POSTOPERATIVE OUTCOME OF INSUFFICIENT SURGERY FOR SMALL DIFFERENTIATED THYROID-CARCINOMA

We performed conservative surgery for small differentiated thyroid car cinoma, but also inadvertently carried out minimal insufficient surger y, such as enucleation (Ex) or partial lobectomy (pLx) without regiona l node dissection for malignant thyroid nodules. In this study, the lo ng-term postoperative outcome after such insufficient surgical treatme nt was evaluated. Of 348 patients with differentiated thyroid carcinom a who underwent initial surgery between 1953 and 1976, 84 underwent ei ther Ex or pLx and their records are herein reviewed. The frequency of recurrence from the remnant gland or regional lymph nodes was examine d in relation to the tumor diameter (less than or equal to 1.0cm, tis; 1.0cm-2.0cm, t1; >2.0 cm, t2). After Ex/pLx, the recurrence rate in t he tis group was 13.3% and not significantly different from that (13.6 %) in the tl group. The recurrence rate was notably increased in the t 2 group. Moreover, there was no significant difference between the rec urrence rate in the tis and tl groups after Ex/pLx and that after lobe ctomy with nodal dissection, These results suggest that a reoperative procedure with a more extensive thyroidectomy and neck dissection migh t not necessarily be required immediately after minimal insufficient s urgery is inadvertently carried out in patients with small differentia ted thyroid carcinoma measuring 2.0 cm in diameter or less.