Optimal extent of surgery for differentiated thyroid cancer

Between 1946 and December 1991, 3995 patients with papillary carcinoma of the thyroid were operated on in one institution. Patients who had primary tumor larger than 10 mm in maximum diameter and underwent curative surgery were analyzed, they were 2976 patients, Types of thyroidectomy did not affect prognosis presumably because size and extent of primary tumor dictated the choice. Regarding types of lymph node excision, 72.2% of patients underwent modified radical neck dissection and they had more advanced disease than those who underwent partial node excision or no node excision. Modified radical neck dissection indicated better prognosis in women having primary tumor invaded extra-thyroidal tissue(s), preoperative diagnosis was cancer and/or older than 60 years old, compared to partial node excision or no node excision.