[Strategy for the surgical treatment of the well-differentiated thyroid carcinoma in our hospital].
Well differentiated thyroid carcinoma (WDTC) consists of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). Although both cancers are excellent prognosis, there are different in carcinogenesis by some genes, criteria of pathological diagnosis and transforming pattern between PTC and FTC. So the strategy for surgical treatment of them should be discussed separately. The patient with PTC less than 45 years old whose tumor is localized in a unilateral lobe without extra thyroidal invasion, lymph node metastasis and distant metastasis should be performed a unilateral lobectomy with central node dissection (D1). PTC patient over 45 years old except micro PTC case (T1a N0, M0) is recommended total thyroidectomy with modified radical neck dissection (D2 or D3). Encapsulated FTC is not necessary prophylactic lymph node dissection and only preformed unilateral lobectomy. If this patient has vascular invasion after lobectomy, completion thyroidectomy will be recommended for monitoring by serum Tg and whole body 123I scan.
Suzuki
Shinichi
S
Division of Endocrine Surgery, Department of Surgery 2, Fukushima Medical University School of Medicine.
Fukushima
Toshihiko
T
Takenoshita
Seiichi
S
D018263:Adenocarcinoma, Follicular / Q000601:surgery*; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy