[Therapeutic results of malignant goiter 1960-1980. Significance of percutaneous radiotherapy in well differentiated carcinomas].

The therapeutic approach in malignant goitre is fairly uniform, apart from use of percutaneous irradiation. The influence of irradiation on survival rate in differentiated carcinomas transgressing organ boundaries was assessed in the evaluation of treatment results in 621 patients (two patient groups: 1960-1980). Early stages of tumour (T0-T1) were seen in only 18% of cases; 24% of all cases had metastases, mainly of the lungs and skeleton. Males died 1.5 times more frequently due to differentiated tumours than did females The 10-year-survival rate was 90% in patients below the age of 50 years in contrast to 60% in older patients. Papillary carcinomas had such a survival rate in 78% and follicular carcinomas in 66%. Stages T0-T2 had a survival of 87% in contrast to 58% in stage T3. Occurrence of distant metastases diminished survival to 48%. 167 patients with irradiation (I) and 73 without (II), but an otherwise equal treatment, with differentiated carcinoma stage T3 could be compared. Group I showed a 5- and 8-year survival of 88% and 75%, group II 68% and 38% (P less than 0.001). Local recurrence was the same in both groups, however metastases occurred more frequently and earlier in group II.