Surgical treatment of differentiated thyroid carcinoma: a retrospective study.
A retrospective study was carried out to assessed reliability of the prognostic factors (histology, age, sex, and stage), and standard procedures for the surgical treatment of differentiated thyroid cancers (DTC). From the 144 DTC cases reviewed with follow-up ranging from 1 to 25 years (m = 6.33 years), total mortality for cancer was found to be 55% (8 patients), with a predictive positive value for recurrence of 95.4% and 91.8% at 12 and 24 months, respectively. Median survival was 8.8 years (range 1 to 25 years). The multivariate analysis showed that factors such as age > 45 years, histology of intermediate malignancy, size up to 1.5 cm, and presence of metastases, significantly worsened the prognosis, regardless of the intervention that was carried out. We suggest total thyroidectomy for the treatment of benign pathologies and confirmed or suspected cases of cancer. We reserve loboisthmectomy for the treatment of benign pathologies confined to one lobe or those with FNAB suggesting a follicular neoplasm.
Sperlongano
Pasquale
P
Department of Anaesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy. pasquale.sperlongano@unina2.it
Parmeggiani
Domenico
D
Pisaniello
Donatella
D
De Falco
Massimo
M
Sordelli
Ignazio
I
Accardo
Marina
M
Cuccurullo
Vincenzo
V
Mansi
Luigi
L
Tartaro
Gian Paolo
GP
Barbarisi
Alfonso
A
Avenia
Nicola
N
Parmeggiani
Umberto
U
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome