갑상선내 유두상암의 재발양상

• 영문명: Recurrence Pattern of Intrathyroidal Papillary Carcinoma
• 발행기관: 대한내분비외과학회
• 저자명: 조영권 조진성 김희경¹ 신선형 송영주 박지영 이정민 박민호 윤정한 제갈영종 Young Goun Jo M.D. Jin Seong Cho M.D. Hee Kyung Kim M.D.¹ Sun Hyoung Shin M.D. Young Ju Song M.D. Ji Young Park M.D. Jeong Min Yi M.D. Min Ho Park M.D. Jung Han Yoon M.D. and Young Jong Jegal M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』11권2호, 86~89쪽, 전체 4쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2011.06.30

영문 초록

Purpose: We investigated the pattern of regional recurrence pattern of intrathyroidal node negative - T1N0 or T2N0 - papillary carcinoma, focusing on skip versus continuous central and lateral lymph node metastasis. Most lymph node metastasis of papillary thyroid carcinoma appear in a step-wise sequential pattern, but discontinuous lymph node metastasis may occur in 11.1∼37.5% in node positive papillary cancer. While skip metastasis has been studied on the synchronous central and lateral lymphatic clearance, it has not been studied in reoperative settings on lateral recurrence.

Methods: From January 2000 to December 2005, Two hundred and seventy-five T1/T2 N0 patients underwent reoperative lymphatic clearance after total thyroidectomy and clinical - not prophylactic - central neck dissection in Gwangju and Hwasoon Chonnam National University Hospitals. We enrolled 210 patients who showed central and lateral neck metastasis as the continuous recurrence group and 65 patients who showed lateral metastasis without central lymph node metastasis as the skip recurrence group.

Results: Skip metastasis occurred in 17.6% (9/27 patients), and skip recurrence was in 23.6% (65/275 patients). In univariate analysis, in case of a single lesion, the skip recurrence was more prone to occur than multiple (P=0.026) and bilateral (P=0.048) papillary carcinoma. Multivariate analysis showed that tumor less than 1 cm (OR=2.24, P= 0.009), single lesion (OR=3.23, P=0.019) for multiple lesion, and (OR=2.22, P=0.025) for bilateral lesion.

Conclusion: Skip metastases were found in 17.6% (9 out of 27) of patients, and skip recurrence in reoperative surgery was found in 23.6% (65 out of 275) of patients. Careful follow-up and low dose radioiodine therapy may be considered in T1N0 or T2N0 papillary carcinoma in selected patients. (Korean J Endocrine Surg 2011;11:86-89)

키워드

갑상성 유두상암, 림프절 전이,Carcinoma, papillary Lymphatic metastasis