Retrospective analysis of 78 cases with differentiated thyroid carcinoma / 中国综合临床

ABSTRACT

Objective To investigate the differentiated thyroid carcinoma diagnosis and treatment options. Methods From Feb. 2002 to Jan. 2008,78 patients received different surgical resection regarding the type of tumor size,number of tumor,ages and jugular lymphatic metastasis. Patients with unilateral differentiated thyroid carcinoma underwent the resection of ipsilateral isthmus of thyroid lobe or plus partial contralateral gland,and those with bilateral-lobe underwent total thyroidectomy or near-total thyroidectomy. High-risk patients (age >45 years,tumor size >4 cm,tumor size ≤4 cm,but surpass the envelop of thyroid) were performed by functional neck dissection or lymph node dissection of central region (Ⅵ area) besides postoperative endocrine therapy. Results Eleven cases underwent the resection of ipsilateral lobe with isthmus, 19 cases underwent surgical removal of ipsilateral lobe with isthmus plus partial contralateral gland,26 cases underwent near-total thyroidectomy and 22 total thyroidectomy. 25 cases underwent functional neck dissection, 23 cases underwent neck dissection of central region. There were 68 papillary thyroid carcinoma (87. 18%), 10 follicular thyroid carcinoma (12. 82%). There were 26 cases with lymphatic metastasis of Ⅵ area. Postoperative complications included 12 cases (15.38%) with deadlimb caused by hypocalcemia, 8 cases (10.26%) with transient recurrent nerve paralysis,2 cases (2.56%) with permanent injury of recurrent laryngeal nerves, 3 cases (3. 58%) with chylous fistula. Seventy-four(94. 87%) cases were followed up postoperatively for a period from 6 months to 6 years,which showed that no death occurred,but 6 relapsed with jugular lymphatic metastasis,after reoperation no distant metastasis occurred. Survival rate was 97. 30% (72/74). Conclusion Treatment of the differentiated thyroid carcinoma should be based on the size of tumor,number of tumor,age and jugular lymphatic metastasis. Lymph node dissection of central region was necessary for high-risk patients of differentiated thyroid carcinoma.