What Constitutes an Adequate Operation for Carcinoma of the Thyroid?

Abstract

INTENSIVE clinicopathologic studies conducted at our institution over the past 14 years have convinced us that total thyroidectomy, with or without neck dissection, constitutes an adequate procedure for cancer of the thyroid. These studies represent the collaborative efforts of our departments of surgery, medicine, and pathology in a multidisciplinary approach to this disease problem. Before the use of iodine 131 for diagnosis and therapy in cancer of the thyroid was established, our surgical staff was generally agreed that thyroid lobectomy with or without radical neck dissection was the surgical treatment of choice. We performed total thyroidectomy only in cases with obvious widespread involvement of the gland or in detectable bilateral disease. Beginning in 1950, following the development of our routine use of iodine 131, we started performing a number of total thyroidectomies<i>primarily</i>to gain better metabolic control of the patient through increasing physiologic demands on the remaining thyroid tissue