par De Sloover, Christian ;Dor, Pierre ;Heimann, Rudolf
Référence Acta chirurgica Belgica (Ed. bilingue), 77, 6, page (435-446)
Publication Publié, 1978
Article révisé par les pairs
Résumé : The authors present a homogeneous series of 110 malignant tumors of the thyroid gland. 3 cases of unproven malignity, 2 of undetermined origin and 8 small cell carcinomas were withdrawn from the study. The remaining 97 cases are analysed according to their histological type, age and sex. 26 patients presented metastases and all died within 3 years. For the 71 patients without metastasis the most frequently used operations were total thyroidectomy (50), subtotal thyroidectomy i.e. at least one complete extracapsular lobectomy (16), and radical neck dissection when cervical nodes were clinically detectable (26). The survival rate of patients with differentiated carcinoma is 81% at 5 yr and 73% at 10 yr; it is 63% at 5 yr and 47% at 10 yr in cases of medullary carcinoma. Patients with an undifferentiated giant cell type usually die within the first year. The authors recommend a total lobectomy on the side of the tumor, the rest of the treatment being adapted to the age of the patient and histological type of tumor. In giant cell undifferentiated carcinoma a simple diagnostic biopsy is the only thing to do. Patients under 40-45 yr old with a differentiated carcinoma are candidates for radical unilateral lobectomy and subtotal contralateral resection, with a modified neck dissection in cases with cervical nodes. In all other cases total thyroidectomy with radical neck dissection is generally warranted.