The Radioiodine Treatment of Thyroid Cancer
A rare disease with a natural history of very long duration and a very high survival rate poses particularly difficult problems in terms of the appraisal of any modality of therapy. It is hardly surprising that in the treatment of thyroid cancer, enormously different results have been reported from many different competent centers. The rarity of the disease permits only the largest centers to accumulate sufficient patients to allow any type of statistical analysis. Even then, local medical situations bring patients to these centers at greatly varying stages and severity of disease, providing enormous preselection of patient populations and significant inherent bias. This ranges from centers that receive patients primarily with small newly discovered nodules to those that primarily see patients with large long standing and progressively growing neck masses. Pathologic classification too, differs from center to center and even from pathologist to pathologist, to say nothing of international differences. This inevitably influences the selection and classification of patients that constitute each published series.
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