Surgical treatment of locally advanced thyroid cancer

Eighty-four patients with locally advanced thyroid cancer treated during the period from 1965 to 1989 were studied in order to evaluate the appropriateness of radical surgery. There were 57 patients who underwent palliative surgery (palliative group) and 27 patients who underwent radical surgery (radical group). Forty-six of the patients in the palliative group and all 27 in the radical group were aged 40 years or more. The survival rates as analyzed by the Kaplan-Meier method revealed no significant difference between patients aged 40 or more in the palliative group and those in the radical group. The control of local disease, however, was much more difficult in the palliative group. From the view of survival rates, the superiority of radical surgery could not be demonstrated, but radical surgery did control local neck disease better. In the palliative group, the survival rate of patients aged under 40 was significantly better than that of patients aged 40 or more. It may thus be better to avoid radical surgery in patients under 40 if it would result in a severe deterioration in their quality of life.