Abstract: . . .  treatment. Ann Surg Oncol . 1997;4:328-333. 8. van Heerden JA, Hay ID, Goellner JR, et al. Follicular thyroid carcinoma with capsular invasion alone: a non-threatening malig- nancy. Surgery . 1992;112:1130-1138. 9. Clark OH. Total thyroidectomy: the treatment of choice for patients with differentiated thyroid cancer . Ann Surg . 1982;196:361- 370. 10. Hughes CJ, Shaha AR, Shah JP, et al. Impact of lymph node metastasis in differentiated carcinoma of the thyroid : a matched-pair analysis. Head Neck . 1996;18:127-132. 11. Shaha AR. Management of the neck in thyroid cancer . Oto- laryngol Clin North Am . 1998;31:823-831. 12. Moley JF. Medullary thyroid cancer . Surg Clin North Am . 1995;75:405-420. 13. Shaha AR. Controversies in the management of thyroid nod- ule. Laryngoscope . 2000;110:183-193.  . . .
. . .  lymph nodes are evident in the jugular area. In clinically apparent cervical lymph nodes in patients with medullary thyroid cancer ,appro- priate neck dissection should be undertaken, which may require the removal of the sternomastoid muscle or jugular vein for proper clearance. Every effort should be made to preserve the accessory nerve if it is not involved directly by the tumor. The appropriate central compartment clearance and total thyroidecto- my may result in higher incidence of temporary or per- manent hypoparathyroidism in this group of patients. The operating surgeon should be quite familiar with autotransplantation of the parathyroid under these cir- cumstances, especially if the blood supply to the parathyroid gland is damaged. Extent of Thyroidectomy for Anaplastic Thyroid Cancer The anaplastic thyroid cancer represents one of the most aggressive cancers in the human body. For the majority of patients with anaplastic thyroid cancer ,out- comes are generally fatal. The average survival in this group is 6 to 9 months, with rapid involvement of the central compartment leading to airway mortality or massive pulmonary disease. Total thyroidectomy is rarely feasible in this group of patients. However,if the patient has minimal disease and a true anaplastic thy- roid cancer that appears to be surgically resectable, then appropriate total thyroidectomy with neck dissec- Page 6 May/June 2000, Vol.7, No.3 Cancer Control 245 tion should be considered. The surgeon’s role in anaplastic . . .
--3000,2,750,2475,25461