KẾT QUẢ PHẪU THUẬT CẮT HOÀN TOÀN TUYẾN GIÁP KẾT HỢP I-131 ĐIỀU TRỊ UNG THƯ TUYẾN GIÁP THỂ NHÚ TẠI VIỆN Y HỌC PHÓNG XẠ VÀ U BƯỚU QUÂN ĐỘI

Abstract

Objective: To evaluate the outcomes of total thyroidectomy followed by I-131 therapy for papillary thyroid carcinoma (PTC) at the Military Hospital of Radiant Medicine and Oncology. Subjects and Methods: A descriptive, retrospective, and prospective study was conducted on 91 PTC patients treated at the Military Hospital of Radiant Medicine and Oncology from January to June 2024. All patients underwent total thyroidectomy, neck dissection, and adjuvant I-131 therapy. Treatment response was assessed after 6 months according to the American Thyroid Association (ATA) 2015 guidelines. Results: The study group was predominantly female (90.1%), with a mean age of 47.7 ± 11.2 years. The majority of patients were in stage T3b (67.0%) and had cervical lymph node metastasis (39.6%). The complete response rate after 6 months was 61.5%. Lateral neck dissection significantly increased the rate of postoperative complications compared to the group without lateral neck dissection (35.3% vs. 10.5%, p=0.04). Multivariate regression analysis identified three independent prognostic factors that reduced the likelihood of achieving a complete response: cervical lymph node metastasis (OR=0.27), multifocal tumors (OR=0.17), and high pre-treatment stimulated Tg levels (OR=0.84). Conclusion: Lymph node metastasis, multifocal tumors, and high stimulated Tg levels are significant adverse prognostic factors that should be considered to personalize treatment strategies and patient follow-up.