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甲狀腺癌 71例에 對한 臨床病理學的 考察 Clinico-Pathological Study of 71 Cases of Cancer of the Thyroid Gland

대한외과학회지 1976년 18권 3호 p.39 ~ 48
강대섭,
소속 상세정보
강대섭 (  ) 
전주 예수병원 외과

Abstract


The surgical approach to cancer of the thyroid gland remains a matter of debate in the medical world. There is a trend toward more radical excision of the thyroid gland, but the management of the lymph glands of the neck remains controversial up to now.
The purpose of this paper is present 71 cases of carcinoma of the thyroid gland which were histollogically diagnosed and treated at Presbyterian Medical Center, Chonju Korea, during the past 7 and 8/12 years period froth January 1, 1968 top July 31,1975, with special emphasis on the management of cervical metastasis from differentiated carcinoma of the thyroid gland.
These 71 cases were analyzed in regard to age and sex incidence, duration of disease, clinical features, surgical findings, pathological findings, cervical lymph node metastases, the method of treatment, postoperative complications and prognosis. The results are summarized as follows:
1. The thyroid cancer was prevalent in third to fifth decades of, life (76% of all). Of these 24 cases were found in the third decade (34% of all).
2. Average age was 41.3 years.
3. The thyroid cancer was predominant in female (4, 9: 1). 4. Average duration of disease was 6,7 years.
5. The most common symptom and sign were a mass or masses in thyroid and/or neck.
6. The main site of origin was the right lobe (44% known 61 cases).
7. Grossly enlarged cervical lymph nodes were palpable in 31 percent of -all cases.
,8. Histologically papillary adencarcinoma was prevalent in both sexes (28% of all cases).
9. In 44 radical neck dissections, 30 cases (70%) had metastatic cervical lymph nodes in their specimens. Also in 44 radical neck dissections, 24 cases had no palpable cervical node clinically, but histologically 17 cases had metastatic cervical lymph nodes in their specimens. So the error in the clinical diagnosis of cervical lymph node metastasis was 71% in our services.
10. In regard to management, 52 cases (73%) of all cases underwent curative surgical procedures and additional postoperative radiation in 9 cases; 42 of the 52 cases(80. 7%) under-went radical neck dissections.
11. Three cases had distant metastasis, in all papillary adenocarcinoma.
12. The most frequent complications were wound infection (7 cases) and facial edema (4 cases).
13. Current follow up information was available in 51 cases of all (71.8%).
14. The survival rate in curative cases is 95%, but only 30% in palliative cases.

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