title: [Evaluation of the therapeutic benefits in relation to the extent of surgery in patients with differentiated thyroid carcinoma].
abstract: BACKGROUND
  Evaluation of the therapeutic benefits in relation to the stage of thyroid cancer and to the extent of surgery and the risk of postoperative complications.
  
  
  METHODS
  Retrospective analysis of differentiated thyroid carcinoma (DTC) patients staged T1M0 versus T2-T4M0 was performed. All of them were treated or diagnosed in Institute of Oncology in Gliwice between 1986-1998. Previously they were operated in various surgical centers all-over Poland. The risk of death, local relapse and postoperative complications were analyzed using the decisiontree model to evaluate the therapeutic benefits.
  
  
  RESULTS
  The recurrent laryngeal nerve injury (transient or permanent) was observed in retrospective analysis in 21% of patients, while postoperative hyperparathyroidism in 15.8%. The analysis of the therapeutic benefit index showed no advantage of total thyroidectomy in the T1M0 group (0.96 vs. 0.98 in patients treated by less than total thyroidectomy). The advantage of radical surgery was confirmed in T2-T4M0 group. The therapeutic benefit index was 0.92 in patients treated by total thyroidectomy and 0.69 in those who received less extensive operation.
  
  
  CONCLUSIONS
  The analysis of therapeutic benefits confirmed the limit of 1 cm tumor diameter between less extensive surgery and total thyroidectomy. It showed that total thyroidectomy brings a significant therapeutic benefits in patients in > T1M0 stage. The improvement of overall survival and decrease of local relapse far outweigh the disadvantages related to postoperative complications.
authors.affiliation: Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Gliwice Branch, Gliwice. aczarniecka@io.gliwice.pl
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Czarniecka
authors.forename: Michał
authors.initials: M
authors.lastname: Jarzab
authors.forename: Jolanta
authors.initials: J
authors.lastname: Krajewska
authors.forename: Beata
authors.initials: B
authors.lastname: Jurecka-Lubieniecka
authors.forename: Ewa
authors.initials: E
authors.lastname: Paliczka
authors.forename: Aleksander
authors.initials: A
authors.lastname: Sacher
authors.forename: Stanisław
authors.initials: S
authors.lastname: Półtorak
authors.forename: Jan
authors.initials: J
authors.lastname: Włoch
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology; D012086:Reoperation; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome