Management of advanced Thyroid Malignancy
【摘要】：Backgroud:This study was done to see the effectiveness of the management of advanced thyroid cancer according to the protocol used in the otolaryngology department of BSM Medical University. Methods:Non-randomized prospective study on advanced cases of thyroid malignancy were marked on the basis of extacapsular spread/Local invasion, regional /or distal metastasis during a period of twelve years (1998-2010). Results:359 consecutive cases of thyroid malignancy were treated within the study period. Papillary Follicular carcinoma formed the main bulk (89%). About 54% cases presented at an advanced stages. Among the advanced cases 82% presented with lymphatic metastasis, skeletal (sternum, skull, ribs, jaw or femur),pulmonary brain metastasis were found in 5%, 12% and 1.5% respectively. Localinvasion to trachea, larynx, pharynx or oesophagus was found in 12.23% cases, fixity to great vessels in neck and recurrent laryngeal nerve involvement was found in 6.47% 15.51% cases. In 6.47% cases no definitive treatment could be offered. Surgery (92%) and radioiodine ablation (86%) were mainstay of treatment;external beam radiation was used in 4% cases. Perioperative mortality was seen in 5 cases. Cases were followed up for a mean period of 7.2 years;30.40% cases were lost to follow up. Among the respondents mortality was 19.54% and recurrence was seen in 25% cases. Conclusion: With definitive treatment of advanced thyroid carcinoma there is a high chance of recurrence which is again treatable in most of the cases.The mortality is also much higher than that of early thyroid malignancy.