engleski

Follow-up of 504 Patients with Thyroid Carcinoma

Aim: The main idea of this work was to show the value of ultrasound examination (UE) in early detection of thyroid carcinoma (TC) as well as its impact upon the final outcome. Material and Methods: The 504 patients (pts) with TC (399 papillary, 62 follicular, 12 Hürtle cell, 31 medullary) were followed-up for the periods ranging from 0.5 to 35 years (mean 6.3). Total thyroidectomy (TT) was performed in 376 pts. Paratracheal, functional or radical neck dissection with simultaneous TT was done in 107 pts with lymph node metastases (LNM). After TT 458 pts were treated with I-131 for complete ablation of thyroid remnant. Patients with TC were divided into two groups: Group A - pts who underwent UE of the neck region before surgery and in whom tumor and possible lymph node metastases (LNM) were revealed by ultrasonically guided fine needle biopsy (UGFNB) (N= 323), Group B - pts who had not been examined by ultrasound prior to surgery (N=181). Results: In 53% of the analyzed pts TC was recognized by UE due to its typical presentation (hypoechogenous, having irregular margins or tiny calcifications). The pts with LNM had larger TC than those without LNM (p<0.001) as well as pts with distant metastases (DM). TC smaller than 1 cm was found in 134 pts (41.4%) from Group A and in 18 (10%) from Group B. From Group A 11% of the pts and from Group B 36% underwent partial thyroid resection and, subsequently, TT. The rates of additional operations, performed for metastases revealed later, measured 2.4% in the Group A and 16% in the Group B. DM were found in 29 pts (6%), out of whom the 26 pts were treated with additional I-131 therapies, achieving complete remission only in 9 patients. The 11 pts died (2% or 38% of those with DM). Three pts died within 12 months after establishment of diagnosis, 5 pts within 2-5 years and 3 after 10 years. Conclusion: UE and UGFNB make it possible to reveal small TC. They allow detection of possible LNM also, which contributes to the complete healing and makes further treatment much easier and less expensive.

Thyroid carcinoma; follow-up; ultrasound examination

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