[Surgical treatment of differentiated thyroid carcinoma and analysis of recurrence-related factors]

Abstract

Background & objective: There are many controversies concerning the treatment to patients with differentiated thyroid carcinoma (DTC), focus on appropriate resection extent of DTC, indications for cervical lymph node dissection, et al. This study was to investigate surgical treatment for DTC, and recurrence-related factors.

Methods: Records of 581 patients with DTC treated at Cancer Center, Sun Yat-sen University from Jan. 1st, 1985 to Dec. 31st, 1997 were reviewed retrospectively. Various operation patterns for DTC and their treatment effects, and recurrence-related factors were analyzed.

Results: Among 377 patients with DTC who received initial surgery at our hospital, and whose main operation patterns were unilateral lobectomy plus isthmectomy with or without cervical lymph node dissection, 28 (7.43%) recurred, the rate of recurrence in contralateral lobe was 0.80%. Among 195 patients with DTC who received initial surgery in other hospitals, and whose main operation patterns were local mass excision with or without cervical lymph node resection, 143 patients received operation again in our hospital, and 100 of 143 (69.93%) were pathologic positive, positive rate of thyroid was 46.15%, that of cervical lymph node was 48.95%; 47 of 195 patients (24.10%) recurred. Recurrence rate of patients mainly received local mass excision with or without cervical lymph node resection was higher than that of patients mainly received unilateral lobectomy plus isthmectomy with or without cervical lymph node dissection (P >0.05).

Conclusions: Unilateral lobectomy plus isthmectomy with or without cervical lymph node dissection should be recommended as the first treatment for DTC with primary focus localized in unilateral lobe. The initial operation pattern may influence recurrence of DTC.