Thyroid carcinoma, ten-years file
Authors:
J. Šafránek 1; V. Třeška 1; T. Skalický 1; V. Špidlen 1; J. Doležal 1; D. Kubačková 1; J. Zeithaml 1; M. Skála 1; P. Hošek 2
Authors‘ workplace:
Chirurgická klinika, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, přednosta: prof. MUDr. V. Třeška, DrSc.
1; Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, vedoucí manažer: doc. Ing. J. Hrabák, Ph. D.
2
Published in:
Rozhl. Chir., 2016, roč. 95, č. 11, s. 394-397.
Category:
Original articles
Overview
Introduction:
Even though thyroid carcinoma has, in general, a good prognosis and low mortality rate, its incidence, especially the incidence of early forms of the disease has been growing.
Method:
Retrospective analysis of the file of surgeries of documented thyroid carcinoma within the years of 2006–2015.
Results:
Thyroid carcinoma was recorded in 145 of 1820 patients operated for thyreopathy (8%); microcarcinoma (<10mm) was recorded in 64 cases (44.1%). The carcinoma was mostly detected accidentally during total thyroidectomy, which was in 70 cases (48.3%). The carcinoma was expected in 35 cases (24.1%) on the basis of prior puncture and total thyroidectomy was carried out straight away. Perioperative histology after hemithyroidectomy was requested in 31 cases (21.4%), and it was found positive only in 13 cases; thyroidectomy was finished in the second period in the other cases. Due to advanced carcinoma, tumour exploration/debulking was performed in 3 cases (2.1%) – for anaplastic carcinoma in all these cases. A permanent unilateral lesion – n. laryngeus recurrens – occurred in 3 cases (2.1%); a permanent bilateral lesion was recorded twice (1.4%).
The most frequently manifested carcinoma was the papillary carcinoma in 114 patients (78.6%; 83 women/31 men; age of 12−84 years; mean age of 50.6), the second most frequent carcinoma was the follicular carcinoma in 16 patients (11.0%; 15/1; 19−69; 55.3), followed by the medullary carcinoma in 10 patients (6.9%; 6/4; 25−76; 58.1). Anaplastic carcinoma was detected only in 4 cases (2.8%; 2/2; 64−87; 75.5), and lymphoma of the thyroid gland occurred twice as well as Hürtle cell carcinoma.
Conclusion:
Thyroid carcinoma is mostly found accidentally during surgery in the early phase of the disease. This proves the high quality of endocrinology care and the correctness of the tendency to indicate early surgical treatment of thyroidal pathology.
Key words:
thyroid carcinoma – thyroidectomy − complications
Sources
1. Staniforth JUL, Erdirimanne S, Eslick GD. Thyroid carcinoma in Graves’ disease: A meta-analysis. International Journal of Surgery 2016;27:118−25.
2. Jin J, Wilhelm SM, McHenry CR. Incidental thyroid nodule: patterns of diagnosis and rate of malignancy. The American Journal of Surgery 2009;197:320−4.
3. Bavor P, Neumann J, Smutný S, et al. Anaplastický karcinom štítné žlázy. Rozhl Chir 2012;91:550−3.
4. Choi H, Kasaian K, Melck A, et al. Papillary thyroid carcinoma: prognostic significance of cancer presentation. The American Journal of Surgery 2015;210:298−301.
5. McConahey WM, Hay ID, Woolner LB, et al. Papillary thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin 1986;61:978−96.
6. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2006;16:109−42.
7. Vlček P, Nováková D, Vejvalka J, et al. Návrh optimálního léčebného postupu v léčbě nízkorizikového karcinomu štítné žlázy. Vnitř Lék 2015;61:769−77.
8. Polistena A, Monacelli M, Lucchini R, et al. Thyroid anaplastic carcinoma: the impact of multi modality treatment on survival. the experience of a referral centre for endocrine surgery, Minerva Chir 2014;69:261−9.
9. Conzo G, Avenia N, Bellastella G, et al. The role of surgery in the current management of differentiated thyroid cancer. Endocrine 2014;47:380−8.
10. Conzo G, Calo PG, Sinisi AA, et al. Impact of prophylactic central compartment neck dissection on locoregional recurrence of differentiated thyroid cancer in clinically node-negative patients: A retrospective study of a large clinical series. Surgery 2014;155:998−1005.
11. Dvořák J. Chirurgická anatomie a technika operací štítné žlázy. Praha 1995;168−70.
12. Lundgren CI, Hall P, Dickman PW, et al. Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case-control study. Cancer 2006;106:524−31.
13. Dudešek B, Gatěk J, Duben J, et al. Lymfadenektomie u papilárního karcinomu štítné žlázy. Rozhl Chir 2010;89:443−7.
14. Beasley NJP, Lee J, Eski S, et al. Impact of nodal metastases on prognosis in patients with well-differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 2002;128:825−28.
15. Wada N, Suganuma N, Nakayama H, et al. Microscopic regional lymph node status in papillary thyroid carcinoma with and without lymphadenopathy and its relation to outcomes. Langenbeck‘s Arch. Surg 2007; 392:417−22.
16. Hughes CJ, Shaha AR, Shah JP, et al. Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched-pair analysis, Head Neck 1996;18:127−32.
17. Carling T, Carty SE, Ciarleglio MM, et al. American Thyroid Association design and feasibility of a prospective randomized controlled trial of prophylactic central lymph node dissection for papillary thyroid carcinoma. Thyroid 2012;22:237−44.
18. Polistena A, Monacelli M, Lucchini R, et al. Surgical morbidity of cervical lymphadenectomy for thyroid cancer. A retrospective cohort study over 25 years. International Journal of Surgery 2015;21:128−134.
19. Palazzo FF, Gosnell J, Savio R, et al. Lymphadenectomy for papillary thyroid cancer: Changes in practice over four decades EJSO 2006;32:340–4.
20. Bishop JA. Pitfalls in the surgical pathologic diagnosis of papillary thyroid carcinoma. Diagnostic Histopathology 2016;22:191−8.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2016 Issue 11
Most read in this issue
- An uncommon case of purulent mesenteric lymphadenitis
- Rare malignant tumors of the appendix: surgical treatment of liver metastases − case reports
- Total glenoid fractures
- Transplantation of allogeneic bone graft in the therapy of massive post-sternotomy defects – 6 years of experience with the method