Graves' Disease Presenting Concurrently with Thyroid Cancer.
- Author:
Jandee LEE
1
;
Kee Hyun NAM
;
Chee Young LIM
;
Jong Ho YOON
;
Hang Seok CHANG
;
Woong Youn CHUNG
;
Cheong Soo PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. ysurg@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Graves' disease;
Thyroid cancer;
Prognostic factor;
Disease-free survival rate
- MeSH:
Diagnosis;
Disease-Free Survival;
Female;
Follow-Up Studies;
Graves Disease*;
Humans;
Lymph Nodes;
Male;
Prognosis;
Retrospective Studies;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy;
Ultrasonography
- From:Journal of the Korean Surgical Society
2005;69(5):374-380
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Graves' disease presenting concurrently with thyroid cancer is a rare condition. The clinical behaviors and the extent of surgery in this condition is still controversial. This study examined the prognostic factors influencing the long-term outcomes as well as the appropriate treatment modalities in patients with Graves' disease presenting concurrently with thyroid cancer. METHODS: Forty nine patients who underwent surgery for thyroid cancer with Graves' disease were enrolled in this study. The outcomes of various types of surgical treatments as well as the factors associated with the long-term outcome were retrospectively analyzed. RESULTS: There were 42 women and 7 men with a median age 39 years (15~70 years). The surgical procedures included a bilateral subtotal thyroidectomy (n=17), a bilateral total thyroidectomy (n=16), and a total and contralateral subtotal thyroidectomy (n=16). The mean follow-up period was 83 months (4~218 months) after surgery. Disease-free survival at 5 and 10 years were 97.6% and 88.9%, respectively. Univariate log-rank survival analyses revealed that the age at diagnosis, the size of the thyroid cancer, capsular invasion, multiplicity, lymph node involvement, and clinical cancer to be poor prognostic factors. However, the extent of the surgical treatment was not significant for survival. CONCLUSION: The prognosis is expected to be poor when thyroid cancer presenting concurrently with Graves' disease is clinically apparent or has invaded the thyroid capsule. Patients with Graves' disease should be screened with ultrasonography to detect thyroid cancer. A total thyroidectomy or completion total thyroidectomy is not necessary in patients who do not have any of the poor prognostic factors, such as incidentally detected microcarcinoma postoperatively.
