The cases of thyroid carcinoma treated at this hospital during the period 1948 to 1981 were reviewed retrospectively. Nine hundred eighty-six patients with thyroid nodules were operated on. One hundred fifty-two were thyroid carcinoma (59 papillary, 36 mixed papillary-follicular, 30 follicular, 20 anaplastic, 5 medullary, and 2 Hurthle cell tumors). There was a 92% follow-up for a mean of 10 years. In the last decade, patients presented at a younger age, the female predominance was diminished, and 15% had had previous neck irradiation. Surgery consisted of total (27) or subtotal thyroidectomy (89), lobectomy or nodulectomy (24), and biopsy (12). Total thyroidectomy had an incidence of postoperative complications that was 20 times higher than that with partial thyroidectomy (P < 0.001). Diseaserelated death, recurrence, and survivor status were discussed. There was no significant difference between total versus subtotal thyroidectomy. This study reaffirms the usefulness of subtotal resection and the avoidance of morbidity of more radical total thyroidectomy surgery.
Cancer 551376-1381, 1985.
URGICAL TREATMENT for thyroid Carcinoma re-S mains controversial, perhaps because of the lack of prospective, randomized trials. The extent of surgery recommended has vaned from simple enucleation of the local tumor to total bilateral thyroid lobectomy. '.*
Although it seems clear that nodulectomy is not sufficient therapy, the role of total thyroidectomy must be questioned given its complication rate reported in several ~e r i e s . ~. ~ The surgical experience with thyroid carcinoma at the Brigham and Women's Hospital from 1948 through 198 1 is retrospectively reviewed. Two previous studies focused on patients from 1948 to 1963 and 1963 to 1 970.4*5 The current report provides follow-up for these patients and, in addition, reviews patients operated upon in the period 197 1 to 198 1.