[Stage-dependent operative treatment of malignant struma. A therapeutic concept based on data and results from the literature].

Basing on analysis of records of 193 thyroid malignomas, treated at the Chirurgische Universitätsklinik Kiel between 1962 and 1982, a stage dependent strategy of surgical treatment of thyroid carcinoma is discussed. Depending on tumor stage, differentiated thyroid carcinoma can be divided in groups of very low and higher risk of lethality. The low risk group consists of intraglandular papillary tumors without or with lymph-node involvement and of intraglandular highly differentiated follicular carcinomas. According to other authors our findings indicate, that the principle of total thyroidectomy in all cases of thyroid malignoma can be abandoned in this low risk group. Following our concept lead to a reduction of incidence of p.o. recurrent laryngeal nerve paresis from 17,1 to 6,4%.