Total Thyroidectomy plus Prophylactic Central Lymph Node Dissection in Treatment of Multifocal Papillary Thyroid Carcinoma: A Clinical Analysis of 103 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WUHong-wei , SHENFeng ,  SUNShao-hua , HUHong-sheng , ZHOUWen-bo

Department of Thyroid Surgery, Affliated Dongfeng Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China;

Corresponding?author：

SUNShao-hua, Email: sysunshaohua@126.com

Keywords：

Multifocal papillary thyroid carcinoma; Central lymph node dissection; Efficacy

DOI：

10.7507/1007-9424.20160086

Video：

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Objective To analyze the clinical and pathological features of multifocal papillary thyroid carcinoma, and to assess the value and safety of total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma. Methods Clinical data of 103 patients with multifocal papillary thyroid carcinoma, who underwent total thyroidectomy plus prophylactic central lymph node dissection in Affliated Dongfeng Hospital from June 2011 to February 2015 were collected retrospectively. Preoperative ultrasound showed that all patients didn't suffered from cervical lymph node metastasis. Results Among 103 patients who underwent total thyroidectomy plus central lymph node dissection, the unilateral multiple lesions were found in 55 patients (53.40%), and the bilateral multiple lesions were found in 48 patients (46.60%). A total of 31 patients (30.10%) were confirmed to have central lymph node metastasis after operation, central lymph node metastasis only located in the same side of multifocal papillary thyroid carcinoma in 16 patients (29.10%), but of 15 patients (31.25%) with 2-side of multifocal papillary thyroid carcinoma, 7 patients suffered from 2-side central lymph node metastasis and 8 patients suffered from 1-side central lymph node metastasis. Thirty patients (12.62%) suffered from transient postoperative hypocalcemia after operation, and returned to normal for longest of 2 weeks; 1 patient (0.97%) suffered from parathyroid permanent damage; 18 patients (17.48%) suffered from transient recurrent laryngeal nerve palsy, no one suffered from permanent recurrent laryngeal nerve injury; 3 patients (2.91%) suffered from postoperative transient drinking cough. All of 103 patients were followed up for 5 months to 4 years, and the postoperative follow-up rate was 100%. During the follow-up period, 3 patients (2.91%) suffered from cervical lymph node metastasis in side region of neck. Conclusion Total thyroidectomy plus prophylactic central lymph node dissection plays an important role in the treatment of multifocal papillary thyroid carcinoma.

Citation： WUHong-wei, SHENFeng, SUNShao-hua, HUHong-sheng, ZHOUWen-bo. Total Thyroidectomy plus Prophylactic Central Lymph Node Dissection in Treatment of Multifocal Papillary Thyroid Carcinoma: A Clinical Analysis of 103 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(3): 324-326. doi: 10.7507/1007-9424.20160086 Copy

1.	向俊, 吳毅. 甲狀腺癌臨床診治新特點(附572例臨床分析). 中國實用外科雜志, 2008, 28(5): 365-367.
2.	張磊, 王洋, 李新喜, 等. 預防性頸中央區淋巴結清掃術與傳統甲狀腺全切除術治療cN0期甲狀腺乳頭狀癌安全性及有效性的meta分析. 中國普外基礎與臨床雜志, 2015, 22(12): 1487-1494.
3.	崔鵬, 徐德全, 殷越, 等. cN0期甲狀腺微小乳頭狀癌頸部淋巴結處理的研究進展. 中國普外基礎與臨床雜志,2015, 22(11): 1405-1409.
4.	吳紅偉, 王飛, 胡洪生, 等. 甲狀腺全切除術技術改進臨床應用分析. 中國普通外科雜志, 2011, 20(5): 523-525.
5.	吳高松, 馬小鵬, 劉巖巖, 等. 甲狀腺全切除術的技術改進(附252例報告). 華中科技大學學報: 醫學版, 2009, 38(6): 829-831.
6.	李加涌, 桑劍鋒, 姚永忠, 等. 雙極電凝鑷在開放性甲狀腺手術中的臨床應用. 中國普外基礎與臨床雜志, 2016, 23(1): 75-78.
7.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4): 225-249.
8.	林琳, 鄭向前, 劉磊, 等. 多灶性甲狀腺乳頭狀癌的生物學特性及治療分析. 中華普通外科雜志, 2010, 25(8): 621-623.
9.	林益凱, 盛建明, 趙文和, 等. 多灶性甲狀腺乳頭狀癌168例臨床研究. 中華外科雜志, 2009, 47(6): 450-453.
10.	李治, 劉春萍, 石嵐, 等. 546例分化型甲狀腺癌手術治療分析. 中華外科雜志, 2008, 46(5): 375-377.
11.	石嵐, 黃韜. 甲狀腺乳頭狀癌淋巴結轉移規律的研究. 中華普通外科雜志, 2007, 22(7): 524-526.
12.	中華醫學會內分泌學分會, 中華醫學會外科學分會內分泌外科學組, 中國抗癌協會頭頸腫瘤專業委員會, 等. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
13.	American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer; Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11): 1167-1214.
14.	NCCN. NCCN clinical practice guidelines in oncology. Thyroid carcinoma. Version 1. 2011-04-25. http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
15.	Pacini F, Castagna MG, Brilli L, et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2010, 21 Suppl 5: v214-v219.
16.	田文. 應重視甲狀腺全切除術中并發癥的預防. 中華外科雜志, 2015, 53(3): 161-163.
17.	田文, 姚京. 重視甲狀腺結節規范化診治. 中國實用外科雜志, 2015, 35(6): 579-583.
18.	吳紅偉, 王飛, 胡洪生, 等. 甲狀腺全切除術治療甲狀腺微小癌128例臨床分析. 中國普通外科雜志, 2014, 23(5): 609-611.
19.	Ito Y, Tomoda C, Uruno T, et al. Clinical significance of metastasis to the central compartment from papillary microcarcinoma of the thyroid. World J Surg, 2005, 30(1): 91-99.
20.	Moo TA, McGill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6): 1187-1191.
21.	黃韜. ATA、NCCN及歐洲分化型甲狀腺癌臨床指南異同點和國內應用探討. 中國實用外科雜志, 2011, 31(5): 407-410.

