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Vol 5, No 3 (2003)
Published online: 2003-10-07

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Progress in the treatment and diagnostic of thyroid cancer on the basis of own experience during the last 10 years

Tadeusz Łukieńczuk, Janusz Dawiskiba, Dariusz Rychlewski, Waldemar Balcerzak, Beata Wojtczak
Chirurgia Polska 2003;5(3):155-164.

Abstract

Background: Despite recent advances, in some patients the diagnosis of thyroid cancer is still established only post-operatively, thus further surgery is inevitable when the surgery is performed. The aim of this study is to review clinical material, including the period of the last ten years, regarding aspects of diagnostic and surgical methods used in treating thyroid cancer patients.
Material and methods: 3350 patients with different thyroid pathologies underwent surgery between 1993–2002; amongst them 85 (2.5%) were diagnosed with thyroid cancer. This study analysed the patient’s sex, age and type of thyroid cancer (morphology, size and localization) using TNM classification. Fine needle biopsy alone and under direct ultrasonography guide and thyroid ultrasonography were the main diagnostic methods. The authors discuss the approach and surgical method of treatment of thyroid cancer on the basis of the analyzed material.
Results: 85 patients with thyroid cancer underwent surgery; amongst them 58 (68%) were diagnosed with papillary cancer. A corresponding diagnosis between BAC and definitive pathological examination was obtained in the patients with solitary tumors of 55% and in those with multinodular goiter of 15%. Primary total thyroidectomy was performed in 37 thyroid cancer patients (44%). 47 patients (52%) underwent radicalization. 10 patients underwent one side cervical lymphangiectomy. Amongst patients operated on with thyroid cancer, permanent one side vocal cords paresis was observed in 5.8% and hypoparathyroidism in 4.7%.
Conclusions: In recent years there has been an increased incidence in the number of primary radical thyroidectomies in patients with differentiated thyroid cancer. Papillary thyroid cancer is the most common malignancy. In presurgical cases of nodular goiter, thyroid cancer was the most commonly missed diagnosis. With the improvement of diagnostic tools, the accuracy of presurgical diagnosis increases with fine needle biopsy under direct ultrasonography guide.

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