Thyroid cancer in 1,330 cases of surgical goiter

Abstract

Abstract The purpose of this survey was to ascertain the incidence of thyroid cancer (ninety-eight cases of thyroid cancer in 1,330 thyroidectomies) in a large Southeastern city, to determine the clinical and pathologic characteristics of the malignant lesions encountered in this area, to outline the surgical procedures employed and to present the follow-up results to date (from several months to ten years). We hope that such a study, representing the total experience with thyroid surgery in four hospitals in Jacksonville, Florida, over a ten year period (1951 through 1961), should afford a true picture of the problem of thyroid cancer as encountered and handled at the community level. The clinical impression as to whether or not the lesions were single nodules or multinodular goiters was compared with the surgical and pathologic findings. The incidence of cancer in single nodules (14.6 per cent) is compared with that in multinodular goiter (4.3 per cent). An analysis was made of the mortality, morbidity and incidence and types of postoperative complications, such as hemorrhage, recurrent nerve injury, parathyroid tetany and respiratory obstruction in the over-all series of 1,330 operations. Findings in this study are compared with similar figures in published studies from other sections of the country. In view of the substantial incidence of cancer (7.4 per cent) in the entire series and of the inaccuracy in the clinical detection of thyroid cancer, surgical removal is advised for single nodules and multinodular goiters. This viewpoint is supported by a surprisingly low incidence of serious complications and by a surgical mortality of 0.5 per cent in the over-all series.