An approach to diagnosis and therapy of thyroid tumors

An extensive literature concerning the relationship between nontoxic goiter and thyroid cancer has accumulated during the past 25 yr. Considerable diversity of opinion still exists, however, concerning selection of appropriate therapy for patients with thyroid nodules. The controversial nature of this important medical problem is perpetuated by the lack of precise knowledge of the natural history of thyroid cancers and by the limited reports concerning the ability of any particular method of therapy to alter the usually benign course of most thyroid cancers. In the absence of sufficient reliable scientific data upon which to make therapeutic decisions, most investigators have based their recommendations upon analysis of available epidemiologic information derived from large series of patients. In this presentation, these general conclusions will be reviewed and examined to provide the practicing physician with sufficient empiric information upon which to organize his own thinking concerning management of patients with thyroid nodules.