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Выбор объема хирургического вмешательства при медуллярном раке щитовидной железы

Выбор объема хирургического вмешательства при медуллярном раке щитовидной железы

Abstract

Медуллярный рак щитовидной железы (МРЩЖ) обладает высокой степенью клинической агрессивности и характе& ризуется склонностью к рецидивирующему течению, причем чаще развивается регионарный рецидив опухоли. Един& ственный радикальный метод лечения МРЩЖ–хирургический, поэтому изначальный выбор адекватного объема опе& рации способен улучшить показатели безрецидивной и общей выживаемости больных. В исследовании анализиру& ется опыт хирургического лечения 125 больных МРЩЖ, который в 25% случаев имел наследственно&генетическую природу (подтвержденную обнаружением герминальной RET/MT C мутации) и в 75% – спорадическую. Сопоставле& ние десятилетней безрецидивной выживаемости при различных объемах первичных операций на шее и регионарном лимфатическом коллекторе выявило, что выполнение тироидэктомии и центральной лимфодиссекции в качестве ми& нимального объема вмешательства достоверно улучшало показатели выживаемости по сравнению с таковыми при меньших по объему операциях.

Medullary thyroid cancer (MTC) has high level of clinical aggressiveness as well as high recurrence rate par& ticularly metastases in regional lymph nodes. Surgery is single curative treatment method thus only initial appropriate operation volume could improve disease&free and overall survival. In our study the experience of surgical treatment of 125 MTC patients is analyzing. In 25% of cases there were familial MTC (germline RET/MTC mutation verified) disease and in 75% – sporadic tumors. Comparison of ten&years disease&free sur& vival in two groups with various initial surgery extensions revealed that thyroidectomy associated with central neck dissection as a minimal operation volume has significantly improved long&term disease&free survival as against to lesser initial surgery extension.

Keywords

МЕДУЛЛЯРНЫЙ РАК ЩИТОВИДНОЙ ЖЕЛЕЗЫ, ТИРЕОИДЭКТОМИЯ, ЦЕНТРАЛЬНАЯ ЛИМФАДЕНЭКТОМИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold
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