In the surgical treatment of differentiated thyroid cancer at the Institut Gustave Roussy, it is attempted to avoid all dogmatism and to tailor the surgical excision of both thyroid and nodal tissues to the anatomic extent of the disease. 'Standard' total thyroidectomy is never carried out if the cancer is limited to a single lobe, and 'systematic' lymph-node resection in the absence of clinical adenopathy is performed only when exploratory supraclavicular lymph-node resection has revealed the presence of a histologically confirmed lymph-node metastasis. A report is presented of the results obtained with this method in 252 patients treated from the beginning in the Institut Gustave Roussy. The frequency and severity of complications were as follows: paralysis of the recurrent nerve occurred in 15% after partial and in 20% after total thyroidectomy; parathyroid insufficiency was the major complication of total thyroidectomy (10%), but occurred in only 1% of the cases treated by hemithyroidectomy. The 10-year results were excellent; two factors appear to influence the prognosis: 1) the histological type - papillary and vesicular cancers have a survival rate of 90%, as against only 68% for trabecular tumors; 2) age appears to be the main prognostic factor: in the group younger than 45, survival was the same as in a comparable group of normal subjects, but beyond that age, the survival curve descended sharply. These findings justify a less aggressive policy in the treatment of all differentiated cancers of the thyroid, especially in young patients.
|Title of host publication||Annales de Radiologie Medecine Nucleaire|
|Number of pages||4|
|Publication status||Published - 1977|
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging