EXAMINATION OF THE OPERATIVE PROCEDURES FOR PAPILLARY CARCINOMA OF THE THYROID WITH CERVICAL LYMPH NODE METASTASIS AND EXTRACAPSULAR INVASION

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  • HAYASHI Takeshi
    Department of Otorhinolaryngology, Showa University Fujigaoka Hospital Department of Otorhinolaryngology, Yokohama Rousai Hospital
  • IKEDA Kenichiro
    Department of Otorhinolaryngology, Showa University Fujigaoka Hospital
  • GOMIBUCHI Hiroshi
    Department of Otorhinolaryngology, Showa University Fujigaoka Hospital
  • SHIMANE Toshikazu
    Department of Otorhinolaryngology, Showa University Fujigaoka Hospital
  • SANBE Takeyuki
    Department of Otorhinolaryngology, Showa University Fujigaoka Hospital

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  • 当科における甲状腺乳頭癌に対する手術術式と頸部リンパ節転移・被膜外浸潤症例の検討
  • トウ カ ニ オケル コウジョウセン ニュウトウガン ニ タイスル シュジュツジュツシキ ト ケイブ リンパセツ テンイ ・ ヒマク ガイ シンジュン ショウレイ ノ ケントウ

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Abstract

We examined 48 patients diagnosed with papillary thyroid cancer who underwent primary treatment in our department. The preoperative diagnosis was based on evaluation of the presence of cervical lymph node metastasis and extracapsular invasion by ultrasonography, CT, and fine-needle aspiration cytology. All patients received surgical treatment. The most common operative procedure was lobectomy (44%) followed by total thyroidectomy (35%), subtotal thyroidectomy (17%), total thyroidectomy combined with resection of the trachea (2%), and total thyroidectomy with total laryngectomy (2%). As for cervical lymph node dissection, D1 dissection was performed in all cases. In cases where preoperative ultrasonography and CT revealed cervical lymph node metastasis, operative procedures were determined according to the extent of metastasis. Cervical lymph node metastasis and extracapsular invasion were examined as prognostic factors. In many cases, lymph node metastasis accompanied extracapsular invasion, suggesting that extracapsular invasion as well as cervical lymph node metastasis were important prognostic factors. In terms of operative procedures, no clear differences were found between patients with extracapsular invasion and those without. All of the patients are alive according to short-term prognosis with a mean observation period of 22.6 months.

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