C lin ica l research on 2228 ca ses of thyro id gland tum ors WANG J ia2dong, D ENG X ing2cheng, J IN

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1 Chin J O torhinolaryngol Head Neck Surg, Ap ril 2005, Vol 40, No , (2072, 156) 2072,4, 011%, 011% ; 55, 216% 156, 8, 3,5 9515% ( 64 /67), Kap lan2meier59810%60 1, % 156 1, 016%,, ; ; ; ; C lin ica l research on 2228 ca ses of thyro id gland tum orswang J ia2dong, D ENG X ing2cheng, J IN X iao2jie, ZHOU Chuan, ZHANG Chun, X IE M ing, ZHOU J ia2qing, Q IAN M in2fei1 D epartm ent of O torhinolaryngology Head and N eck Surgery, A ffiliated Renji Hospital, Shanghai Second U niversity, Shanghai , China Corresponding author: WANG J ia2dong, Em ail: online1sh1cn AbstractO bjectiveto discuss outcome of thyroid tumor patients treated with surgery1 M ethods Total number of patients was 22281These patients of thyroid tumors from ( 2072 cases of benign thyroid diseases and 156 cases of thyroid carcinoma) were recruited1 The clinical and follow2up datum were retrospective analyzed1 Results( 1) Benign thyroid tumors with near2total thyroidectomy including 1761 thyroid adenoma, 207 nodular goiter and 104 Hashimotos thyroiditis, the incidence of recurrent laryngeal nerve paralysis was 012%, 55 cases ( 216% ) received secondary surgery 1A ll the patients have no hypocalcem ia or hemorrhage after operation1 ( 2) Eighty2one cases of pap illary carcinoma of the thyroid ( > 1 cm) and 60 cases of m icrocarcinoma1 Unilateral thyroidectomy, contralateral near2total thyroidectomy and ip silateral modified neck dissection were performed in unilateral pap illary carcinoma of thyroid1 Among the 9 cases of follicular carcinoma of thyroid, 7 were performed of near2total thyroidectomy without neck dissection, others were the same as pap illary carcinoma 1 B ilateral total thyroidectomy and bilateral modified neck dissection were performed in 2 cases of the medullary thyroid cancer and 1 case of the undifferentiated thyroid cancer1 By direct method the 52year survival was 9515% ( 64 /67), and by Kap lan2meier method, it was 9810% 1The treatment of m icrocarcinoma are multip le1 There is no relap se or metastases in 60 cases of pap illary thyroid m icrocarcinoma1 The 52year survival was 10010%, 1 cases occurred recurrent laryngeal nerve paralysis in thyroid cancer1 No hypocalcem ia or hemorrhage1 Eight case relap sed in 156 cases of thyroid carcinoma, 3 cases died1 ConclusionThe correct surgical management for the patients with thyroid tumor should benefit for the p rognosis and reduce the comp lications and the recurrence of the operation1 Key wordsthyroid neop lasm s; Thyroidectomy; Radical neck dissection; Survival rate; Intraoperative comp lications 2, 2 : :, jiadongw@online1sh1cn,,

2 Chin J O torhinolaryngol Head Neck Surg, Ap ril 2005, Vol 40, No ,, 14 5 (1,2,1, 1 ), 2072, 9310%,1601,471 ; 12 87, 4915 (1761 ), 8510%, (207),1010%, ( 104 ) 510%150, 2,,40 mg, , 710%,, > 1 cm 81,( 1 cm ) 60; 9; 3;2 ; 1 131, 25; 12 79, TNM(U ICC, 1997) : 97, 55, 1, 1; ( cn0)152 2, 1 cm + +(79) ; +(3), 97, cm, 2 1 : 28+ +; 13 ;3 4, 911% 16, , 2516%, 8, 4, 4 3, 7 /8 11 (3), (8),,, 5060 Gy(56) 40 mg,,t3 T4 TSH, 012% (4), 2, 3 ; 2,, 13,,,, 5 742, 51330, 55 (216% ), 40, 15, 320, , 13, 35, 57, 1 cm 150 1, 016%,

3 Chin J O torhinolaryngol Head Neck Surg, Ap ril 2005, Vol 40, No % ( ), 3 44, , : 5 2 ( T2N0M0), 1 ( T3N0M0) ; 54 ( T1N0M0), 1( T1N0M0), ( T1N0M0), % (111 /112), % (64 /67) 11 2 Kap lan2meier % 60 1, 5 100%, , 5 5, 1 10,, 9310% , [ 1 ],,, 011%, 011%,,, [ 2, 3 ],,11,216% [ 4 ],,, 150, 2,, , 710% 1, 016%,, 7, 1, Chao [ 5 ] 61Graves, 58, 1, 1, 10 mm, 61,1, [ 6 ] (90% ) (52% ) (45% ) cn + [ 7 ],cn0 [ 8 ] 1173 (N0 ),,6518% cN , 2516%, 1219%,> 1 cm > 1 cm(n0 ),,, Shaha [ 9 ] 3,, ; Kim [ 10 ], (22) (38) 20 ( 7214%3012% ) ;,,

4 Chin J O torhinolaryngol Head Neck Surg, Ap ril 2005, Vol 40, No1 4,,, 156 4,5,, [ 11 ], 7 /8,, 1 /3, [ 12 ],, , 2414% [ 13 ] % (4 /44, [ 13 ] ),1, [ 14 ] 139( cn0) (),,cn0 83% (73 /88), 76% (67 /88), 17% (17 /98), cn0, ( ), 13, 17,,,,,,, 10,,,, %,,,,,, :, Benzarti S, M iled I, Bassoumi T, et al1 Thyroid surgery ( 356 cases) : risks and complications1 Rev Laryngol O tol Rhinol (Bord), 2002, 123: Acun Z, Comert M, Cihan A, et al1near2total thyroidectomy could be the best treatment for thyroid disease in endem ic regions1 A rch Surg, 2004, 139: B ron LP, O B rien CJ1 Total thyroidectomy for clinically benign disease of the thyroid gland1 B r J Surg, 2004, 91: Chao TC, L in JD, Chen MF1 Surgical treatment of thyroid cancers with concurrent Graves disease1 Ann Surg Oncol, 2004, 11: Frankenthaler RA, Sellin RV, Canglr A, et al1 Lymph node metastasis from pap illary follicular thyroid carcinoma in young patients1 Am J Surg, 1990, 160: , 1N0 1, 2001, 36: , , 2003, 11: Shaha AR1 Imp lications of p rognostic factors and risk group s in the management of differentiated thyroid cancer1 Laryngoscope, 2004, 114: Kim S, W ei JP, B raveman JM, et al1 Predicting outcome and directing therapy for pap illary thyroid carcinoma1 A rch Surg, 2004, 139: L in JD, H sieh SH, Chang HY, et al1 Outcome after treatment for pap illary thyroid cancer1 Head Neck, 2001, 23: L in KD, L in JD, Huang HS, et al1 Skull metastasis with brain

5 Chin J O torhinolaryngol Head Neck Surg, Ap ril 2005, Vol 40, No invasion from thyroid papillary m icrocarcino1 J Formos Med A ssoc, 1997, 96: ,,, 1 451, 2001, 15: ,,,1 1, 2004, 42: ( : ) ( : ), 32,10,,, :,0101,,,,,, 1CTMR I : CT 210 cm 116 cm,,,, (1) ;MR I,;, : CT :,,,,,,,,, 5 018, :, caorongp@1631com,, 2 CT,,, 1014% 1817% CTMR I 5: [ 1 ],,,,,,,,,,, [ 2 ],,,,,,,,,,,,,,,, 1,,, 1 1, 2002, 18: , 1994, 29: ( : ) ( :)