Total thyroidectomy plus functional neck lymph node dissection for the treatment of papillary thyroid carcinoma
10.3760/cma.j.issn.1007-631X.2010.08.003
- VernacularTitle:全甲状腺切除加功能性颈淋巴结清扫治疗甲状腺乳头状癌172例
- Author:
Qingqing HE
;
Dayong ZHUANG
;
Luming ZHENG
;
Ziyi FAN
;
Yinggang SUN
;
Jinming ZHU
;
Yanning LI
;
Xueliang LI
;
Xihong FAN
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Thyroidectomy;
Neck dissection;
Parathyroid hormone
- From:
Chinese Journal of General Surgery
2010;25(8):611-615
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.
