J Korean Surg Soc.
2000 Sep;59(3):335-343.
Operation Method for Well-Differentiated Thyroid Cancer
- Affiliations
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- 1Department of Surgery, Kwangju Christian Hospital.
Abstract
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PURPOSE: The treatment of choice for well-differentiated thyroid cancer is surgical excision. However,
the operation method is still controversial. Also, the operation method has been changing gradually. Thus,
we reviewed the records of patients with well-differentiated thyroid cancer who had received operations
in our hospital to assess the trend in surgical procedure, and to determine the proper procedure, method,
considering both recurrence and complications. METHODS: We retrospectively analyzed the cases of 452
patients with differentiated thyroid cancer who had received operations from January 1989 to December
1998. We divided the 10 years into two periods; period I was from 1989 to 1993 (254 patients) and
period II was from 1994 to 1998 (198 patients). We analyzed recurrences and complications according
to the operation method, including neck lymph-node dissection. The incidences and locations of lymph-
node metastasis were taken into account, too. The statistical analysis was done by using the Fisher's
exact test. RESULTS: In period I, 147 patients (58%) received a total thyroidectomy, and in period II,
all patients received total thyroidectomy. In period I, 24 patients (9.4%) had a recurrence, and in period
II, 13 patients (6.6%) had a recurrence. In period I, 55 patients (21.7%) had postoperative hypoparathyr
oidism, and in period II, 38 patients (19.2%) had postoperative hypoparathyroidism. In period I, 15
patients (5.9%) had postoperative hoarseness, and in period II, 7 patients (3.5%) had postoperative
hoarseness. Two hundred eighty-one patients (62.2%) had lymph-node metastasis, and the anterior neck
region was the most common site of metastasis (60.2%). CONCLUSION: In the operation method for
differentiated thyroid cancer, the trend is toward a total thyroidectomy away from a lobectomy. Also,
a skillful and experienced surgeon can reduce the incidence of postoperative complications. Thus the
best operation method for differentiated thyroid cancer is a total thyroidectomy, including a preventive
anterior-neck lymph-node dissection, which is done by a skillful and experienced surgeon.