Varying survival rates have been reported for differentiated
carcinoma of the thyroid gland. The rate, however, does progressively decrease over a longer period of time than the usually reported five-year survival rates. Significant local invasion outside the thyroid
capsule and of blood vessels yields a poorer prognosis, and mortality is largely attributed to distant
metastasis. To improve the long-term survival rate, 1) sharp dissection with ample safety margin including resection of the neighboring organs, 2) reconstruction of the sacrificed organs, if possible, and 3) postoperative prophylactic radioiodine
therapy, were adopted for invasive well-differentiated
carcinoma for a period of 10 years. Of the 191 well-differentiated
carcinomas operated on, in a series of 486 consecutive thyroid operations, 33 patients underwent this prophylactic radioactive
iodine therapy (dose amount up to 300 mCi) following ablative surgery including, in several patients, mediastinal dissection. Periodical whole body survey by
sodium iodide 131I showing no signs of recurrence up to five years except in three patients indicating two suspected lung
metastasis and one death from bone
metastasis, demonstrated that this is a promising method for the treatment of invasive well-differentiated
carcinoma of the thyroid gland, although further long-term analysis is required.