I. Preoperative management 1. Patients with suspicious FNA results must undergo neck ultrasonography to evaluate the contralateral thyroid, central region and lymph nodes in the lateral neck region; preoperative CT, MRI and PET are not recommended to be performed routinely, and Tg testing is not required. 2. All patients should undergo noise assessment (voice assessment) preoperatively; abnormal noise, previous neck or upper Patients with abnormal noise, previous history of neck or upper thoracic surgery, confirmed nail cancer with posterior external invasion or extensive metastasis to lymph nodes in the central region should also undergo preoperative laryngeal return nerve examination. Surgical management 1. The morphology of the recurrent laryngeal nerve must be identified during surgery, and the lateral branches of the superior laryngeal nerve should be preserved as much as possible when removing the upper pole of the thyroid gland. Intraoperative nerve stimulation can be used to help find the nerve and determine its function. 2. Surgery is usually recommended for patients with a cytologic diagnosis of primary thyroid malignancy. Patients with high risk of surgical complications, short life expectancy (e.g., with severe cardiopulmonary disease, malignancy, advanced age), and combined with other medical or surgical conditions requiring priority treatment may be withheld from surgery and replaced with close monitoring. Patients with very low-risk tumors, such as microscopic papillary carcinoma (PTMC) without metastasis and local invasion, may not be treated with surgery for the time being. Mutation analysis, such as BRAF combined with other oncogenic mutations (e.g. PIK3CA, AKT1) as well as TERT and P53 mutations, can be used as indicators to predict poor prognosis of PTMC and help identify patients with PTMC who need surgical treatment. 4. Lobectomy is feasible for solid nodules of unknown benignity or malignancy and thyroid cancer of <1cm in diameter. Patients with nodules of unknown benignity or malignancy >4 cm in diameter, thyroid cancer >1 cm in diameter, bilateral lesions, significant heterogeneous hyperplasia, family history of nail cancer or history of radiation exposure should undergo total thyroidectomy. 5.If lymph node involvement in the central region or contralateral lymph nodes is found, total thyroidectomy + therapeutic VI region lymph node dissection should be performed. If biopsy confirms metastasis in the lateral cervical lymph nodes, therapeutic lateral cervical lymph node dissection should be performed. In contrast, T3/T4 PTC (stage cN0), PTC invading cervical lymph nodes (stage cN1b), or PTC requiring information to develop further treatment options, may undergo prophylactic zone VI lymph node dissection (unilateral or bilateral). Stage T1/T2 PTC without lymph node metastasis and most FTC do not require prophylactic VI lymph node dissection. 6. Except for single focal low-risk nail cancer without lymph node metastasis with a diameter of <1 cm, all other nail cancers should undergo total thyroidectomy. It is not recommended to replace total thyroidectomy with RAI nail clearing treatment. 7. The pathological description should be complete in terms of information, including stage, vascular invasion, lymph node invasion, extra-nodal spread and histological subtypes. III. Postoperative management All patients with DTC should have AJCC/UICC staging to predict the risk of death, but AJCC/UICC staging is not applicable to predict the risk of recurrence, and the risk of recurrence should be assessed using the ATA clinicopathological 3-level risk stratification system. Assessment (voice assessment), patients with abnormal noise, history of previous neck or upper thoracic surgery, confirmed nail cancer with invasion to the posterior extremity or extensive metastasis to the lymph nodes in the central region, and preoperative laryngeal return nerve examination are also required.