Papillary thyroid microcarcinoma and papillary thyreoid cancer at the Department of Surgery, EUC Clinic Zlín

Česká verze

Authors: B. Dudešek ¹; M. Ratajský ¹; P. Vážan ²; P. Kosáč ¹; V. Petrů ¹; P.jančík ¹; K. Lajmar ¹; J. Duben ¹
Authors place of work: Chirurgické oddělení EUC Klinika Zlín, a. s. ¹; CGB laboratoř, a. s., pracoviště Zlín ²
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 11, s. 487-491.
Category: Původní práce

Summary

Introduction: Papillary thyroid cancer (PTC), especially micropapillary variant (MPTC), is the most common thyroid malignancy. Biological behavior is not aggressive and the patient’s prognosis is satisfactory. The objective of our comparative retrospective study was to evaluate whether the incidence is rising in the Region of Zlín and if less extensive approach was adopted by Czech endocrinologists.

Methods: We compared 2 groups from years 2005–2008 and 2014–2018. The incidence of thyroid cancer, the PTC and the MPTC, the extent of the surgery and the lymphadenectomy, number of removed lymph nodes and the number of positive lymph nodes were observed.

Results: We gathered 1353 patients in group 1. We found 220 malignancies (16.3%), 180 (81.8%) were PTC with MPTC variant in 44.4% (80 patients). All patients underwent a total thyroidectomy. We made 18 central and 10 lateral lymphadenectomies, 280 lymph nodes were collected with metastasis in 29,3 %. In group 2 with 1569 patients we found 318 (20.3%) carcinomas, PTC in 302 (94.6%) cases. The MPTC accounted for 215 (67.4%) cases. 10 patients with MPTC underwent hemithyroidectomy only. Numbers of central and lateral lymphadenectomies rose to 52 and 24 respectively. We gathered 376 lymph nodes with proven metastasis in 44.4% of these nodes.

Conclusion: Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing a sufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.

Keywords:

thyroid cancer – papillary – micropapillary thyroid carcinoma – PTC – MPTC

Zdroje

Bílek R, Horáková L, Goš R, et al. Onemocnění štítné žlázy v České republice: projekt EUthyroid a vyhodnocení epidemiologických dat VZP za období 2012–2015. Vnitřní lékařství 2017;63(3):548–554.
Roti E, degli Uberti EC, Bondanelli M, et al. Thyroid papillary microcarcinoma: A descriptive and meta-analysis study. European Journal of Endocrinology 2008;159(6):659–673. https://doi.org/10.1530/EJE-07-0896.
Paulson VA, Rudzinski ER, Hawkins DS. Thyroid cancer in the pediatric population. Genes 2019;10(9):723. https://doi.org/10.3390/genes10090723.
Weber T, Peth S, Hummel R. Chirurgie papillärer Mikrokarzinome der Schilddrüse. Der Chirurg 2018;89(6):415–421. https://doi.org/10.1007/s00104-017-0571-4.
Kopečková, K. et al. Nádory štítné žlázy. 1. vydání Praha, Mladá fronta 2019;10–24.
Bramley MD, Harrison BJ. Papillary microcarcinoma of the thyroid gland. BJS 1996;83(12),1674–1683.https://doi.org/10.1002/bjs.1800831206.
Kopečková K, et al. Nádory štítné žlázy. 1. vydání, Praha, Mladá fronta, 52–76.
Dvořák J. Rakovina štítné žlázy: Zaměření na postavení chirurgie v komplexu protinádorových opatření. Libri 1997 : 43–68.
Siewert JR, Rothmund M, Schumpelick V. Praxis der Viszeralchirurgie. Endokrine Chirurgie. Springer 2007 : 131–148.
Ryška A. Co je nového v patologii štítné žlázy. Čes-slov patol. 2008;44(4), 90–95.
Vorländer C, Lienenlüke RH, Wahl RA. Lymphknotendissektion beim papillären und follikulären Schilddrüsenkarzinom. Der Chirurg 2008;79(6):564–570. https://doi.org/10.1007/s00104-008-1489-7.
Zeng R, Zhang W, Gao E, et al. Number of central lymph node metastasis for predicting lateral lymph node metastasis in papillary thyroid microcarcinoma. Head & Neck 2014;36(1):101–106. https://doi.org/10.1002/hed.23270.
Bilimoria KY, Bentrem DJ, Ko CY, et al. Extent of surgery affects survival for papillary thyroid cancer. Annals of Surgery 2007;246(3):375–381; discussion 381–384. https://doi.org/10.1097/SLA.0b013e31814697d9.
Dralle H, Gimm O. Lymphadenektomie beim Schilddrüsencarcinom. Der Chirurg 1996;67(8):788–806. https://doi.org/10.1007/PL00002519.
Cobin RH, Gharib H, Bergman DA, et la. Thyroid carcinoma task force. AACE/AAES medical/surgical guidelines for clinical practice: Management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2001;7(3):202–220.
Ullmann TM, Gray KD, Stefanova D, et al. The 2015 American Thyroid Association guidelines are associated with an increasing rate of hemithyroidectomy for thyroid cancer. Surgery 2019;166(3):349–355. https://doi.org/10.1016/j.surg.2019.03.002.