Prognostic factors and surgical treatment strategy of occult cancer in the contralateral side of the unilateral papillary thyroid carcinoma
10.16571/j.cnki.1008-8199.2017.06.018
- VernacularTitle:单侧甲状腺微小乳头状癌对侧腺体隐匿癌灶的预测因素及手术治疗策略
- Author:
Tongchang LI
;
Biao WANG
;
Xiuqing DUAN
- Keywords:
Papillary thyroid microcarcinoma;
Occult cancer;
Predictive factors
- From:
Journal of Medical Postgraduates
2017;30(6):641-644
- CountryChina
- Language:Chinese
-
Abstract:
Objective Previously, there was an argument on the surgery way of unilateral papillary thyroid microcarcinoma(PTMC).The purpose of this study was to investigate the predictive factors of occult thyroid carcinoma in unilateral thyroid papillary microcarcinoma, and to compare the surgical methods of unilateral thyroid papillary microcarcinoma.Methods We retrospective analyzed 327 cases of unilateral PTMC patients confirmed by preoperative color Doppler ultrasound examination from January 2014 to January 2016 in Department of Breast Surgery, First Affiliated Hospital of Harbin Medical University.According to the presence of occult cancer, patients were divided into unilateral glandular foci (n=278) and bilateral glandular foci(n=49);according to whether carry out the prevention of central lymph node dissection, patients were divided into lymph node dissection(n=117) and without lymph node dissection(n=210) to further analyze the predictive factors of contralateral gland occult cancer and postoperative complications of preventive central lymph node dissection.Results 55 cases had central lymph node metastasis in 117 cases with lymph node dissection, the metastasis rate was 47.0%.The multiple foci in the ipsilateral gland is a risk factor for the presence of occult foci in the contralateral gland (OR=4.924, 95%CI: 1.605~15.107).There was no significant difference in postoperative complications between lymph node dissection and without lymph node dissection(P>0.05).Conclusion multiple foci in the unilateral thyroid papillary thyroid microcarcinoma can help us to predict the contralateral gland occult cancer, and the central lymph node metastasis rate is higher, therefore, for the unilateral glands of multiple tumors in the papillary thyroid microcarcinoma, we recommended the total thyroidectomy+prophylactic central lymph node dissection surgery way.
