Improved survival of patients with papillary thyroid cancer after surgical microdissection
Improved survival of patients with papillary thyroid cancer after surgical microdissection
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DOI：
10.1007/s002689900130
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发表时间：
1996-09-01
影响因子：
2.6
通讯作者：
Wingren, U
中科院分区：
文献类型：
--
作者：
Tisell, LE;Nilsson, B;Wingren, U
共有195名患者接受了甲状腺乳头状癌手术。平均手术年龄50岁。采用显微切割技术进行甲状腺全切除术和淋巴结清除术。术后放射性碘检查显示，77%的受检患者没有摄取或摄取接近本底放射性。通过计算手术切除的淋巴结，我们能够检查淋巴结清扫的质量，男性淋巴结转移的发生率（70%）高于女性（45%）。只有4%的患者进行了甲状腺残留的放射性碘消融。中位随访时间为13个档位。手术时年龄低于45岁的患者无一死于甲状腺癌。在老年组中，8名患者死于甲状腺癌，平均年龄为75岁。其中5名死于甲状腺癌的患者在诊断时有远处转移。在可切除疾病的患者中，3例（1.6%）死于甲状腺癌，所有患者术后均存活超过17年。因此，在我们知道最终的死亡率之前，需要更长的随访时间。结果表明，手术技术和策略可以积极影响甲状腺乳头状癌患者的生存。
A total of 195 patients had surgery for papillary thyroid cancer. The mean age at operation was 50 years. A microdissection technique was used for total thyroidectomy and lymph node clearance. Postoperative radioiodine tests showed no uptake or an uptake close to the background activity in 77% of the examined patients. By counting the lymph nodes removed at surgery we were able to check on the quality of the lymph node dissection, Men had a higher incidence (70%) of lymph node metastases than women (45%). Only 4% of the patients had radioiodine ablation of the thyroid remnant. The median follow-up time was 13 gears. None of the patients below 45 years of age at surgery died of thyroid cancer. In the older age group eight patients died of thyroid cancer at a mean age of 75 years. Five of those who died of a thyroid carcinoma had distant metastases at diagnosis. Among patients with resectable disease, three (1.6%) died of thyroid cancer, all of whom had lived for more than 17 years after surgery. Hence longer follow-up is needed before se know the final mortality in our series. The results suggest that surgical technique and strategy can positively influence the survival of patients with papillary thyroid cancer.