To the Editor In the context of the expanding adoption of de-escalation strategies for medullary thyroid carcinoma (MTC), we read with great interest the systematic review and meta-analysis by Lincango et al. This study supports thyroid lobectomy (TL) as treatment option for sporadic MTC, with outcomes comparable with total thyroidectomy (TT) as recommended by guidelines. However, several methodological and clinical issues deserve further consideration.