[Retrospective analysis of the results of surgical treatment of 407 patients with differential thyroid gland cancer over a period of 23 years].
Over a period of 23 years (1980-2002) 407 cases of differential thyroid gland cancer were operated, monitored and analyzed at the Endocrine Surgery Clinic of Alexandrovska University Hospital. Of them 71.7% were monitored over a period of more than 10 years (up to 23 years), and 39.3% were monitored between 15 and 23 years. The youngest patient was 12 years old, and the oldest--78 years old. All patients were at a T(1-3) N(a-b) M0 stage. 308 (75.7%) patients had papillary carcinoma, and multi-centric localization was established in 3.9%, while capsular invasion and unilateral lymph-nodular metastases--in 6.2% of those patients. Follicular cancer was found in 24%, and vascular invasion--in 15.1%. 72.4% of the patients fall within the low-risk age groups (women under 50 years of age and men under 40). The treatment of 22.1% (90) of the patients comprised thyroidectomy with a follow-on 131J therapy. 77.9% (317) of the patients underwent radical thyroid gland resections of various size. Bilateral subtotal resections were applied most often--in 64.5% of all cases, and the rest of the patients underwent lobectomy with contra-lateral subtotal resection. The recurrence rate among the patients treated with radical resections is 6.1%, mainly within the high-risk age group. No correlation was established between the recurrence rate and the type of organ-saving surgery. In the group of patients treated with thyroidectomy and 131J, recurrences of the disease were established in 16.2%, again mainly within the high-risk age group. Remote metastases and mortality were established in 3% and 2.5% respectively. In conclusion, preference is given to organ-saving surgical treatment of differential thyroid gland cancer, and it is recommended that in the high-risk age groups the operations be of a broader scope.
Petkov
R
R
Mikhaĭlov
N
N
Todorov
G
G
Mladenovski
V
V
Kŭtev
N
N
Mal'ov
I
I
Goranov
N
N
D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002031:Bulgaria; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018265:Carcinoma, Papillary, Follicular / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013965:Thyroidectomy / Q000706:statistics & numerical data
D007457:Iodine Radioisotopes