[Is unilateral total lobectomy adequate treatment for a single malignant thyroid nodule? 67 patients operated upon between 5 and 18 years age (author's transl)].

In the treatment of thyroid carcinoma, there is still some discussion about the best operation for a solitary and well encapsulated nodule. 18 years ago, it was decided to treat every case of "cold" thyroid nodule by total lobectomy and isthmectomy. 56 patients were reevaluated 5 to 18 years after such limited operation for malignant nodules. 8 of them died between the 19 th month and the 14 th year after surgery, the death being possibly related to the thyroid cancer in only 4 patients, but without any clinical evidence of local recurrence. Among 50 surviving patients, only one controlateral recurrence was observed, two years after lobectomy; it was treated by surgical totalisation of thyroidectomy, without any new recurrence after 10 more years. These results (although the small number of cases, and too short follow-up exclude definitive conclusions) are comparable to those obtained by a more aggresive surgical approach, but have the great advantage of total absence of any functional sequellae. So are we encouraged to go further in the experience of a rather conservative surgery in the treatment of uninodular thyroid carcinoma.