KẾT QUẢ PHẪU THUẬT UNG THƯ TUYẾN GIÁP THỂ BIỆT HÓA GIAI ĐOẠN CN1 TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: To describe the clinical and subclinical characteristics and evaluate the early outcomes of surgery in patients with differentiated thyroid cancer and clinical regional lymph node metastasis. Subjects and Methods: A retrospective descriptive study was conducted on 112 patients with differentiated thyroid cancer and clinical regional lymph node metastasis who underwent surgery at Hanoi Medical University Hospital from March 2023 to June 2024. Results: The male-to-female ratio was 1:3, and the mean age was 42.24±12.36. The majority of patients were incidentally diagnosed with a tumor during a check-up (66.69%). On ultrasound, most thyroid tumors were multifocal (60.71%), with a size of ≤20 mm (73.21%), and were primarily classified as TIRADS 5 (74.11%). Preoperative ultrasound detected metastasis to the central neck lymph nodes (42.86%), unilateral lateral neck lymph nodes (38.39%), and bilateral lateral neck lymph nodes (7.14%). One hundred percent of patients underwent total thyroidectomy and central neck dissection. The majority of patients also underwent unilateral lateral neck dissection (52.68%). Postoperative pathology showed that most were papillary thyroid carcinoma (94.64%), with metastasis to the central neck lymph nodes (92.86%), unilateral lateral neck lymph nodes (53.7%), and bilateral lateral neck lymph nodes (10.19%). The tumor was confined within the thyroid capsule in 67.86% of cases, with capsular invasion into muscle in 20.54%, and invasion into organs such as the trachea, esophagus, and recurrent laryngeal nerve in 11.6%. No cases of dyspnea were recorded. The main postoperative complications were hoarseness, numbness, and tingling in the extremities (hypocalcemia). Seroma (4.47%) and lymphatic fistula (1.78%) were effectively managed and controlled. Conclusion: Surgical treatment for differentiated thyroid carcinoma with clinical regional lymph node metastasis yields favorable early outcomes and high safety.