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Surgery for thyroid carcinoma.

H F Starnes, D C Brooks, G S Pinkus

    Cancer
    |March 15, 1985
    PubMed
    Summary
    This summary is machine-generated.

    This retrospective study of thyroid carcinoma cases found that subtotal thyroidectomy is as effective as total thyroidectomy but with significantly fewer complications. Subtotal resection is recommended to avoid the morbidity associated with more radical surgery.

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    Area of Science:

    • Endocrinology
    • Surgical Oncology
    • Pathology

    Background:

    • Thyroid carcinoma is a significant health concern.
    • Surgical management of thyroid nodules has evolved over time.
    • Understanding long-term outcomes and complication rates is crucial for treatment decisions.

    Purpose of the Study:

    • To retrospectively review thyroid carcinoma cases treated between 1948 and 1981.
    • To compare the outcomes and complication rates of different surgical approaches for thyroidectomy.
    • To evaluate the long-term efficacy and safety of subtotal versus total thyroidectomy.

    Main Methods:

    • Retrospective chart review of 986 patients with thyroid nodules who underwent surgery.
    • Analysis of 152 confirmed thyroid carcinoma cases, including papillary, follicular, anaplastic, medullary, and Hurthle cell types.

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  • Follow-up data for 92% of patients over a mean of 10 years, assessing disease-related death, recurrence, and survival status.

    • Main Results:

    • Total thyroidectomy resulted in a 20-fold higher incidence of postoperative complications compared to partial thyroidectomy (P < 0.001).
    • No significant difference in disease-related death, recurrence, or survival was observed between total and subtotal thyroidectomy.
    • In the latter decade of the study period, patients presented younger, with diminished female predominance, and 15% had prior neck irradiation.

    Conclusions:

    • Subtotal thyroidectomy is a useful and effective surgical approach for thyroid carcinoma.
    • Avoiding radical total thyroidectomy can significantly reduce postoperative morbidity.
    • The findings support the continued use of subtotal resection for selected thyroid cancer patients.