[Undifferentiated thyroid cancer: improved therapeutic results following initial radical intervention and early...

During a 16-year period (1972-1988), 40 out of 477 thyroid cancer patients underwent thyroidectomy for undifferentiated thyroid carcinoma. To analyse the significance of "radical" versus "palliative" surgical procedures with regard to early postoperative course, operative complications and survival, all patients records were reviewed and actually followed up. A significant better survival was correlated with radical (n = 17) versus palliative tumor resection (n = 23) (p less than 0.001), and total thyroidectomy (n = 22) versus subtotal thyroidectomy (n = 18) (p less than 0.006). Radical surgery with early postoperative external irradiation revealed no postoperative mortality and only one symptomatic cervical tumor recurrence. In contrast, palliative surgery, particularly in the case of synchronous tracheotomy, was attended with a relatively high mortality (30%) and symptomatic local recurrences. The results of this study suggest that in undifferentiated thyroid carcinoma without infiltration of the esophageal or tracheal mucosa an attempt of radical tumor resection should be undertaken, since palliative surgical procedures revealed a significantly lower survival due to complications of persistent or recurrent cervical tumor infiltration and frequently were accompanied by local complications during the postoperative course.