The surgical approach to cancer of the thyroid gland remains a matter of debate in the medical world. There is a trend toward more radical excision of the thyroid gland, but the management of the lymph glands of the neck remains controversial.
The purpose of this paper is to present 44 cases of carcinoma of the thyroid gland which were histologically diagnosed and treated at Presbyterian Medical Center, Chonju, Korea, during last 6 and 8/12 years up to August, 67, with special emphasis on the manegement of cervical metastases from differentiaed carinoma of the thyroid gland.
These 44 cases were analysed in regard to incidence, duration of disease, clinical features, surgical findings, pathological findings, cervical lymph node metastases, the method of treatment, postoperative complications and prognosis. The results are summarized as follows:
1. The incidence of thyroid cancer was 1.78% among all kinds of cancers.
2. The thyroid cancer was prevalent in female (4 to 1), and in third fourth decades of life (45% of all).
3. The average age was 43.2 years.
4. The average duration of disease was 6.8 years.
5. The most common symptom and sign were a mass or masses in thyoid and/or neck.
6. The main site of origin was the right lobe (45.7% of known 35 cases).
7. Grossly enlarged cervical lymph nodes were palpable in 40% of all cases.
8. Histologically differentiated carinoma comprises about 91% of all cases, papillary carcinoma is 50% of all cases.
9. In 26 radical neck dissections, 22 cases(84.5%) had metastatic cervical lymph nodes in their specimens. The error in the clinical diagnosis of cervical lymph node matastasis was 75% in our series.
10. In regard to management, approximately 73%(32/44 cases) of all cases underwent curative surgical procedures and additional postoperative radiation therapy in 6 cases; 26 of the 32 cases(81%) underwent radical neck dissections.
11. The most frequent complications were wound infection (8 cases) and facial edema (8 cases).
12. Curent follow-up information is available in 33 cases (75%).
13. The survival rate in curative cases is 88%, but only 12.5% in palliative cases.
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