van der Sluis R F, Wobbes T
Eur J Surg Oncol. 1985 Dec;11(4):343-6.
A review of 46 patients with differentiated thyroid cancer, diagnosed and treated in the St. Radboud Hospital from 1977 till 1984, is presented. The age of the patients ranged from 16 to 80 years. There were 39 women and 7 men. Thirty of 31 patients with papillary carcinoma and 13 of 15 patients with follicular carcinoma underwent total thyroidectomy. If less than total thyroidectomy had been performed, 13 (43%) patients with papillary cancer and 2 (15%) with follicular cancer would have had cancer left in the residual lobe. The complication rate was acceptable, two cases of permanent hypoparathyroidism, one recurrent nerve palsy. During a short follow-up period of 7 years maximum already 6 patients older than 60 years with papillary carcinoma had died, 5 of widespread cancer (16.6%) and one of an unrelated disease. Three patients developed local recurrences, on in the trachea and 2 outside the thyroid bed. One patient with follicular carcinoma, who had undergone a lobectomy, developed recurrent disease. These figures plus the increased risk of complications in a second neck exploration suggest that total thyroidectomy is the treatment of choice for patients with differentiated thyroid cancer. Total thyroidectomy can be done without mortality and without significant morbidity.
本文回顾了1977年至1984年在圣拉德布德医院诊断和治疗的46例分化型甲状腺癌患者。患者年龄在16岁至80岁之间。其中女性39例，男性7例。31例乳头状癌患者中的30例和15例滤泡状癌患者中的13例接受了甲状腺全切除术。如果未进行甲状腺全切除术，13例（43%）乳头状癌患者和2例（15%）滤泡状癌患者的残留叶中会残留癌症。并发症发生率可以接受，2例永久性甲状旁腺功能减退，1例喉返神经麻痹。在最长7年的短期随访期内，已有6例60岁以上的乳头状癌患者死亡，5例死于广泛转移癌（16.6%），1例死于无关疾病。3例出现局部复发，1例发生在气管，2例发生在甲状腺床外。1例接受叶切除术的滤泡状癌患者出现复发疾病。这些数据加上二次颈部探查中并发症风险的增加表明，甲状腺全切除术是分化型甲状腺癌患者的首选治疗方法。甲状腺全切除术可以在无死亡率和无明显并发症的情况下进行。
