SURGICAL REINTERVENTION FOR DIFFERENTIATED THYROID-CANCER

Reoperation was performed in 110 of 185 patients with a differentiated thyroid carcinoma. In 25 patients (23 per cent) the indication for re intervention was a large thyroid remnant and in the other 85 (77 per c ent) persistent or recurrent cancer was suspected. In 32 (29 per cent) of the 110 patients undergoing reoperation no evidence of cancer tiss ue was found. Tumour tissue in 33 patients (30 per cent) was resectabl e. Of 45 patients (41 per cent) with residual tumour after operation 2 4 showed only occult thyroid carcinoma with a raised serum thyroglobul in level. Eight of 21 patients with macroscopically persistent tumour died from the disease during a mean follow-up of 2.3 years. In 13 of 3 8 patients the investigated recurrent tumours were histologically less differentiated than the primary lesions, stressing the importance of total tumour clearance. The treatment of choice for persistent and rec urrent differentiated thyroid carcinoma is surgical reintervention, if feasible, before radioiodine and radiation therapy are considered.