Uzak metastaz ile ortaya çıkan diferansiye tiroid kanserleri
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Tarih
2008
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, uzak metastaz ile ortaya çıkan diferansiye tiroid kanserli hastaların incelenmesi amaçlanmıştır. Durum Değerlendirmesi: Diferansiye tiroid kanserleri, multidisipliner tedavi protokolleriile uzun dönem sağ kalım oranlarına sahiptirler. Bununlabirlikte, uzak metastaz gelişen hastalarda mortalite oranları anlamlı derecede artmaktadır Hastalar ve Yöntem: Şubat 1997 – Şubat 2008 tarihleri arasında diferansiye tiroid kanseri nedeniyle tedavi ve takip edilen 531 hastanın kayıtlarıgeriye dönük olarak incelendi. Bulgular: Uzak metastaz ile ortaya çıkan diferansiye tiroid kanserli hasta sayısı 9 olarak bulundu. Metastatik lezyonların 7 hastadakemikte, 1 hastada akciğerde ve 1 hastada saçlı deride geliştiği görüldü. Tiroidektomi 8 hastada total, 1 hastada totaleyakın olarak uygulandı. Beş hastada papiller, 4 hastada folliküler kanser saptandı. Tüm hastalara radyoaktif iyot tedavisiverildi. Dokuz hastanın ortanca sağ kalım süresi 103 ay olarak bulundu. Metastatik lezyonlara yönelik 4 hastada uygulanan küratif amaçlı cerrahinin sağ kalım üzerinde anlamlıetkisi bulunamadı (p = 0.743). Sonuç: Diferansiye tiroid kanserli hastalar, agresif olarak tedavi edildikleri takdirde uzak metastaz varlığında dahi uzun dönem sağ kalım oranlarına ulaşabilirler. Bu hasta grubu için, total tiroidektomi sonrasında radyoaktif iyot ile ablasyonve tiroksin ile tiroid-stimülan hormon supresyonu önerilentedavi protokolünü oluşturmaktadır.
Purpose: the aim of this study was established as investigating the patients with differentiated thyroid cancers diagnosed initially with distant metastasis. Materials and Methods: the medical records of 531 patients with differentiated thyroid cancers who were treated and followed up in departments of general surgery and nuclear medicine between February 1997 and February 2008 were retrospectively analyzed. Results: There were 9 patients who were initially diagnosed with distant metastasis. the locations of metastases were bone in 7 patients, lungs in 1 patient and scalp in 1 patient. Thyroidectomies were total in 8 patients and near total in one. the types of cancers were papillary in 5 and follicular in four patients. All the patients received radioactive iodine treatment. the median survival time of the nine patients was determined as 103 months. the resections of metastatic lesions in 4 patients with curative intent did not effect survival significantly (p = 0.743). Conclusion: the patients with differentiated thyroid cancers may have long term survival rates with aggressive treatments even with the presence of distant metastasis. Radioactive iodine and thyroid-stimulating hormone suppression with thyroxine subsequent to total thyroidectomy constitute the recommended treatment protocol for these kind of patients.
Purpose: the aim of this study was established as investigating the patients with differentiated thyroid cancers diagnosed initially with distant metastasis. Materials and Methods: the medical records of 531 patients with differentiated thyroid cancers who were treated and followed up in departments of general surgery and nuclear medicine between February 1997 and February 2008 were retrospectively analyzed. Results: There were 9 patients who were initially diagnosed with distant metastasis. the locations of metastases were bone in 7 patients, lungs in 1 patient and scalp in 1 patient. Thyroidectomies were total in 8 patients and near total in one. the types of cancers were papillary in 5 and follicular in four patients. All the patients received radioactive iodine treatment. the median survival time of the nine patients was determined as 103 months. the resections of metastatic lesions in 4 patients with curative intent did not effect survival significantly (p = 0.743). Conclusion: the patients with differentiated thyroid cancers may have long term survival rates with aggressive treatments even with the presence of distant metastasis. Radioactive iodine and thyroid-stimulating hormone suppression with thyroxine subsequent to total thyroidectomy constitute the recommended treatment protocol for these kind of patients.
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Cerrahi
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Ulusal Cerrahi Dergisi
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Cilt
24
Sayı
4
