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[Thyroid cancers: the Geneva experience]
F Triponez1, S Simon, J Robert
1Clinique de chirurgie thoracique, département de chirurgie, hôpitaux universitaires de Genève, rue Micheli-du-Crest 24, 1211 Genève 14, Suisse. frederic.triponez@hcuge.ch
Aim Of The Study:
To study the survival of patients with thyroid cancer operated in the same centre from 1978 to 1999.
Patients And Method:
This retrospective study included 218 patients operated on for thyroid carcinoma from january 1978 to december 1999. Modified neck dissection was performed only in the presence of one or more suspected lymph nodes. The stage of the cancer was defined according to the last TNM classification (1997). Survival data were taken from the Geneva Tumour Registry (168 patients = 77% of the series, 109 papillary carcinomas, 37 follicular, 14 undifferentiated and 8 medullary carcinomas).
Results:
The overall 5, 10 and 15-year survival rates were respectively 88%, 84% and 80%. Papillary carcinoma was associated with the best survival at 5, 10 and 15 years (99%, 97% and 93%), despite a recurrence rate of 20% treated mainly by surgery often associated with radioiodine therapy. Follicular carcinoma had a survival rate of 83% at 5 years and 75% at 10 years. Undifferentiated carcinoma had a median survival rate of 56 days. None of the 8 patients with medullary carcinoma had died from that cancer in this series.
Conclusion:
Thyroid carcinoma carries such a good prognosis (except for undifferentiated carcinoma) that invasive surgery at first operation, like radical neck dissection, is not justified, despite a high rate of recurrence.