[Type of surgery for 147 patients with medullary carcinoma of the thyroid]

To study the optimum type of surgical treatment for thyroid medullary carcinoma.From May 1960 to July 2000, 147 patients with thyroid medullary carcinoma were treated with surgical treatment. The results of tumorectomy, subtotal and total thyroidectomy were compared.The overall 5-, 10- and 15-year survival rates were 85.4%, 77.4% and 73.1%. The recurrence rate was lowest in the total thyroidectomy group, medium in the subtotal group and highest in tumor extirpation group (P0.05). The overall cervical lymph node metastasis rate was 72.1%. The cervical occult nodal metastasis rate in clinically N0 patients was 42.1% (occult metastasis rates in central and lateral cervical regions were 24.6% and 36.8%). Thirteen patients with persistent postoperative hypercalcitoninemia were observed from 5 months to 6 years without tumor recurrence.Total thyroidectomy is the optimal treatment for thyroid medullary carcinoma. Regardless of clinical N0 or N1, central and ipsilateral neck dissection should be considered. Patients with persistent postoperative hypercalcitoninemia should be observed closely.