Sometimes, I-131 is used to eliminate any remaining thyroid tissue . Similarly, when therapeutic doses of I-131 are planned, all or almost all of the thyroid gland should be removed first.
Less extensive operations such as lobectomy have fewer complications, but 5 to 10 percent of patients will have a recurrence in the thyroid. Metastatic disease also cannot be treated with I-131 until the normal thyroid tissue has been removed.
As with papillary carcinoma , enlarged lymph nodes discovered at surgery, although less frequently involved, should be removed without extensive surgery. In patients who have a limited surgical procedure (lobectomy), thyroid hormone is given postoperatively to suppress TSH and decrease the chance of recurrence.
Five-Year Survival 70 to 90 percent
Stage II
The tumor has spread to lymph nodes (IIA if on one side, IIB if on both sides or to the mediastinal nodes—those in the center of the chest).
Standard Treatment Treatment is similar to that for Stage I. The only difference is the involvement of nearby lymph nodes, which increases local recurrence but only minimally influences survival.
