[Clinical analysis of 44 cases of recurrent thyroid carcinoma]

Although the most thyroid cancers are well-differentiated low malignant neoplasms and their prognoses are relatively good generally if they were treated routinely, there are still a few cases of this tumor recurred. This study was designed to sum up and analyze the cause, treatment, and prognosis of these cases to seek for the cause and the proper treatment method of the recurrent cases.

From 1980 January to 1996 January,44 cases of the recurrent thyroid carcinoma of the total 764 cases of thyroid carcinoma were treated in Department of Head & Neck,Cancer Institute & Hospital, Affiliated Tianjin Medical University. The clinical and follow-up data of these 44 cases were analyzed retrospectively.

Forty-four cases of the recurrent thyroid carcinoma accounted for 5.76%(44/764) of 764 cases of thyroid carcinoma treated. Thirty-eight cases of these 44 cases were differentiated thyroid carcinoma (28 cases were papillary thyroid carcinoma,7 cases were follicular thyroid carcinoma, 3 cases were medullary thyroid carcinoma and 6 cases were anaplastic thyroid carcinoma).The percentages of them accounted for the same histopathologic pattern thyroid carcinoma treated in the hospital at the same time were 4.1% (28/676), 18.9%(7/37), 8.1% (3/37), and, 42.9% (6/14), separately. Thirty-three of these 44 cases were lymphatic recurrence (75.0%). In spite of 5 cases were given radiotherapy only, the other 39 cases were treated surgically with extensive dissection of recurrent lesions and post-operative radiotherapy. After treatment, the 3-year survival rates were 85.7%, 71.4%, 100.0%, and 0; the 5-year survival rates were 60.7%, 57.0%, 66.7%, and 0, and the 10-year survival rates were 35.7%, 42.9%, 33.3%, and 0, respectively.

The clinical and subclinical metastatic lymph nodes left in the previous operations were the main cause of the recurrence of thyroid carcinoma. The recurrent thyroid carcinoma should be treated with surgical operation mainly, as most of them may have a relatively good prognosis after the treatment.