Following staging procedures, differentiated thyroid cancers i. e. papillary and follicular carcinomas, are operated on for intra- or extracapsular total thyroidectomy (depending on the anatomical extent of the disease) and selective lymph node dissection. Postoperative complementary use of adjuvant external and systemic radiotherapy is the general practice. External irradiation diminishes local/regional relapses in all cases. Radioiodine treatment decreases local/regional/distant recurrences in cases of tumour cells capable of iodine uptake. Life-long thyroxine medication is needed, with a TSH-suppressive dose for relapse prevention and hormone substitution. This treatment regimen, a careful follow-up and adequate rescue therapy are the prerequisites of the generally excellent patient prognosis, a survival probability measurable in decades. In anaplastic carcinoma following extracapsular total thyroidectomy and lymph node dissection, external irradiation is always indicated. Chemotherapy has a beneficial effect on survival. Hormone replacement therapy is necessary to substitute the missing metabolic effect of the thyroid. This combined modality treatment leads to some improvement as concerns the prognosis of this poor-risk type of cancer.
|Number of pages||9|
|Publication status||Published - Jan 1 1994|
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