Year: 2024
Type: article
Study design: Observational Study
Abstract: The study analyzed the examination and treatment outcomes of patients with surgical thyroid pathology. Objective: to systematize preoperative diagnostic methods and develop a comprehensive approach to organ-preserving surgeries in patients with follicular thyroid neoplasms. Material and Methods. The study analyzed the examination and treatment outcomes of 749 patients treated at the Precarpathian Clinical Oncology Center, Ivano-Frankivsk, Ukraine, between 2019 and 2024. All patients underwent fine-needle aspiration biopsy of clinically significant thyroid gland nodules at the preoperative stage. Results. The causes of the disease were as follows: colloid nodular goiter in 566 (75.6%, 95% CI 72.3-78.6%) patients, adenomatous nodular goiter with follicular neoplasms in 72 (9.6%, 95% CI 7.612.0%) cases, papillary carcinoma in 54 (7.2%, 95% CI 5.5-9.3%) patients, suspicious for papillary carcinoma in 17 (2.3%, 95% CI 1.3-3.6%) cases (based on cytological examination), medullary carcinoma in 12 (1.6%, 95% CI 0.8-2.8%) patients, anaplastic carcinoma in 6 (0.8%, 95% CI 0.3-1.7%) cases, and other tumors in 22 (2.9%, 95% CI 1.8-4.4%) patients. The results were statistically processed using the standard software package “Statistica 6.0 for Windows” (StatSoft, USA). Hemithyroidectomy was performed in 28 (42.4%, 95% CI 0.31-0.54%) cases, thyroidectomy in 16 (24.2%, 95% CI 0.12-0.32%) cases, subtotal lobectomy in 19 (28.7%, 95% CI 0.16-0.37%) cases, and lobectomy in 9 (13.6%, 95% CI 0.05-0.20%) cases. Central compartment lymph node dissection as an adjunct to thyroidectomy was performed on six (31.0%, 95% CI 0.32-0.61%) patients. Conclusions. The primary method for preoperative diagnosis of follicular neoplasms is fine-needle aspiration biopsy, followed by cytological examination. In follicular neoplasms against the background of multinodular goiter, thyroidectomy is recommended. In all other cases, the initial surgical approach should prioritize organ-preserving procedures to improve quality of life. The extent of the final surgical intervention depends on the pathological findings. If a patient with follicular neoplasms refuses surgery, prolonged monitoring by an oncological surgeon is essential. Molecular genetic diagnostics can facilitate the preoperative identification of follicular carcinoma, guiding the subsequent treatment algorithm.
Source: Archive of Clinical Medicine
Authors: Andrii Pasko, Vasyl Skrypko
Institution: Ivano-Frankivsk National Medical University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407762004