Thyroid cancer: some basic considerations

CA: a Cancer Journal for Clinicians
H J WaneboD L Kaiser

Abstract

From these data and data from the literature, our recommended treatment for well-differentiated cancer is as follows: For papillary cancer, resection should be adequate to encompass the entire tumor, which in most cases would be complete lobectomy and possibly isthmusectomy. Prophylactic neck dissection is of no value; therapeutic modified neck dissection should be done for stage II disease. Follicular cancer can be treated by lobectomy (for small lesions) or subtotal thyroidectomy. Although total or near-total thyroidectomy may be required in selected patients with large primary cancers or in those with extensive capsular invasion or extrathyroid extension, the number of cases indicating this is small. There were only a few such patients with large primaries requiring total thyroidectomy in this study. Total thyroidectomy is best avoided in most cases, considering the price of hypoparathyroidism and the lack of significant improvement in survival compared with lesser ablative techniques. Postoperative ablation with iodine-131 did not improve survival in staged patients with papillary cancer (the number of patients with follicular cancer was too small for analysis). Postoperative thyroid suppression by exogenous thyroid hormone...Continue Reading

Citations

Jun 12, 2002·Current Treatment Options in Oncology·J H Yim, G M Doherty
Oct 12, 2004·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Sylvie ChevillardAdel K El-Naggar
May 1, 1995·American Journal of Otolaryngology·T T TsueE A Weymuller

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