유두 갑상선 미세암의 수술적 치료

• 영문명: The Surgical Management of Papillary Thyroid Microcarcinoma
• 발행기관: 대한내분비외과학회
• 저자명: 임라주 이숙현 윤찬석 고승상 허민희 강성수 이해경 Ra Joo Lim M.D. Sook Hyun Lee M.D. Chan Seok Yoon M.D. Ph.D. Seung Sang Ko M.D. Ph.D. Min Hee Hur M.D. Ph.D. Sung Soo Kang M.D. Ph.D. and Hae Kyung Lee M.D. Ph.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』9권2호, 74~78쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2009.06.30

영문 초록

Purpose: There has been a rapid rise in the incidence of thyroid cancer, particularly papillary thyroid microcarcinoma (PTMC). However, there is a lack of consensus of treatment guidelines or follow-up strategies. Methods: A retrospective analysis of 606 patients who underwent operation due to thyroid cancer from March 2000 to December 2008 was conducted. Of these patients, 587 with pure papillary carcinomas were studied, of whom 392 (67%) presented with PTMC. Results: Only 23% of patients were symptomatic, but 75% of patients were positive using the imaging techniques ultrasonography or positron emission tomography. When the microcarcinoma patient group (G1) was compared with the group of remaining patients (G2), less aggressive operations were chosen for G1. A lobectomy was performed in 63.8% of G1 versus in 14% of G2, and the central compartment neck dissection was omitted in 30% of G1 versus 16% of G2. During the follow-up period (mean 37.9±25.2 months), there were 11 recurrences. Two patients developed contralateral cancers 42 and 49 months after lobectomy. One patient had recurrences on central compartment lymph nodes 34 months post-operatively. Eight patients had lateral neck lymph nodes metastases 13∼52 months post- operatively. Three of these eight patients had concomitant central neck lymph node metastases. Conclusion: Less aggressive treatments can be chosen for PTMC patients compared to non-PTMC patients. To clarify these results, longer follow up and larger and multi-institutional data are needed. (Korean J Endocrine Surg 2009; 9:74-78)

키워드

갑상선암, 유두 갑상선 미세암, 최소침습적 수술,Thyroid cancer, Papillary thyroid microcarcinoma, Less aggressive operation