Huang Cai-ping, Zhu Yong-xue, Tian Ao-long
Department of Head and Neck Surgery, Cancer Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Zhong Liu Za Zhi. 2003 Sep;25(5):490-2.
To study the optimum type of surgical treatment for thyroid medullary carcinoma.
From May 1960 to July 2000, 147 patients with thyroid medullary carcinoma were treated with surgical treatment. The results of tumorectomy, subtotal and total thyroidectomy were compared.
The overall 5-, 10- and 15-year survival rates were 85.4%, 77.4% and 73.1%. The recurrence rate was lowest in the total thyroidectomy group, medium in the subtotal group and highest in tumor extirpation group (P < 0.05). The overall cervical lymph node metastasis rate was 72.1%. The cervical occult nodal metastasis rate in clinically N0 patients was 42.1% (occult metastasis rates in central and lateral cervical regions were 24.6% and 36.8%). Thirteen patients with persistent postoperative hypercalcitoninemia were observed from 5 months to 6 years without tumor recurrence.
Total thyroidectomy is the optimal treatment for thyroid medullary carcinoma. Regardless of clinical N0 or N1, central and ipsilateral neck dissection should be considered. Patients with persistent postoperative hypercalcitoninemia should be observed closely.
研究甲状腺髓样癌的最佳手术治疗方式。
1960年5月至2000年7月，147例甲状腺髓样癌患者接受了手术治疗。比较了肿瘤切除术、甲状腺次全切除术和甲状腺全切除术的结果。
总体5年、10年和15年生存率分别为85.4%、77.4%和73.1%。甲状腺全切除术组的复发率最低，次全切除术组居中，肿瘤切除组最高（P<0.05）。颈部淋巴结总体转移率为72.1%。临床N0患者的颈部隐匿性淋巴结转移率为42.1%（中央和侧颈部区域的隐匿转移率分别为24.6%和36.8%）。观察到13例术后持续性降钙素血症患者，持续时间为5个月至6年，无肿瘤复发。
甲状腺全切除术是甲状腺髓样癌的最佳治疗方法。无论临床N0或N1，均应考虑行中央区和同侧颈部淋巴结清扫术。术后持续性降钙素血症患者应密切观察。
