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Titolo:
Unilateral total lobectomy: Is it sufficient surgical treatment for patients with AMES low-risk papillary thyroid carcinoma?
Autore:
Hay, ID; Grant, CS; Bergstralh, EJ; Thompson, GB; van Heerden, JA; Goellner, JR;
Indirizzi:
Mayod,lin & Mayo Fdn, Dept Surg, Biostat Sect, Div Endocrinol & Internal Me Mayo Clin & Mayo Fdn Rochester MN USA 55905 Div Endocrinol & Internal Me Mayo Clin & Mayo Fdn, Div Anat Pathol, Rochester, MN 55905 USA Mayo Clin &Mayo Fdn Rochester MN USA 55905 thol, Rochester, MN 55905 USA
Titolo Testata:
SURGERY
fascicolo: 6, volume: 124, anno: 1998,
pagine: 958 - 964
SICI:
0039-6060(199812)124:6<958:UTLIIS>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGNOSTIC SCORING SYSTEM; CANCER; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Hay, ID MayoAClin & Mayo Fdn, Div Endocrinol, 200 1st St SW, Rochester, MN55905 US Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 55905 US
Citazione:
I.D. Hay et al., "Unilateral total lobectomy: Is it sufficient surgical treatment for patients with AMES low-risk papillary thyroid carcinoma?", SURGERY, 124(6), 1998, pp. 958-964

Abstract

Background. Controversy continues regarding the optimal extent of primary thyroid resection in most patients with papillary thyroid carcinoma (PTC), who are at minimal risk of cause-specific mortality (CSM). This study was designed to compare CSM and recurrence rates after either unilateral lobectomy (UL) or bilateral lobar resection (BLR) in patients with PTC considered low risk by AMES criteria. Methods. Outcome was studied in 1685 patients initially treated during 1940 through 1992 and followed for up to 54 postoperative years (mean, 18 years). One thousand six hundred fifty-six patients (98 %) had complete primarytumor resection; 634 (38%) had involvement of regional nodes. One hundred ninety-five patients (12 %) had UL; BLR accounted for 1468 (near-total GO %; total thyroidectomy 18%). Results. Thirty-year rates for CSM and distant metastasis were 2 % and 3 %, respectively. Twenty-year rates for local recurrence and nodal metastasiswere 4% and 8%, respectively. There were no significant differences in CSMor distant metastasis rates between UL and BLR (P > .2). After UL, 20-yearrates for local recurrence and nodal metastasis were 14 % and 19 %, significantly higher (P = .0001) than the 2 % and 6% rates seen after BLRConclusions. UL war not associated with higher CSM rates, but it was associated with a significantly higher risk of locoregional recurrence. Thus BLRprobably represents a preferable initial surgical approach to patients with low-risk PTC.

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Documento generato il 05/07/20 alle ore 23:01:56