Local complications after surgical resection for thyroid carcinoma.

BACKGROUND: One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. MATERIALS AND METHODS: Ninety-one patients with thyroid carcinoma were identified from tumor registries at a university, veterans administration, and private hospital over a 36-year period. Forty-five patients (49%) underwent total thyroidectomy, 28 (31%) subtotal thyroidectomy, and 18 (20%) thyroid lobectomy. RESULTS: Permanent postoperative local complications occurred in 4% of patients. Forty-four patients (48%) experienced temporary local complications: transient hypocalcemia in 38 (42%), airway obstruction in 3 (3%), postoperative bleeding in 2 (2%), and recurrent laryngeal nerve injury in 1 (1%). The local complication rate increased in direct relationship to the extent of thyroid resection. There were no postoperative deaths. CONCLUSION: The most frequent underreported morbidity after thyroid resection is transient hypocalcemia. Compared to other life-threatening or permanent postoperative complications that could occur, transient hypocalcemia is relatively less important, and the significance of its identification is predominantly economic.

Squamous cell carcinoma of the upper aerodigestive tract in patients 40 years of age and younger.

Oral squamous cell carcinoma in patients 40 years of age and younger has been noted to be infrequent. The incidence is not as noticeable because the majority of oral cancers are diagnosed during the later decades of life. This study was undertaken to evaluate the incidence, site predilection, etiologic factors, and modes of treatment and to compare these results with available data on this topic. Of 1387 cases of oral and pharyngeal squamous cell carcinoma diagnosed from 1968 to 1989 at University Hospital and affiliated institutions, 28 occurred in patients under 40 years of age. When these lesions were staged according to the American Joint Committee for Cancer Staging, we found 6 stage I lesions, 3 stage II, 2 stage III, and 11 stage IV. Six lesions could not be staged from information available in the patient records. Present data corroborate the national average of 1% to 3% of cases of oral squamous cell carcinoma found within the 40 and under age group.