[Effect of the plan of therapy on prognosis in thyroid cancer]

The therapeutic concept used in our Department for the treatment of thyroid cancer is characterized by a facultative external irradiation of the neck region and by a mandatory and intense treatment with radioiodine. The latter includes a complete elimination of remaining normal thyroid tissue and a combined diagnostic add therapeutic radioiodine application in the follow-up of the disease. The therapeutic effect of surgery, hormone substitution, radioiodine treatment and external irradiation combined with the prognosis of thyroid cancer was obvious, but that of individual steps was difficult to separate and quantitate. External irradiation of the neck improved the prognosis of patients with anaplastic carcinoma but no significant effect was observed in patients with follicular carcinoma. Even after prophylactic treatment with high doses of radioiodine the prognosis of differentiated thyroid cancer remained to be highly dependent on biological factors. Radioiodine treatment is recommended in all patients with follicular carcinoma and in patients older than 30 years with papillary carcinoma, but prophylactic treatment should only be performed for a period of 5 years.