Conservative surgical treatment in differentiated thyroid carcinoma

Background. Purpose of the present study was to compare survival of patients affected by differentiated thyroid carcinoma after total and partial thyroidectomy. Methods. The study has been carried in a retrospective way; mean follow-up has been 160 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 80 thyroid surgical procedures are performed every year. Patients have been divided into two groups: the first included 65 patients who underwent total thyroidectomy, while the second group included 67 patients who underwent partial thyroidectomy. Ten patients affected by a T3-T4, N0-N1 tumor were ruled out of the study to allow better uniformity of data. Besides early postoperative complications (recurrent nerve lesion, hypoparathyroidism), patients have been followed by periodic clinical and instrumental examinations. Results. Follow-up has shown similar survival between patients treated by total thyroidectomy and those who underwent partial thyroidectomy (respectively 92.3% and 92.5%). Postoperative complications were instead significantly less in group 2. Conclusions. For patients affected by differentiated thyroid carcinoma at early stages it is suggested to perform a partial thyroidectomy since, compared to total thyroidectomy, a similar survival rate and a lower incidence of postoperative complications are obtained. According to personal opinion, total thyroidectomy should be performed in cases of thyroid carcinoma with vascular involvement and metastases.