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OBJECTIVES Evaluate the impact of microscopic extrathyroid extension (MEE) on outcome and therapy response in patients with cT1 and cT2 papillary thyroid carcinoma (PTC). SUBJECTS AND METHODS Retrospective study of 970 consecutive patients, who underwent surgery for PTC between 2000 and 2016. All patients had tumours ≤ 4 cm, apparent complete tumour resection, without clinically apparent lymph node or distant metastasis at diagnosis and nonaggressive histologic variant. RESULTS Based on the finding of MEE, 175 (18.0%) patients were upsta