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[全甲状腺切除术及淋巴结切除术作为儿童分化型甲状腺癌的治疗方法是否合理?]

[Is total thyroidectomy and lymph node excision as therapy of differentiated thyroid gland carcinomas in childhood justified?].

作者信息

Witte J, Goretzki P E, Simon D, Röher H D

机构信息

Klinik für Allgemeine und Unfallchirurgie, Heinrich-Heine-Universität Düsseldorf.

出版信息

Langenbecks Arch Chir Suppl Kongressbd. 1996;113:196-8.

PMID:9101829
Abstract

The extent of radical resection of differentiated thyroid carcinomas in children (< 18 years) is discussed controversially because of good prognosis, on the one hand, but a high rate of lymph node metastases, greater tumor size, lung metastases and tumor recurrences on the other. Because of our data we advocate thyroidectomy, cervical lymph node dissection and postoperative 131J-therapy as the treatment of choice in patients with manifest disease in order of further detection and/or treatment of lung metastases. Limited radicality (i.e. hemithyroidectomy) should be reserved for children with small and occult tumors.

摘要

由于分化型甲状腺癌在儿童(<18岁)中的预后良好,但另一方面其淋巴结转移率高、肿瘤体积较大、存在肺转移和肿瘤复发,因此对于此类癌症的根治性切除范围存在争议。基于我们的数据,我们主张对于有明显疾病的患者,首选甲状腺切除术、颈部淋巴结清扫术和术后碘-131治疗,以便进一步检测和/或治疗肺转移。有限的根治性手术(即半甲状腺切除术)应保留给肿瘤小且隐匿的儿童。

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