• Title/Summary/Keyword: 국소 진행성 갑상선암

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Surgical Treatment in Locally Advanced Thyroid Cancer - Trachea, Larynx, Esophagus Invasion Management (국소 진행된 갑상선암의 수술 - 기관 및 후두, 식도 침범의 치료)

  • Lee, Guk Haeng;Kang, Ju Yong
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.99-108
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    • 2018
  • Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

The Role of External Irradiation for the Locally Advanced Papillary Thyroid Cancers (국소적으로 진행된 갑상선 유두암에서의 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.187-194
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    • 1999
  • Purpose : The aim of this study is to look for the possible efficacy of external irradiation for locally advanced papillary thyroid cancers (stage pT4 or Nl ). Methods and Materials : From August 1981 through September 1997, 91 Patients with locally advanced papillary thyroid cancers (stage pT4 or Nl ) have been treated with external irradiation and followed up at our clinic. All of the patients have been treated with surgical resection. After surgery, 23 patients received postoperative external irradiation with or without ablative radioiodine therapy, whereas the other 68 patients were treated with ablative radioiodine therapy alone. Distributions of sex, age, and stage were comparable in both irradiated and nonirradiated groups. Multivariate analysis of the influence by age, sex, stage, ablative radioiodine therapy and external irradiation on local control were peformed by using Cox's proportional hazard model. Results : Overall survival rates at 7 years were of no significant difference in both groups. There were $98.1\%$ for no RT group and $90\%$ for RT group (p=0.506). 5-year local control rates were significantly different, these were $95.2\%$ for RT group and $67.5\%$ for no RT group (p=0.0408). An analysis of the prognostic factors, age, sex, stage, and RAI were not significant variables, except for the external irradiation. Conclusion : Adjuvant postoperative external irradiation did not affect overall survival, but significantly improved local control in the patients with locally advanced papillary thyroid cancers (stage pT4 or lympy node involvement).

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Evaluate Utility of Thyroid Incidentaloma Discrimination by $^{18}F$-FDG PET/CT Delay Scan Images ($^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가)

  • Lee, Hyun-Kuk;Yang, Seoung-Oh;Song, Gi-Deok;Song, Chi-Ock;Lee, Gi-Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.184-191
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    • 2008
  • Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

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