Abstract
Long term results of treatment for 53 patients with stage III, IV differentiated thyroid cancer (47 with papillary carcinoma, 6 with follicular carcinoma), treated at Gunma Cancer Center Hospital, were reviewed. The ten-year cumulative survival rate of 44 cases treated with surgery was 84%. Only one patient out of 34 cases who underwent hemilobectomy had a recurrence in the remaining lobe of her thyroid gland. Total laryngectomy was performed on two patients. Prognosis for the patients with distant metastasis was poor, but locoregional recurrence was not an obstacle to long term survival.
Treatment results for 30 patients who underwent thyroidectomy combined with resection of the tracheal wall at the National Cancer Center Hospital were discussed. The surgical procedure was fenestration following partial resection of the trachea or laryngeal wall in all cases. Peroral alimentation was achieved in all patients on the 7th day (median) after surgery. Closure of the tracheal defect was obtained in 25 patients. Pathological examination revealed a positive margin in 13 patients, and clinical recurrence at the surgical margin was observed in only two cases.
In summary, distant metastasis occurred in 15 patients, and all of the seven patients who died from their disease had distant metastasis. The ten-year cumulative survival rate of all patients was 67%.
