TITLE:
Treatment Outcome of Papillary Carcinoma Confined to the Thyroid Isthmus
AUTHORS:
Hui Huang, Shao-Yan Liu, Song Ni, Zong-Min Zhang, Xiao-Lei Wang, Zhen-Gang Xu
KEYWORDS:
Thyroid Tumor, Isthmus of Thyroid, Papillary Carcinoma, Surgery
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.12,
November
21,
2016
ABSTRACT: Objective:
The purpose of this study is to
evaluate the clinicopathologic characteristics and treatment outcomes of Papillary
Thyroid Carcinomas (PTC) of the isthmus and to establish an appropriate
surgical strategy. Methods: Thirty-four patients with PTC in isthmus are managed by surgery in National Cancer Center/Cancer
Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College
from 1985-2008.
Demographic data, surgical procedures, pathological features, stages and outcomes
are analyzed. Results: Seven patients were men and 27 were women. The median
age was 41 years (range,
20 - 71). Twenty-five patients
were treated with thyroid isthmusectomy or wide field isthmusectomy, five with hemithyroidectomy (lobectomy and
isthmusectomy) and four with hemithyroidectomy and partial resection of the
contralateral lobe. Twenty-eight patients had a pathologically T1 lesion (pT1); two patients had a pT2 lesion and four had a pT3
lesion. Five patients (14.7%) had papillary carcinoma detected in one of the
pretracheal lymph nodes. Thirty-two
patients had a solitary lesion confined to the thyroid isthmus. One patient had
two lesions in the thyroid isthmus and another one had two lesions located in
the thyroid isthmus and right lobe respectively. With a median follow-up of 94 months (range, 12 - 274), two
patients had a recurrence and both survived after a re-operation. There was no regional lymph node or distant organ
recurrences. No deaths occurred. Conclusions: Isthmusectomy or wide field
isthmusectomy could be a sufficient
treatment for PTC confined to the thyroid isthmus. We also recommend that pretracheal lymph node
dissection be
considered.