Surgery of differentiated thyroid adenocarcinomas

The authors present a retrospective study of 110 patients operated for adenocarcinoma of the thyroid between 1950 and 1975, and submitted to standard postoperative radiotherapy. Clinical manifestations are poor and preoperative scintigraphy display a cold tumor in 80 percent of those performed. The preoperative cytodiagnosis confirms malignancy in 90 percent of cases approximately, thereby reducing the number of complementary reoperations. In the latter the rate of complications. Increases from 25 percent to 44 percent. Three are twice as many recurrent nerve palsies and parathyroid resections in total thyroidectomies as compared to subtotal. However after radical resection local recurrences and metastases are 4 times less frequent. Under combined radio-surgical treatment 82 percent of patients are alive with a mean survival time of 9.4 years; 9 percent have died of their disease after a mean 4.1 years and 9 percent have died of an unrelated condition an average 7.2 years after. The authors favor total or near-total, i.e. extracapsular homolateral and intracapsular controlateral, thyroidectomy for follicular and papillar adenocarcinomas alike, followed by local radiotherapy and destruction by 131 iodine (Acta chir. belg., 1977,76, 553-561).