Results of the treatment of locally invasive thyroid carcinoma

Abstract

BACKGROUND: Well-differentiated thyroid carcinoma usually has an excellent prognosis. However, when extrathyroidal invasion occurs, it is associated with significant morbidity and mortality. This report presents the experience of a single institution in the treatment of patients with locally invasive, well-differentiated thyroid carcinoma. PATIENTS AND METHODS: Forty-six patients with locally invasive well-differentiated thyroid carcinoma were diagnosed. Histopathologic types included: 28 papillary carcinoma and 18 follicular. RESULTS: Patients with exclusive invasion of the muscle or recurrent laryngeal nerve usually had complete tumor resection. Patients with tracheal, laryngeal, or esophageal invasion usually underwent shave resection. The factors that adversely affected survival were: age >45 years, preoperative diagnosis of extrathyroidal extension, and incomplete resection (p <.05). CONCLUSIONS: There were similar survival results after complete or shave resection and poor survival when the resection was incomplete. Tumors with minimal invasion can be treated by shave resection with acceptable survival and low morbidity.