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Abstract
Background  A number of reports have been published concerning the surgical treatment of substernal goiters; however, there is yet to
be a comprehensive review of this body of literature using evidence-based methodology.

Methods  This article is a systematic review of the literature using evidence-based criteria and a review of unpublished data from
our institution.

Results  Issue 1. Limited level III/IV data suggest that the incidence of cancer in substernal goiters is not higher than the incidence

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