Analysis Of The 77 Cases Of Follicular Thyroid Carcinoma

Objective The 12 year experiences of surgical treatments of follicular thyroid carcinoma were reviewed and advancements in follicular thyroid carcinoma clinical character and prognosis were discussed.Methods Follicular thyroid carcinoma cases which were treated in our hospital were collected from Jan.1997 to Jan.2009.Some of them were follow up.Result There were 77 cases,17 male,60 female,the average age of them was 45.8 (20-76),with highest prevalence during 31-60(74.0%,57/77).4(5.2%,4/77) cases had thyroid disease history.Ultrasound was done in all patients,with 21(27.3%,21/77) cases of enlarged lymph nodes,22(28.6%,22/77) cases of calcification.ECT was done in 14(18.2%,14/77) patients,with 11(78.6%,11/14) cases of cool or cold nodules.Most common operative method was lobectomy plus isthmusectomy plus contralateral near-total thyroidectomy.Lymphadenectomy was done in 20(26.0%,20/77) cases,only 1(5.0%,1/20) was proved of metastases to lymph nodes.There were 12(16.0%,12/75) frozen sections mismatch postoperative pathologic findings.9(12.0%,9/75) cases could not distinguish benign or malignant by frozen section.32(41.6%,32/77) cases were follow up.24(75.0%,24/32) insisted on endocrine treatment.6(18.8%,6/32) patients stopped endocrine treatment by themselves after some time.2(6.3%,2/32) patients did not have endocrine treatment all the time.3(9.4%,3/32) had postoperative ¹³¹â… radiotherapy.8(25.0%) cases recurrent,1 case recurrent at the remains,4 case had lymph nodes metastases,3 case had distant metastases.3(9.4%,3/32) cases died during the follow-up period.1,2,3,5 and 8 year survival rate was 100%,96.9%,93.4%,88.2%,88.2%.Conclusions It is usually difficult to differentiate the follicular thyroid carcinoma and follicular adenoma,even by fine-needle aspiration or frozen section.So the surgical method and prognosis are influenced.So far,it is a big problem for surgeon to choose the proper surgical method and the secondary operation.In our opinion,bilateral lobectomy is the first choice for the typic follicular thyroid carcinoma,unilateral lobectomy is one of the choice for the follicular thyroid tumour which frozen section can not make sure.lymphadenectomy is not recommend unless lymph nodes metastases are evident in the cervical compartments or the tumor has invaded beyond the thyroid capsule.