[Surgical treatment of thyroid cancer]

From 1957 to 1980, 151 patients with thyroid cancer were treated by surgery in our hospital. Papillary adenocarcinoma was predominant (53%), followed by undifferentiated (23%) and follicular types (20%). The diagnosis, established only according to the clinical symptoms and 131I scan, gave a high misdiagnosis rate (44%). The misdiagnosis could also be made on the operation. The causes are: 1) limitation of 131I scan in diagnostic specificity; 2) lack of vigilance for thyroid cancer; 3) neglecting the subtle histological changes during the operation; 4) failure in submitting the frozen section. Fine needle aspiration cytology is emphasized in order to improve the preoperative diagnostic accuracy. Lobectomy and modified neck dissection are the most common modalities of operation for papillary and follicular cancers. The 5 year survival rates were 74% and 50% respectively. Modified neck dissection increased the 5 year survival up to 85%. Undifferentiated cancer could be treated, at best, by palliative treatment. The authors believe that a rational radical operation should be performed according to the pathological type, biological behavior and stage of the lesion, followed by adjuvant endocrine and/or isotope therapy, which could improve the treatment result.