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B. MARDEN BLACK, SURGICAL TREATMENT OF CARCINOMA OF THE THYROID GLAND, The Journal of Clinical Endocrinology & Metabolism, Volume 9, Issue 12, 1 December 1949, Pages 1422–1428, https://doi.org/10.1210/jcem-9-12-1422
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Abstract
ATTEMPTS to devise a standardized surgical procedure for managing carcinoma of the thyroid gland have not been signally successful, chiefly because of the marked differences in biologic behavior of the different types of carcinoma. Thus, a procedure that is rational for the management of papillary lesions is irrational for the treatment of malignant adenomas and diffuse adenocarcinomas. Removal of thyroid, contiguous tissues and zones of venous and lymphatic spread is an impossibility because of neighboring vital structures; and the necessity of radical operation in the majority of cases has been challenged. Survival and recurrence rates have been disappointing in the evaluation of the procedures which have been proposed, partly because of the slow natural progress of lower grades of malignancy and partly because of extremely rapid progress of more malignant lesions. In addition, because of differences in fundamental criteria of malignancy adopted by different pathologists, results following treatment at different institutions may not be comparable.