AI Summary & Key Takeaways
AI InsightConclusions: Since the papillary thyroid microcarcinomas have a good prognose in the incidental cases which were found in subtotal thyroidectomy patients we recommend fallow up without additional treatment.In the cases who has risk factors related to the tumor our opinion is to perform a total thyroidectomy in order to achieve a safe oncological fallow up.
📌 3 Key Takeaways
Abstract
Objective: To evaluate the papillay microcarcinoma incidence and the treatment options in the patients that we operated for nodular goiter. Study design: The datasfor 215 patients who has been examined with the diagnosis of nodular goiter and has been operated in our clinic in the period of 2002-2004 were rewiewed retrospectively Results: In the 215 patients a total of 15 papillary thyroid microcarcinoma was detected and the incidence was %6.98 . The mean age of the patients who has a tumor was 46.5 and 13 of them were women (%86.7). The mean diameter of the tumors was 0.41cm (0.1-1cm). Extrathyroidal and capsular invasion was observed in the %13.3 of the patients. %6.6 of the tumors were multifocal and in %6.6 of them cervical lenf node metastase was found. The surgical procedures that were administered to these patients were 1 lobectomy, 6 total thyroidectomy,! near total thyroidectomy and in 7 cases total lobectomy plus subtotal lobectomy was made. In 3 of these patients completion thyroidectomy was necessary because of risk factors. In the mean fallow up of 22,6 months recurrence or mortality was not encountered. Conclusions: Since the papillary thyroid microcarcinomas have a good prognose in the incidental cases which were found in subtotal thyroidectomy patients we recommend fallow up without additional treatment.In the cases who has risk factors related to the tumor our opinion is to perform a total thyroidectomy in order to achieve a safe oncological fallow up.
Özet
Amaç: Noduler guatr tanısı ile öpere ettiğimiz hastalardaki papiller mikrokarsinom insidansını ve tedavi seçimlerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Kliniğimizde 2002-2004 tarihleri arasında klinik olarak noduler guatr tanısı ile araştırılıp, operasyon uygulanan 215 hastanın verileri retrospektif olarak değerlendirildi. Bulgular: 215 olguda toplam 15 tiroit papiller mikrokanseri saptanmış olup, insidans % 6.98'di. Tümörlü hastaların yaş ortalaması 46.5 olup, 13'ü (% 86.7) kadındı. Tümör çapı or¬talama 0.41 (0.J-I) cm'di. % 13.3 kapsüler invazyon ve ekstratiroidal yayılım, % 6.6 multisentrite, %6.6 servikal lenf bezi metastazı saptandı. 1 lobektomi, 6 total tiroidektomi, 1 totale yakın tiroidektomi uygulandı. 7 olguda ise total lobektomi+ subtotal lobektomi uygulandı. Bunlardan 3'ünde risk faktörü olduğu için tamamlayıcı tiroidektomi uygulandı. Ortalama 22,6 aylık takipte nüks ve mortalite saptanmadı. Sonuçlar: Tiroit papiller mikrokarsinomlarınm iyi seyirlerinden dolayı, insidental saptanan subtotal tiroidektomili olgularda risk faktörleri yok ise ek tedaviye gerek olmadan olguların takip edilebileceği kanısındayız. Subtotal tiroidektomili olgularda insidental saptanan ve tümör ile ilgili risk faktörü olan olgularda onkolojik ve güvenli takip açısından tiroidek-tominin totale tamamlanması gerektiği kanısındayız.