Starnes H F, Brooks D C, Pinkus G S, Brooks J R
Cancer. 1985 Mar 15;55(6):1376-81. doi: 10.1002/1097-0142(19850315)55:6<1376::aid-cncr2820550636>3.0.co;2-r.
The cases of thyroid carcinoma treated at this hospital during the period 1948 to 1981 were reviewed retrospectively. Nine hundred eighty-six patients with thyroid nodules were operated on. One hundred fifty-two were thyroid carcinoma (59 papillary, 36 mixed papillary-follicular, 30 follicular, 20 anaplastic, 5 medullary, and 2 Hurthle cell tumors). There was a 92% follow-up for a mean of 10 years. In the last decade, patients presented at a younger age, the female predominance was diminished, and 15% had had previous neck irradiation. Surgery consisted of total (27) or subtotal thyroidectomy (89), lobectomy or nodulectomy (24), and biopsy (12). Total thyroidectomy had an incidence of postoperative complications that was 20 times higher than that with partial thyroidectomy (P less than 0.001). Disease-related death, recurrence, and survivor status were discussed. There was no significant difference between total versus subtotal thyroidectomy. This study reaffirms the usefulness of subtotal resection and the avoidance of morbidity of more radical total thyroidectomy surgery.
对1948年至1981年期间在本院接受治疗的甲状腺癌病例进行了回顾性研究。986例甲状腺结节患者接受了手术治疗。其中152例为甲状腺癌（59例乳头状癌、36例乳头状-滤泡状混合癌、30例滤泡状癌、20例未分化癌、5例髓样癌和2例许特耳细胞肿瘤）。随访率为92%，平均随访时间为10年。在过去十年中，患者就诊时年龄较轻，女性占比降低，15%的患者曾接受过颈部放疗。手术方式包括全甲状腺切除术（27例）、次全甲状腺切除术（89例）、叶切除术或结节切除术（24例）以及活检（12例）。全甲状腺切除术的术后并发症发生率比部分甲状腺切除术高20倍（P<0.001）。讨论了与疾病相关的死亡、复发和生存状况。全甲状腺切除术与次全甲状腺切除术之间无显著差异。本研究再次证实了次全切除术的有效性以及避免更激进的全甲状腺切除术带来的并发症。
