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Abstract
Background. Controversy persists regarding the role of surgery in the treatment of stage IE non-Hodgkin's
lymphoma of the thyroid. Treatment options vary from complete surgical resection only
to needle biopsy as the only invasive procedure required.
Methods. During a 29-year period 15 patients with stage IE non-Hodgkin's lymphoma were treated,
with complete follow-up available in all patients. All patients had surgical exploration,
followed in most cases by radiation therapy and/or chemotherapy.
Results. After operation six patients exhibited no gross residual tumor, all with intrathyroid
disease, and all remained disease free; five of nine patients with residual disease,
all with extrathyroid lesions, had persistent or recurrent disease (p < 0.04). Among patients with residual disease after operation five of six receiving
postoperative radiation therapy exclusively have died of or had recurrence of disease,
whereas no further persistent or recurrent disease occurred in the three patients
who received adjuvant chemotherapy (p < 0.02).
Conclusions. Surgery permitted the distinction between intrathyroid tumor, which may be treatable
by local therapy alone, and extrathyroid lesions, which appear to require systemic
chemotherapy. Surgery provides not only the same diagnostic ability as needle biopsy
but also important therapeutic implications regarding adjuvant therapy.
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Article info
Footnotes
☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.
Identification
Copyright
© 1994 Published by Elsevier Inc.