Deshmukh Anuja, Gangiti Kranthikumar, Pantvaidya Gouri, Nair Deepa, Basu Sandip, Chaukar Devendra, Pai Prathamesh, Nair Sudhir, Hawaldar Rohini, Dusane Rohit, Chaturvedi Pankaj, D'Cruz Anil
Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Nuclear Medicine, Radiation Medicine Centre, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India.
Indian J Cancer. 2018 Jan-Mar;55(1):23-32. doi: 10.4103/ijc.IJC_528_17.
Surgery is the mainstay in the management of thyroid cancer. Surgical outcomes need to be tempered against the excellent prognosis of the disease.
This study aims to study the surgical outcomes including the 30-day morbidity and 5-year survival of thyroid cancer patients.
Retrospective analysis of a prospectively maintained surgical database in a tertiary cancer center in India.
We analyzed 221 surgically treated patients in the year 2012.
Used IBM SPSS 24.0 (Armonk, NY) with p < 0.05.
The median age was 40 years with predominantly papillary thyroid carcinoma (55%). Localized disease in 47% of cases, locoregional disease in 42.5% and distant metastasis in 10.2% of cases at presentation was noted. Treatment naïve patients were 71% and revision surgeries were done in 29% patients. Extended thyroidectomy constituted 11% of the surgeries. Temporary hypocalcemia was seen in 30.8% of patients, 5% requiring intravenous calcium supplementation. Vocal cord palsy as per nerve at risk and chyle leak were seen in 4.5% and 3.1%, respectively. Aggressive histology, extended thyroidectomy, and inadvertent parathyroidectomy were significant factors associated with complications. Five year estimated overall survival with median follow-up of 50 months was 98%, and event-free survival was 84.8%. Advanced age, distant metastasis at presentation and aggressive histology connoted poor outcomes.
Thyroid cancer, irrespective of the extent of disease, has good prognosis. Aggressive histology, the extent of thyroid surgery, distant metastasis and age are important factors, which should be factored in the algorithm of thyroid cancer management.
手术是甲状腺癌治疗的主要手段。手术结果需结合该疾病良好的预后情况综合考量。
本研究旨在探讨甲状腺癌患者的手术结果，包括30天发病率和5年生存率。
对印度一家三级癌症中心前瞻性维护的手术数据库进行回顾性分析。
我们分析了2012年接受手术治疗的221例患者。
使用IBM SPSS 24.0（纽约州阿蒙克），p < 0.05。
中位年龄为40岁，以乳头状甲状腺癌为主（55%）。初诊时47%的病例为局限性疾病，42.5%为局部区域疾病，10.2%为远处转移。未经治疗的患者占71%，29%的患者接受了再次手术。扩大甲状腺切除术占手术的11%。30.8%的患者出现暂时性低钙血症，5%的患者需要静脉补钙。根据有风险的神经计算，声带麻痹和乳糜漏的发生率分别为4.5%和3.1%。侵袭性组织学、扩大甲状腺切除术和意外甲状旁腺切除术是与并发症相关的重要因素。中位随访50个月，5年估计总生存率为98%，无事件生存率为84.8%。高龄、初诊时远处转移和侵袭性组织学提示预后不良。
无论疾病范围如何，甲状腺癌预后良好。侵袭性组织学、甲状腺手术范围、远处转移和年龄是甲状腺癌治疗方案中应考虑的重要因素。
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