Vol.98 No.1 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 1 January 2005
Retrospective Study of Patients with Recurrent Papillary
Carcinoma of the Thyroid Treated at Our Department
Kyoichi Terao, Takeshi Kusunoki, Kazunori Mori and Kiyotaka Murata
(Kinki University School of Medicine)
Yukio Tanaka
(Sakai Hospital of Kinki University)
Hiroyuki Sunami
(Sunami Clinic)
Among patients who received primary treatment for papillary carcinoma of the thyroid at our department between 1975 and 2003, 29 patients developed recurrence. The interval until recurrence ranged from 6 months to 20.5 years, with a mean of 6.5 years. According to the T classification, 1 patient was T1, 6 were T2, and 22 were T4. The initial surgery included partial resection in 1 patient, lobectomy in 15, subtotal thyroidectomy in 5, and total thyroidectomy in 8. Unilateral paratracheal lymph nodes were resected in 15 patients treated by lobectomy and the bilateral paratracheal lymph nodes were resected in 13 patients who received subtotal or total thyroidectomy. Cervical lymph nodes were also resected in patients who were N＋ clinically. The first recurrence involved the site of the primary lesion in 11 patients (at a site of infiltration in 6 and in the residual thyroid gland of 5), while lymph nodes were affected in 17 patients (cervical lymph nodes on the affected side in 13, contralateral cervical nodes in 3, and paratracheal nodes in 1), and remote organs were involved in 3 patients (lung in 1, skin in 1, and brain in 1) (some patients experienced recurrence at 2 sites). The outcomes after repeat surgery was disease-free survival in 20 patients and re-recurrence in 9. Among the 9 patients who experienced re-recurrence, 6 are currently alive with disease and 3 have died. Among the 3 deaths, 2 were due to recurrence at the site of tracheal infiltration and 1 followed progression to undifferentiated carcinoma. In the present study, these cases were examined to discuss measures for improving the prognosis and salvage methods for patients with recurrent thyroid carcinoma.
Key words : papillary carcinoma of the thyroid, tracheal infiltration, improvement of the prognosis, salvage method