[Evaluation of surgical treatment results in patients with differentiated thyroid cancer from materials in the Oncologic Institute in Gliwice]

The optimal surgical treatment for patients with differentiated thyroid carcinoma is still controversial and discussed. The aim of this study was to analyze the effectiveness of treatment in differentiated thyroid carcinoma, to establish the prognostic value of histopathological type, clinical advancement, the extent of surgery and to estimate the therapeutic benefit rate of the radical approach. The randomized group of 768 patients with differentiated thyroid carcinoma, aged between 16 to 40 (median age 44), treated in Oncology Center Institute in Gliwice between 1986 and 1997 were analyzed. They were operated in different surgical clinics in Poland. The primary total thyroidectomy was performed in 153 of patients (20%), the secondary radical operation in 474 (62%). 136 persons were operated by less radical approach. Cervical lymph node metastases were observed in 26% of patients. Distant metastases occurred in 8% of cases. 610 persons were treated with 131I. All patients were administered hormonal therapy to suppress TSH. Locoregional recurrence occurred in 7.5% of patients. Complete remission was observed in 71.5% of persons (548 patients). The influence of distant metastases lymph node metastases and tumor size on the long-term prognosis was analyzed in univariate statistic analysis. There were no differences in survival in patients with papillary and follicular carcinoma. The 10-year survival was statistically significantly longer in patients who underwent radical surgical treatment (92%) than after non-total thyroidectomy (80%). Despite the relatively high risk of surgical complications the benefits of the radical approach were significant.