Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

Performance of Preoperative Sonography and Fine Needle Aspiration Cytology on Treatment of Thyroid Papillary Microcarcinoma : Preliminary Study

갑상선 미세 유두암의 수술 전 초음파 검사와 세침흡입검사의 결과에 따른 수술범위 선택의 타당성 검토 : 예비 보고

  • Kwon, Joong-Keun (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Sang-Min (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Ho-Min (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Nam, Jung-Gwon (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Tae-Hoon (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Jong-Cheol (Department of Otorhinolaryngology, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 권중근 (울산대학교 의과대학 울산대학교병원 이비인후과교실) ;
  • 이상민 (울산대학교 의과대학 울산대학교병원 이비인후과교실) ;
  • 이호민 (울산대학교 의과대학 울산대학교병원 이비인후과교실) ;
  • 남정권 (울산대학교 의과대학 울산대학교병원 이비인후과교실) ;
  • 이태훈 (울산대학교 의과대학 울산대학교병원 이비인후과교실) ;
  • 이종철 (울산대학교 의과대학 울산대학교병원 이비인후과교실)
  • Published : 2011.05.27
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Abstract

Background and Objectives : Although it is well established that patients with papillary thyroid microcarcinoma (PTMC) have a highly favorable prognosis, the extent of thyroid surgery for PTMC remains unclear. According to the 2011 revised Korean Thyroid Association guideline, the choice of surgical strategy(total thyroidectomy versus lobectomy) for PTMC depends on solely preoperative diagnostic scrutinies-ultrasonography and fine needle aspiration cytology. We want to know how accurately these preoperative diagnostic scrutinies define the choice of surgical strategy for PTMC. Materials and Methods : For 119 patients who underwent total thyroidectomy with central neck dissection for PTMC, retrospectively, we compared the choice of surgery according to preoperative work up and postoperative pathologic findings. Results : Overall accuracy of the choice of surgery by preoperative work up was 61%. Among patients recommended lobectomy on preoperative work up, completion thyroidectomy on postoperative pathology might be necessary for 60% of patients and hidden central node metastasis was revealed in 31% of patients. Conclusions : The results of this study compel us to reinvestigate the current treatment guideline for PTMC. On current guideline according to the sonography and fine needle aspiration cytology, it might be thought to be better to choose more aggressive surgical strategy.

Keywords

References

  1. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006;295:2164-2167. https://doi.org/10.1001/jama.295.18.2164
  2. Chen AY, Jemel A, Ward EM. Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005. Cancer. 2009;115:3801-3807. https://doi.org/10.1002/cncr.24416
  3. Hughes DT, Haymart MR, Miller BS, Gauger PG, Doherty GM. The most commonly occurring papillary thyroid cancer in the United States is now a microcarcinoma in a patient older than 45 years. Thyroid. 2011;21:231-236. https://doi.org/10.1089/thy.2010.0137
  4. Appetecchia M, Scarcello G, Pucci E, Procaccini A. Outcome after treatment of papillary thyroid microcarcinoma. J Exp Clin Cancer Res. 2002;21:159-164.
  5. Hay ID, Grant CS, Heerden JA, Goellner JR, Ebersold JR, Bergstralh EJ. Papillary thyroid microcarcinoma: A study of 535 cases observed in a 50-year period. Surgery. 1992;112:1139-1146.
  6. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. 2006 The American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109-142. https://doi.org/10.1089/thy.2006.16.109
  7. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, 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
  8. Yi KH, Park YJ, Koong SS, Kim JH, Na DG, Ryu JS, et al. Revised Korean Thyroid Association management guidelines for patients with thyroid nodules and thyroid cancer. Korean J Otorhinolaryngol-Head Neck Surg. 2011;54:8-36.
  9. Abati A. The National Cancer Institute Thyroid FNA State of the Science Conference: "Wrapped up". Diagn Cytopathol. 2008;36:388-389. https://doi.org/10.1002/dc.20850
  10. Ito Y, Uruno T, Nakano K, Takamura Y, Miya A, Kobayashi K, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid. 2003;13:381-387. https://doi.org/10.1089/105072503321669875
  11. Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid. A "normal" finding in Finland. A systematic autopsy study. Cancer. 1985;56:531-538. https://doi.org/10.1002/1097-0142(19850801)56:3<531::AID-CNCR2820560321>3.0.CO;2-3
  12. Lee J, Rhee Y, Lee S, Ahn CW, Cha BS, Kim KR, et al. Frequent aggressive behaviors of thyroid microcarcinomas in Korean patients. Endocr J. 2006;53:627-632. https://doi.org/10.1507/endocrj.K06-013
  13. Mendelsohn AH, Elashoff DA, Abemayor E, St John MA. Surgery for papillary thyroid carcinoma: Is lobectomy enough? Arch Otolaryngol Head Neck Surg. 2010;136:1055-1061. https://doi.org/10.1001/archoto.2010.181