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Objective: To evaluate the surgical approaches and prognosis of thyroid carcinomas invading the adjacent structures. Methods:The medical records of 197 patients with a pathology diagnosis of thyroid cancer were retrospectively reviewed.Results: 17 patients (9%) with thyroid carcinoma invading surrounding structures were included. Patients were initially divided into 2 groups on the basis of tumor histology: papillary (Group A) and nonpapillary (Group B). Then patients were divided into 3 groups: Group 1: patients who underwent total thyroidectomy. Group 2: patients who underwent total thyroidectomy with shaving resection. Group 3: patients who underwent total thyroidectomy with extensive surgery. All patients who didn't survive were more than 45-year-old. The survival rate was better in group A compared to group B (92% versus 20%). The survival rate increased from Group 1 through Group 3. Conclusion:Age and histologic type are important in determining the prognosis of locally invading thyroid cancer.