대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)

  • 제31권2호
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  • Pages.16-20
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  • 2015
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  • 1229-5183(pISSN)
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  • 2586-2553(eISSN)
대한두경부종양학회 (The Korean Society for Head and Neck Oncology)
권호 표지

갑상선 유두암의 크기에 따른 임상병리학적 특징

Clinical and Pathologic Characteristics of Papillary Thyroid Carcinoma According to the Size of Primary Tumor

  • 이주형 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 김형규 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 김석모 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 장호진 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 김법우 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 이용상 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 박정수 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터) ;
  • 장항석 (연세대학교 의과대학 외과학교실, 강남세브란스 병원 갑상선암센터)
  • Lee, Joo Hyung (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Hyung-Kyu (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Seok-Mo (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Chang, Ho Jin (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Bup-Woo (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Yong Sang (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Cheong Soo (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Chang, Hang-Seok (Thyroid Cancer Center, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 투고 : 2015.10.26
  • 심사 : 2015.10.31
  • 발행 : 2015.11.30
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초록

Background and Objectives : In papillary thyroid carcinoma (PTC), multiplicity and central or lateral lymph node metastases significantly affect the recurrence. This study was carried out to evaluate the clinical and histological characteristics of PTC according to the tumor size. Materials and Method : Between January 1, 2009 and December 31, 2014, 12,269 PTC patients underwent thyroid surgery at the Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea. We analyzed pathologic findings and clinical features according to the size of tumor Results : The mean size of tumor was $0.89{\pm}0.70cm$. The Central and lateral compartment metastases were observed 64.7% and 37.6% on the range that the primary tumor size is 1cm. There was a significant association between the PTC primary tumor size and multiplicity and cervical neck metastasis (p<0.001). Conclusion : The PTC primary tumor size for prediction of multiplicity and neck node metastasis can be helpful in optimization of the surgical extent for each patient.

키워드

참고문헌

  1. Shaha AR, Tuttle RM, Shah JP. Papillary microcarcinoma of the thyroid. J Surg Oncol. 2007;95:532-533. https://doi.org/10.1002/jso.20743
  2. Noguchi S, Murakami N, Yamashita H, Toda M, Kawamoto H. Papillary thyroid carcinoma: modified radical neck dissection improves prognosis. Arch Surg. 1998;133:276-280.
  3. Kim KJ, Kim SM, Lee YS, Chung WY, Chang HS, Park CS. Prognostic significance of tumor multifocality in papillary thyroid carcinoma and its relationship with primary tumor size: a retrospective study of 2,309 consecutive patients. Ann Surg Oncol. 2015;22:125-131. https://doi.org/10.1245/s10434-014-3899-8
  4. Kim SM, Kim HK, Kim KJ, Chang HJ, Kim BW, Lee YS, et al. Thyroidectomy without lateral neck dissection for papillary thyroid carcinoma with lateral neck lymph node metastases and negative intraoperative frozen section. Head Neck. 2014.
  5. Shaha AR. TNM classification of thyroid carcinoma. World J Surg. 2007;31:879-887. https://doi.org/10.1007/s00268-006-0864-0
  6. Jun HH, Kim SM, Kim BW, Lee YS, Chang HS, Park CS. Overcoming the limitations of fine needle aspiration biopsy: detection of lateral neck node metastasis in papillary thyroid carcinoma. Yonsei Med J. 2015;56:182-188. https://doi.org/10.3349/ymj.2015.56.1.182
  7. Moo TA, Fahey TJ, 3rd. Lymph node dissection in papillary thyroid carcinoma. Semin Nucl Med. 2011;41:84-88. https://doi.org/10.1053/j.semnuclmed.2010.10.003
  8. Wada N, Duh QY, Sugino K, Iwasaki H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg. 2003;237:399-407.
  9. American Thyroid Association Guidelines Taskforce on Thyroid N, Differentiated Thyroid C, Cooper DS, Doherty GM, Haugen BR, Kloos RT, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167-1214. https://doi.org/10.1089/thy.2009.0110
  10. Rotstein L. The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol. 2009;99:186-188. https://doi.org/10.1002/jso.21234
  11. Kammori M, Fukumori T, Sugishita Y, Hoshi M, Yamada T. Therapeutic strategy for low-risk thyroid cancer in Kanaji Thyroid Hospital [Review]. Endocr J. 2013.
  12. Takada H, Kikumori T, Imai T, Sawaki M, Shibata A, Kiuchi T. Patterns of lymph node metastases in papillary thyroid carcinoma: results from consecutive bilateral cervical lymph node dissection. World J Surg. 2011;35:1560-1566. https://doi.org/10.1007/s00268-011-1133-4
  13. Association BT. Guidelines for the management of thyroid cancer. Royal College of Physicians, 2007.
  14. Kim SM, Chun KW, Chang HJ, Kim BW, Lee YS, Chang HS, et al. Solitary lateral neck node metastasis in papillary thyroid carcinoma. World J Surg Oncol. 2014;12:109. https://doi.org/10.1186/1477-7819-12-109
  15. Jun HH, Kim SM, Lee YS, Hong SW, Chang HS, Park CS. Cervical bronchogenic cysts mimic metastatic lymph nodes during thyroid cancer surgery. Ann Surg Treat Res. 2014;86:227-231. https://doi.org/10.4174/astr.2014.86.5.227
  16. do Rosario PW, Fagundes TA, Maia FF, Franco AC, Figueiredo MB, Purisch S. Sonography in the diagnosis of cervical recurrence in patients with differentiated thyroid carcinoma. J Ultrasound Med. 2004;23:915-920; quiz 921-912. https://doi.org/10.7863/jum.2004.23.7.915
  17. Ahn JE, Lee JH, Yi JS, Shong YK, Hong SJ, Lee DH, et al. Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer. World J Surg. 2008;32:1552-1558. https://doi.org/10.1007/s00268-008-9588-7
  18. Park JS, Oh KK, Kim EK, Son EJ, Chang HS, Hong SW, et al. Sonographic detection of thyroid cancer in breast cancer patients. Yonsei Med J. 2007;48:63-68. https://doi.org/10.3349/ymj.2007.48.1.63
  19. Lee YS, Nam KH, Chung WY, Chang HS, Shigematsu N, Takami H, et al. Practical management of well differentiated thyroid carcinoma in Korea. Endocr J. 2008;55:1015-1024. https://doi.org/10.1507/endocrj.K08E-188
  20. Kim SM, Chun KW, Chang HJ, Kim BW, Lee YS, Chang HS, et al. Reducing neck incision length during thyroid surgery does not improve satisfaction in patients. Eur Arch Otorhinolaryngol. 2015;272:2433-2438. https://doi.org/10.1007/s00405-014-3150-z