1. 向俊, 吳毅. 甲狀腺癌臨床診治新特點(附572例臨床分析). 中國實用外科雜志, 2008, 28(5): 365-367.
2. 張磊, 王洋, 李新喜, 等. 預防性頸中央區淋巴結清掃術與傳統甲狀腺全切除術治療cN0期甲狀腺乳頭狀癌安全性及有效性的meta分析. 中國普外基礎與臨床雜志, 2015, 22(12): 1487-1494.
3. 崔鵬, 徐德全, 殷越, 等. cN0期甲狀腺微小乳頭狀癌頸部淋巴結處理的研究進展. 中國普外基礎與臨床雜志,2015, 22(11): 1405-1409.
4. 吳紅偉, 王飛, 胡洪生, 等. 甲狀腺全切除術技術改進臨床應用分析. 中國普通外科雜志, 2011, 20(5): 523-525.
5. 吳高松, 馬小鵬, 劉巖巖, 等. 甲狀腺全切除術的技術改進(附252例報告). 華中科技大學學報: 醫學版, 2009, 38(6): 829-831.
6. 李加涌, 桑劍鋒, 姚永忠, 等. 雙極電凝鑷在開放性甲狀腺手術中的臨床應用. 中國普外基礎與臨床雜志, 2016, 23(1): 75-78.
7. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4): 225-249.
8. 林琳, 鄭向前, 劉磊, 等. 多灶性甲狀腺乳頭狀癌的生物學特性及治療分析. 中華普通外科雜志, 2010, 25(8): 621-623.
9. 林益凱, 盛建明, 趙文和, 等. 多灶性甲狀腺乳頭狀癌168例臨床研究. 中華外科雜志, 2009, 47(6): 450-453.
10. 李治, 劉春萍, 石嵐, 等. 546例分化型甲狀腺癌手術治療分析. 中華外科雜志, 2008, 46(5): 375-377.
11. 石嵐, 黃韜. 甲狀腺乳頭狀癌淋巴結轉移規律的研究. 中華普通外科雜志, 2007, 22(7): 524-526.
12. 中華醫學會內分泌學分會, 中華醫學會外科學分會內分泌外科學組, 中國抗癌協會頭頸腫瘤專業委員會, 等. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
13. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer; Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11): 1167-1214.
14. NCCN. NCCN clinical practice guidelines in oncology. Thyroid carcinoma. Version 1. 2011-04-25. http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
15. Pacini F, Castagna MG, Brilli L, et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2010, 21 Suppl 5: v214-v219.
16. 田文. 應重視甲狀腺全切除術中并發癥的預防. 中華外科雜志, 2015, 53(3): 161-163.
17. 田文, 姚京. 重視甲狀腺結節規范化診治. 中國實用外科雜志, 2015, 35(6): 579-583.
18. 吳紅偉, 王飛, 胡洪生, 等. 甲狀腺全切除術治療甲狀腺微小癌128例臨床分析. 中國普通外科雜志, 2014, 23(5): 609-611.
19. Ito Y, Tomoda C, Uruno T, et al. Clinical significance of metastasis to the central compartment from papillary microcarcinoma of the thyroid. World J Surg, 2005, 30(1): 91-99.
20. Moo TA, McGill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6): 1187-1191.
21. 黃韜. ATA、NCCN及歐洲分化型甲狀腺癌臨床指南異同點和國內應用探討. 中國實用外科雜志, 2011, 31(5): 407-410.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Total Thyroidectomy plus Prophylactic Central Lymph Node Dissection in Treatment of Multifocal Papillary Thyroid Carcinoma: A Clinical Analysis of 103 Cases

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