[Choice of appropriate surgical treatment of thyroid cancer: review of 2,244 malignant thyroid tumors].
The aim of this study was to determine the appropriate surgical treatment of thyroid cancer. Follow-up results of 2,244 patients with malignant thyroid tumors were analyzed. As factors affecting the prognosis of thyroid cancer, histological type, sex, age, size of the primary tumors, extention of the primary tumor and the incidence of metastasis in excised lymphnodes were analyzed. Eight hundred and twenty-eight patients with papillary cancer were divided into 3 groups according to the combinations of the factors. Low-risk group (L group): Male under 30 years of age or female under 50 years of age, primary tumor less than 20 mm in maximum diameter, confined to one lobe and metastasis to the cervical lymphnodes less than 40%. High-risk group (H group): Male over 30 years of age or female over TP years of age, tumor more than 30 mm, primary lesion extended beyond isthmus and 40% or more metastasis to lymph nodes. Intermediate-ris group (I group): Other than the L and H groups. From the results of studies in each group on recurrence sites and recurrence rates, it was suggested that appropriate surgical treatment for L group was partial thyroidectomy or total lobectomy with local neck dissection, that for I group was total lobectomy with ipsilateral modified radical neck dissection and that for H group was subtotal thyroidectomy with bilateral modified radical neck dissections.
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012737:Sex Factors; D013964:Thyroid Neoplasms / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy