소아 분화 갑상선암의 15년 이상의 추적 관찰

• 영문명: Fifteen Years or Greater Follow-Up of Pediatric Differentiated Thyroid Cancer
• 발행기관: 대한내분비외과학회
• 저자명: 김아람 성치원 박영삼 김철승 김갑태 A Ram Kim M.D. Chi Won Sung M.D. Young Sam Park M.D. Cheol Seung Kim M.D. Ph.D. and Kab Tae Kim M.D. Ph.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』10권1호, 34~38쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2010.03.30

영문 초록

Purpose: Thyroid cancer is rare in childhood. Although thyroid cancer is biologically more aggressive in children because of the high incidence of lymph node metastasis and distant metastasis when compared with that of adults, the prognosis is better. This study investigated the prognosis of pediatric differentiated thyroid cancer with 15 years or greater follow-up and we consider the proper treatment of pediatric differentiated thyroid cancer. Methods: From January, 1979 to December, 1994 during 16 years, 17 patients younger than 17 years old and who underwent thyroid surgery for well differentiated thyroid cancer at the Department of Surgery at Presbyterian Medical Center were retrospectively reviewed by the medical records and they were interviewed by telephone. Results: Total thyroidectomy was performed in 4 patients (23.5%), subtotal thyroidectomy was performed in 10 patients (58.8%) and lobectomy was performed in 3 patients (17.7%). The mean follow-up period was 23.5 years (range: 15∼28.2 years) and recurrence was found in 7 cases (41.3%). Five cases (29.5%) showed locoregional recurrence and 2 cases (11.8%) showed distant metastasis. Postoperative radioiodine (¹³¹I) therapy was done in 6 cases (35%) and 6 cases (35%) underwent radioiodine therapy as a therapeutic modality for metastasis. Conclusion: The pediatric well differentiated thyroid cancer in this study showed high rates of lymph node metastasis at the time of diagnosis and a high recurrence rate, but the prognosis was good (100% overall survival rate during the follow-up period). Therefore, total thyroidectomy, radical lymph node dissection and postoperative radioiodine therapy are considered the initial patient management. This aggressive therapeutic management can decrease of the recurrence rate and increase the therapeutic effect. A radioiodine scan and thyroglobulin can used for follow-up. (Korean J Endocrine Surg 2010;10:34-38)

키워드

소아 분화 갑상선암, 갑상선 전절제술과 림프절 곽청술, 방사선 요오드 치료,Pediatric differentiated thyroid cancer, Total thyroidectomy and radical lymph node dissection, Radioiodine therapy