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Thyroid cancer: the case for total thyroidectomy.

O H Clark1, K Levin, Q H Zeng

  • 1Veterans Administration Medical Center, San Francisco, California.

European Journal of Cancer & Clinical Oncology
|February 1, 1988
PubMed
Summary
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Total thyroidectomy is a viable treatment for thyroid cancer, with experienced surgeons achieving minimal complications. However, careful patient selection is crucial to avoid significant risks like permanent hypoparathyroidism.

Area of Science:

  • Endocrinology
  • Surgical Oncology

Background:

  • Disagreement exists regarding the optimal surgical treatment for papillary and follicular thyroid cancer due to a lack of prospective studies.
  • Surgical options range from thyroid lobectomy to total thyroidectomy, with the latter being preferred if complications can be minimized.

Purpose of the Study:

  • To evaluate the complication rate associated with total thyroidectomy in patients with suspected or confirmed thyroid cancer.
  • To determine the feasibility and safety of total thyroidectomy as a primary treatment modality.

Main Methods:

  • Retrospective review of 160 consecutive patients undergoing total thyroidectomy for thyroid cancer.
  • Analysis of complication rates, including vocal cord paralysis and hypoparathyroidism, in primary and reoperative cases.

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Main Results:

  • The study identified a low rate of serious complications, including transient vocal cord paralysis and one case of permanent hypoparathyroidism.
  • Three recurrent laryngeal nerves were sacrificed due to tumor invasion, and two patients developed wound infections.
  • Only the permanent hypoparathyroidism case could potentially have been avoided by a less extensive procedure.

Conclusions:

  • Experienced surgeons can perform total thyroidectomy with minimal morbidity, offering theoretical and practical advantages for thyroid cancer treatment.
  • Total thyroidectomy should be avoided if complication rates are significant; selective procedures may be preferable in certain patients.
  • Careful patient selection and surgical expertise are key to successful total thyroidectomy for thyroid cancer.