence rate outcomes after HT in this low-risk group. Thirty-one studies (with a total of 228,746 patients (HT: 36,129, total thyroidectomy, TT: 192,617) were identified, which had published recurrence and/or survival data for patients having had HT for DTC. The research provides a comprehensive systematic review of evidence primarily designed to identify the rate of recurrence in DTC after HT, and more precisely within the low-risk subgroup. They identify pooled recurrence and 10-year survival rates from a larger, broader, and more contemporary patient population than previously reported. The findings indicate that there is a small yet significantly higher risk of recurrence after HT than TT, but the basis of evidence is heterogeneous and prone to confounding factors, and would ultimately benefit from prospective randomized trials to resolve such limitations.