| Risk-stratified management of well-differentiated thyroid cancers: a review of experience from a single institution, 1990-2003. | |
| | |
MedLine Citation:
|
PMID: 18188642 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Controversy persists regarding ideal management strategies in well-differentiated thyroid cancers (WDTC). This retrospective study reviews the utilization of a modified AMES risk stratification in the management of our institution's patients. METHODS: A total of 352 patients (median follow-up of 5.5 years) were reviewed and were risk stratified. Surgical resection was performed, and patients with clinically palpable lymph nodes were subjected to radical neck dissection. Patients were referred for adjuvant therapy if necessary. RESULTS: Of the 352 patients, 264 (75%) were females and 276 (78%) had papillary thyroid cancer (PTC). For those with lymph nodes (50%), 95% had PTC. In this series, 72% of the patients underwent total thyroidectomy; 5-year disease-free survival probability was 100% in low-risk patients, 92% in intermediate-risk patients, and 64% in high-risk patients. The 5-year overall survival probability was 100% in low-risk patients, 96% in intermediate-risk patients, and 69% in high-risk patients, respectively (both logrank trend p<0.001). CONCLUSIONS: Management of WDTC requires multimodal treatment and should be based on patient risk classifications. We recommend aggressive surgical resection for all gross disease in high-risk and intermediate-risk patients. Adjuvant therapy is recommended in high-risk patients, but should be individualized for intermediate-risk patients. Total thyroidectomy may not be necessary in low-risk patients. |
| | |
Authors:
|
M H Chew; G Chan; M M A Siddiqui; B C Tai; R Sivanandan; K C Soo; D T H Lim |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: World journal of surgery Volume: 32 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2008 Mar |
Date Detail:
|
Created Date: 2008-02-21 Completed Date: 2008-07-22 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 386-94 Citation Subset: IM |
Affiliation:
|
Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenocarcinoma, Follicular
/
mortality,
surgery* Adult Carcinoma, Papillary / mortality, surgery* Female Humans Kaplan-Meiers Estimate Male Middle Aged Postoperative Complications* Retrospective Studies Risk Singapore / epidemiology Thyroid Neoplasms / mortality, surgery* Thyroidectomy / methods, statistics & numerical data* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Complications after esophagectomy for cancer: 53-year experience with 20,796 patients.
Next Document: Long-term outcome of reoperations for medullary thyroid carcinoma.