미세 갑상선 유두암에서 반갑상선절제술 후 발견된 잠복성 다발병변의 임상적 의의

안동빈; 손진호; 김희진; 정지윤; 정훈

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자료유형: 학술저널

저자정보: 안동빈 손진호 김희진 정지윤 정훈

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제57권 제3호

발행연도: 2014.1

수록면: 166 - 171 (6page)

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Background and Objectives Occult multifocal diseases are often identified after hemithyroidectomy in patients with papillary thyroid microcarcinoma (PTMC). There has been considerable debate with regard to whether multifocal diseases actually behave more aggressively compared with unifocal diseases, particularly PTMC. The present study aimed at evaluating the clinical impact of occult multifocal diseases on the recurrence of PTMC treated with hemithyroidectomy. Subjects and Method We compared the clinicopathological characteristics and 5-year outcomes for 319 patients with unifocal PTMC patients and 29 patients with occult multifocal PTMC, all of whom were treated with hemithyroidectomy between January 2004 and December 2010. Results The incidence of occult multifocal disease was 8.4%, with a mean size of 0.28 cm. Although microscopic extrathyroidal extension (ETE) was more frequent in patients with occult multifocal PTMC as compared with that of unifocal diseases (41.4% vs. 23.2%, p=0.030), multifocality was not associated with age, primary tumor size, and concurrent Hashimoto’s thyroiditis. With respect to recurrence, there was no difference between the unifocal and multifocal groups during the mean 55.8-month follow-up period (4.4% vs. 10.3%, p=0.160). In addition, univariate and multivariate analyses revealed no meaningful association between recurrence and presence of occult multifocal diseases in patients with PTMC treated with hemithyroidectomy. Conclusion Although presence of occult multifocal diseases was associated with microscopic ETE, its clinical impact on disease recurrence was not significant in PTMC patients treated with hemithyroidectomy. Therefore, multifocality identified after hemithyroidectomy would not be an absolute indication for the completion of thyroidectomy in patients with PTMC. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(3):166-71

#Papillary thyroid microcarcinoma #Recurrence #Thyroidectomy

참고문헌 (15)

참고문헌 신청

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American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer / 2009 / Revised American Thyroid Association management guidelin

Besic N / 2008 / Papillary thyroid microcarcinoma: prognostic factors and treatment / J Surg Oncol 97 (3) : 221 ~ 225

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Chow SM / 2003 / Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality / Cancer 98 (1) : 31 ~ 40