THE SURGICAL management of thyroid carcinoma remains controversial. Operation is necessary to establish the diagnosis and operation provides more effective treatment than any other modality. However, surgeons are not agreed as to how much thyroid should be removed, or whether to perform neck dissection. This controversy can be resolved only by the long-term follow-up of patients, since their survival provides the only good criterion of surgical success. Therefore, we analyzed our entire hospital's experience with thyroid cancer in the hope of learning the important factors affecting survival. Materials and Methods This study is based on the 130 cases of primary thyroid carcinoma seen from 1946 to 1966 in the Western Pennsylvania Hospital, Pittsburgh. Excluded from this study were four cases of metastatic carcinomas to the thyroid gland coming from the colon, lung, larynx, and stomach. All of the cases had histologically-proven