临床颈淋巴结阴性的甲状腺癌181例治疗分析

通过对临床颈淋巴结阴性的甲状腺癌治疗结果分析,提出采用甲状腺腺叶加峡部切除加中央区颈淋巴清扫术的治疗方法可获长期治愈的结果。方法:回顾分析1985年1月至2000年6月181例临床颈淋巴结阴性的甲状腺癌采用上法治疗的结果。结果:181例病人中仅12例(6.6%)补充作了同侧的颈淋巴结清扫术;12例行颈清扫术者中有10例见淋巴结转移。结论:对临床颈淋巴结阴性的甲状腺癌可以采用甲状腺腺叶加峡部切除加中央区淋巴结清扫术,其长期疗效同传统的甲状腺癌联合根治术,但生活质量却大为提高,值得临床推广。

Management of Thyroid Carcinoma without Clinical Cervical Lymph Node Involvement

Purpose:To discuss the possibility of using conservative surgical treament for thyroid carcinoma patients without clinical cervical lymph node involvement(cNo).Methods:One hundred and eighty-one cases of thyroid carcinoma without clinical cervical lymph node involvement admitted from January1985to June2000,were analyzed retrospectively.We performed thyroid lobectomy isthmectomy local-regional dissection of pretracheal and paratracheal lymph nodes for these patients.All the patients were followed up closely.Secondary neck dissection was performed when cervical lymph node metastasis occurred later.Results:In181cNo cases,12patients were subjected to neck dissection during the follow-up period when they were suspected clinically of LN metastasis;10of them were pathologically proved to have cervical LN metastases.Conclusions:Conservative thyroid lobectomy isthmectomy local-regional dissection of anterior and paratracheal LNs for cNo patients with differentiated thyroid carcinoma is a rational choice;prophylactic neck dissection seems to be unnecessary for these patients.Neck dissection postponed until there is suspicion of clinical cervical LN metastases does not influence the survival rate and improves the quality of life in these pationts.