[The choice of the extent of the operation in patients with thyroid cancer]

The results of 676 radical operations for thyroid cancer are discussed. The choice of procedure was determined by tumor histology which was assessed using trephine biopsy. Extracapsular hemithyroidectomy was the basic procedure (420 out of 676 cases) used for the treatment of well-differentiated thyroid cancer affecting one lobe only. No fatalities were registered. Bilateral surgery was associated with paralysis of n. laryngeus in 1.5% of cases and with the nerve injury in 5.1%. With unilateral surgery, the parameter was 2.8%. The unilateral procedure offered the advantage of sparing the intact lobe which assured a decrease in thyrotropin and lower rates of relapse, hypothyrosis, hypoparathyroidism and paresis of n. laryngeus. Five-, ten- and twenty-year cumulative survival rates were 91.8, 87.8 and 71.6% whereas corrected rates--94, 93.6 and 92.9%, respectively.