Naslov
Ultrasound and guided cytology in preoperative approach on thyroid cancer and neck metastases

Autori
Bence-Žigman, Zdenka

Izvornik
LIJEČČNIČKI VJESNIK (1330-4917) 126 (2) (2004);

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, kongresno priopcenje, znanstveni

Ključne riječi
Ultrasound; Thyroid cancer

Sažetak
Aim: to show the value of ultrasound examination (UE) in early detection of thyroid cancer (TC) and lymph node metastases (LNM) and its impact on preoperative approach and final outcome. Material: The 698 patients with TC (557 papillary, 89 follicular, 13 Hürthle cell, 38 medullary and 1 anaplastic) were followed-up for the periods ranging from the 0, 5 to 37 years (6, 6&plusmn ; ; 6). Results: In 451 patients UE and ultrasound guided cytology (UGFNB) revealed TC (in 188 patients TC<1cm). In these patients we performed UE of the neck to detect lymph nodes and UGFNB to detect LNM before surgery. In 118 patients LNM were diagnosed. In these patients neck dissection with total thyroidectomy (TT) was done in same act. 13 patients (2, 8%) underwent subsequent operation for LNM recurrences, revealed later on, during follow-up. The 247 patients had not been examined by ultrasound prior initial operation. They were followed-up by ultrasound only after initial operation. In this group, rate of subsequent operations for LNM was significantly higher, 17%. In 43 patients (6, 2%) distant metastases (DM) were observed. Patients with DM had larger TC, with extrathyroidal extension, 81% had also LNM, 43% intraglandular dissemination, and among them 37% died during the period of follow-up. Conclusion: Now, we have tools for the detection of small TC and LNM, but still don&#8217; t have the tools to predict biological behaviour of TC. Based on these observation we plead for TT even when small TC are diagnosed, dissection of LNM if they are diagnosed by UGFNB, and radioiodine ablation of thyroid remnant, because the early detection and initial treatment is the most important on the final outcome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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