Abstract
We have not come to any agreement for the therapeutic guidelines for locally invasive differentiated thyroid carcinomas. In this paper long-term therapeutic outcomes and some problems were studied in 28 patients undergoing aggressive surgery for the disease at the department from 1965 to 1989. There were 7 men and 21 women, ranging in age from 29 to 80 years old. In 5 patients the resection of the trachea was required, in 10 the esophagus, 5 both the trachea and the larynx, and in 8 the trachea, the larynx and the esophagus. Ten patients died of the disease. Six died of local neck disease and 4 of distant metastasis. Overall survival rates analyzed by Kaplan-Meier method in 5, 10 and 15 years were 60.5, 38.4 and 38.4%, respectively. Survival rates of the patients aged 60 years and more were significantly worse than that of the patients under 60. These long-term outcomes are not satisfactory in terms of the malignity of this disease, but it can be inferred that early deaths might be greatly attibutable to the conversion of differentiated carcinomas into the poorly differentiated ones. Further adjuvant chemotherapy and radiation therapy would be necessary after surgery to gain an improved survival rate.
