A Prospective Study About the Surgical Management of Thyroid Carcinoma

Abstract

INTRODUCTION : Thyroid cancer is one of the most common endocrine cancer and has the highest mortality among endocrine neoplasms. In India, its incidence is between 0.8–2 per 1,00,000 population. Early diagnosis and treatment remain the cornerstone of management to decrease the mortality rates. lack of prospective randomized trials, the management of these cancers generates tremendous controversy. study was planned to assess & evaluate the management of various thyroid carcinomas. METHODS: A total of 40 patients were selected which were pathologically / histologically proven cases of Thyroid carcinoma in this Prospective study design in 2.5 years. Detailed Clinical Examination was done & Prior to surgery all the patients went through investigations. Subjects included both the genders , all age groups including pediatric and geriatric age group and all classes of socio economic strata. RESULTS: No of female patients were 30 and male patients 10.Male :female ratio in this study was 1:3.FNAC / Biopsy / Cytology detected papillary carcinoma in 26 patients (65%) ,follicular neoplasm in 11 patients (27.5%) ,2 (5%) patients of anaplastic and one (2.5%) of medullary carcinoma. 86.6% of the patients had a firm gland & hard gland and rest presented with a soft gland on palpation.Total Thyroidectomy with cervical block dissection was performed in 32 (80%) cases .Rest of the 20 % were dealt with Sub total Thyroidectomy with cervical block dissection. CONCLUSION: Most of the cancers present as a slow growing goiter for few months to few years duration.Most of the cancers are of papillary carcinoma type , FNAC detects the majority of the cancers and is an important diagnostic test.Thyroid cancers have a good prognosis as most of the patients present as Stage I disease & most of the patients require total thyroidectomy with or without lymph node dissection followed by radio iodine ablation as treatment.Thyroid cancer,irrespective of the extent of disease,has good prognosis