Surgical Treatment of Thyroid Carcinoma

There is general agreement that the primary method for treating thyroid cancer should be by surgical operation. Subtotal thyroidectomy, lobectomy and total thyroidectomy are advocated by different surgeons. A classical type radical neck dissection is thought indicated by some surgeons when there has been extension of the primary lesion to the cervical lymph nodes. This operation, in the judgment of most surgeons, is not considered justifiable as a "prophylactic procedure" in the absence of established lymph node involvement, as has sometimes been recommended in the past. Some surgeons perform less extensive cervical lymph node dissections which vary in extent from modified neck dissections, with preservation of the sternocleidomastoid muscle and internal jugular vein, to "berry picking" operations, ie, excision only of the involved lymph nodes. The methods of treatment used when it is not possible to excise the primary lesion completely are hormone suppression with desiccated thyroid or an equivalent