During a 16-year period (1972-1988), 40 out of 477
thyroid cancer patients underwent
thyroidectomy for undifferentiated
thyroid carcinoma. To analyse the significance of "radical" versus "palliative"
surgical procedures with regard to early postoperative course, operative complications and survival, all patients records were reviewed and actually followed up. A significant better survival was correlated with radical (n = 17) versus palliative
tumor resection (n = 23) (p less than 0.001), and total
thyroidectomy (n = 22) versus subtotal
thyroidectomy (n = 18) (p less than 0.006). Radical surgery with early postoperative external irradiation revealed no postoperative mortality and only one symptomatic cervical
tumor recurrence. In contrast,
palliative surgery, particularly in the case of synchronous
tracheotomy, was attended with a relatively high mortality (30%) and symptomatic local recurrences. The results of this study suggest that in undifferentiated
thyroid carcinoma without infiltration of the esophageal or tracheal mucosa an attempt of radical
tumor resection should be undertaken, since palliative
surgical procedures revealed a significantly lower survival due to complications of persistent or recurrent cervical
tumor infiltration and frequently were accompanied by local complications during the postoperative course.