Tiroid papiller mikrokarsinomlarında multisentrisite
Küçük Resim Yok
Tarih
2010
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada tiroidin papiller mikrokarsinomu olan hastalarda multisentrisite ve bu hastalarda uygulanması gereken cerrahi tedavi yönteminin belirlenmesi amaçlanmıştır. Durum Değerlendirmesi: Papiller mikrokarsinomlar uygun tedavi yöntemleri ile uzun dönem sağ kalım oranlarına sahiptirler. Multisentrik mikrokarsinomların tanısı, boyut olarak da küçük olmaları nedeniyle, ameliyat öncesi dönemdeki tanısal yöntemlerle, sıklıkla atlanmaktadır ve tanı, ameliyat sonrası piyesin histopatolojik incelemesi ile konulmaktadır. Bu durumda hastayı, ikincil bir cerrahinin riskinden korumak için uygun cerrahi tedavi uygulanmış olması gerekmektedir. Gereç ve Yöntem: Kliniğimizde tiroid cerrahisi uygulanan toplam 1818 hastadan histopatolojisi tiroid kanseri olarak rapor edilen 379 hasta geriye dönük olarak değerlendirildi. Bu hastalar içerisinden toplam 137 papiller mikrokarsinom olgusu belirlendi. Tıbbi kayıtları incelenen hasta grubunda papiller mikrokarsinomun multisentrisite sıklığı araştırıldı. Hastalar, tiroid kanseri evreleme sistemlerinden MACIS, EORTC ve TNM kullanılarak evrelendirildi. Bulgular: Toplam 137 papiller mikrokarsinomlu hastadan 33'ünde (%24) multisentrisite saptandı. Yedi (%21) hastada 2'den fazla tümör odağı saptandı. Aynı lobda birden fazla odağın saptanması durumunda diğer lobda kanser görülme oranı %33 idi. Ameliyat öncesi yapılan ultrasonografide tüm hastalarda bilateral multinodüler tiroid bezi mevcut idi. Ultrasonografide malignite açısından kuşku uyandıracak bulgular arandı ve hastaların %44‘ünde bu bulgular mevcuttu. İnce iğne aspirasyon biyopsisi uygulanan 31 hastadan 23'ünün (%74) ince iğne aspirasyon biyopsisi sonucu benign, frozen uygulanan 58 papiller mikrokarsinomlu hastadan 17 (%29) hastanın frozen kesit sonucu benign olarak yorumlandı. Sonuç: Papiller mikrokarsinomdaki multisentrisite oranının yüksekliği cerrahi tedavinin belirlenmesi aşamasında mutlaka göz önünde bulundurulmalıdır. Multisentrisiteyi atlamamak için tiroid ultrasonografisinin titizlikle yapılması gerekmektedir.
Purpose: in this study we aimed to determine, the multcentricity rates in patients with papillary microcarcinoma and the surgical method that should be applied. Materials and Methods: A total of 1818 patients underwent thyroid surgery and we evaluated 379 patients retrospectively, who were reported to have thyroid cancer histopathologically. in these patients, 137 patients with papillary microcarcinoma were determined. We reviewed medical records of patients, for mulicentricity and frequency of microcarcinoma. Patients were classified according to MACIS, EORTC and TNM classification systems for thyroid cancer. Results: Thirty-three (24%) of 137 patients with papillary microcarcinoma were detected to be multicentric. in 7 (21%) there were two or more tumor foci. the incidence of cancer was 33% in the other lobe when there was more than one foci in the same lobe. in all patients preoperative ultrasonography of the thyroid gland was multinodular. Ultrasonographic findings suspicious for malignancy were sought and in 44% patients these findings were present. Fine needle aspiration biopsy was performed in 31 patients and results of 23 patients were benign. Frozen section was performed 58 patients, where 17 patients had a benign frozen section report. Conclusion: the risk of multicentricity in papillary microcarcinoma patients should be taken into account for determining the optimal surgical treatment. To prevent missing microcarcinoma foci, ultrasonography should be applied meticulously.
Purpose: in this study we aimed to determine, the multcentricity rates in patients with papillary microcarcinoma and the surgical method that should be applied. Materials and Methods: A total of 1818 patients underwent thyroid surgery and we evaluated 379 patients retrospectively, who were reported to have thyroid cancer histopathologically. in these patients, 137 patients with papillary microcarcinoma were determined. We reviewed medical records of patients, for mulicentricity and frequency of microcarcinoma. Patients were classified according to MACIS, EORTC and TNM classification systems for thyroid cancer. Results: Thirty-three (24%) of 137 patients with papillary microcarcinoma were detected to be multicentric. in 7 (21%) there were two or more tumor foci. the incidence of cancer was 33% in the other lobe when there was more than one foci in the same lobe. in all patients preoperative ultrasonography of the thyroid gland was multinodular. Ultrasonographic findings suspicious for malignancy were sought and in 44% patients these findings were present. Fine needle aspiration biopsy was performed in 31 patients and results of 23 patients were benign. Frozen section was performed 58 patients, where 17 patients had a benign frozen section report. Conclusion: the risk of multicentricity in papillary microcarcinoma patients should be taken into account for determining the optimal surgical treatment. To prevent missing microcarcinoma foci, ultrasonography should be applied meticulously.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Ulusal Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
26
Sayı
4