Searching of Rational Volume Surgery in Cases of Locally-Invasive Differentiation Thyroid Cancer
Romanchishen AF*, Bagaturia GO and Tovbina MH
Department of Hospital Surgery of Saint-Petersburg State Pediatric Medical Academy, Saint-Petersburg Center of Endocrine Surgery and Oncology, Russia
- corresponding Author:
- Romanchishen AF
Professor, Department of Hospital Surgery of Saint-Petersburg State Pediatric Medical Academy
Saint-Petersburg Center of Endocrine Surgery and Oncology, Russia
Tel: +7 921 9621527
E-mail: [email protected]
Received Date: November 23, 2011; Accepted Date: December 20, 2011; Published Date: December 23, 2011
Citation: Romanchishen AF, Bagaturia GO, Tovbina MH (2012) Searching of Rational Volume Surgery in Cases of Locally-Invasive Differentiation Thyroid Cancer. Endocrinol Metabol Syndrome 1:101. doi: 10.4172/2161-1017.1000101
Copyright: © 2012 Romanchishen AF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Surgical intervention is the preferred method for eradicating invasive thyroid carcinoma (TC), but the extent of resection is still controversial.
Materials and Methods: A total of 2593 patients were operated on for differentiate TC between 1973 and 2007. Wide extrathyroid TC spread (T4) was fined in 464 (21.9%) cases of 2115 included in that research. We performed 256 combined thyroid and adjacent organ resections, 246 extended neck and mediastinum lymphadenectomy, 146 palliative operations. Transsternal approach have used during 31 operations. Totally were carried out 581 such operation at 441 patients. There were 19.2% males, 80.8% females (1:4.2). Average age made 57.7. Papillary TC was found in 62.9%, follicular - in 24.8% and medullar - in 12.3%. TC extension on muscles of neck and larynx (73.8%), RLN (37.9%), trachea (35.2%), pharynx and esophagus (23.8%), main neck or meditational vessels (21.9%) were
Results: Seven patients died after 435 operations. No lethal outcomes happened of 97 patients operated on into two stages. Unexpected RLN palsy, temporary HPT observed at 6.2%. Follow up results (median 9.6+0.9) were investigated in 84.9%. The 5-year survival rate made 81.9% and 10-year – 71.1% after combined and 86.7% and 70.6% - after extended operations. The local failure rate after organs paring “shaving” and “wedge” aero digestive organ resections were not significantly worse than after of those circular resections (9.8% and 3.7%). But quality of life, 5 and 10 years survival rates after organ-sparing were much better (80.5% and 35.7% compared to 76.0% and 7.1%). 5-year follow-up results after palliative operations made 40.7% in papillary and follicular TC cases and 17.1%
- in medullary carcinoma. 29.1% of differentiated TC patients were alive after palliative operations, adjuvant therapies during 10 and more years.
Conclusion: “Shave” excision, “wedge” resection procedures in cases of TC aerodigestive organ invasions have produced better results than “sleeve” resection for recovery and improving of patient’s quality life.