[Unique treatment policy for thyoid cancer in Japan and other countries]

The treatment policy for patients with well-differentiated thyroid cancer varies among institutions. Although surgery has been the mainstay of treatment for this cancer, there is no consensus concerning the optimal extent of thyroid resection or the extent of lymph node dissection. Furthermore, controversy remains with regard to the indications for radiation therapy and hormonal therapy in surgical or nonsurgical cases. Thyroid resection is more extensive in other countries than in Japan, although the extent of lymph node dissection is limited in the former. For papillary carcinoma, total thyroidectomy is the treatment of first choice for all overseas respondents, but of only 20% in Japan, despite lymph node dissection being more extensive in Japan than in other countries. In Japan, high-dose 131I therapy is available only in a few institutions. Such limited indications reflect a discrepancy in the frequency of total thyroidectomy, a prerequisite for postoperative high-dose 131I therapy, between Japan and other countries.