Park C S, Suh K W, Min J S
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Head Neck. 1993 Jul-Aug;15(4):289-91. doi: 10.1002/hed.2880150403.
This study was carried out to ascertain whether the cartilage-shaving procedure is appropriate to control thyroid carcinoma with tracheal cartilage invasion. Of 432 thyroid carcinoma patients treated between 1979 and 1988, 16 had tracheal cartilage invasion only. This patient population was made up of 3 men and 13 women, with a mean age of 55.8 years. Fourteen were diagnosed histologically as having papillary carcinoma and the remaining two as having follicular carcinoma. Cartilage shaving was the primary treatment in all the patients, and subsequent radioactive iodine (131I) or external-beam radiotherapy was administered to control any possible residual disease. Lifelong thyroid hormone replacement was instituted in all patients, and the follow-up period averaged 70.7 months. Only four of the 16 patients remained disease free; the disease was not controlled in the other 12, and seven of this latter group eventually died of their disease. We feel that a more extensive resection procedure than cartilage shaving should be considered, even in patients with superficial tracheal invasion, to increase the disease-free survival rate.
本研究旨在确定软骨刮除术是否适用于控制侵犯气管软骨的甲状腺癌。在1979年至1988年间接受治疗的432例甲状腺癌患者中，16例仅侵犯气管软骨。该患者群体由3名男性和13名女性组成，平均年龄为55.8岁。14例经组织学诊断为乳头状癌，其余2例为滤泡状癌。软骨刮除术是所有患者的主要治疗方法，随后给予放射性碘（131I）或外照射放疗以控制任何可能的残留病灶。所有患者均开始终身甲状腺激素替代治疗，随访期平均为70.7个月。16例患者中只有4例无疾病复发；其他12例疾病未得到控制，其中7例最终死于该疾病。我们认为，即使对于气管浅层侵犯的患者，也应考虑采用比软骨刮除术更广泛的切除手术，以提高无病生存率。
