Surgical treatement of thyroid carcinoma:a report of 487 cases

Objective To investigate the diagnosis and treatment of thyroid carcinoma,and prevention of surgical complications.Methods Clinical data of 487 cases of thyroid carcinoma in our hospital from March 1990 to July 2006 were analyzed retrospectively.Results Among them,279(57.3%) and 162(33.3%) patients were diagnosed before and during operation respectively,and 46 patients were diagnosed after operation.Reoperation was performed in 140 patients(28.7%) and residual carcinoma was found in 79 patients(56.4%).No hospital deaths occurred in the 487 cases after operation.A total of 17 cases showed temporary vocal cord paralysis,2 cases showed permanent vocal cord paralysis,and 14 cases had convulsion or limb numbness due to hypocalcemia.Follow-up of 413 cases showed cervical lymph node tumor recurrence in 33 patients,local tumor recurrence in 24 patients and remote metastasis in 17 patients.The 5-year survival rate after operation of differentiated,medullary and undifferentiated thyroid carcinoma was 99.8%,95.8% and 87.0%,respectively.Conclusions The thyroid nodule with calcification should be considered to be thyroid carcinoma,and intra-operative frozen section is helpful for the diagnosis and the choice of operative method.The first thyroid operation should not be taken lightly.Patients should take thyroxine tablets for prophylaxis of tumor recurrence and metastasis.