V.А. Chernyshev, Р.G. Khamidullin, А.N. Rudyk, М.А. Busygin, S.V. Zinchenko, Z.А. Afanasieva, А.L. Kosova, N.А. Glukhova, G.А. Usmanova
Tatarstan Cancer Center, Kazan
Chernyshev V.A. ― Cand. Med. Sc., cancer surgeon at Department of head and neck tumors in Tatarstan Cancer Center
29 Sibirsky Trakt, Kazan, Russian Federation, 420029, tel. (843) 519-27-40, e-mail: firstname.lastname@example.org
Introduction. During last 20 years, significant changes took place in the TNM classification, the treatment and observation standards of patients with thyroid cancer (TC).
Objectives of the study ― appraisal of the diagnosis and treatment of patients with thyroid cancer evolution in the Republic of Tatarstan on the basis of TCC.
Results. During the last 20 years: 1. The specialized oncologist reception was organized for the patients with nodular thyroid disease. 2. A complex of thyroid cancer diagnostics was implemented, which includes both invasive ultrasound techniques (non-palpable and suspicious nodes), and CT and PET with 18 fluoro-dehydro-glucose. 3. The main approaches of surgical treatment of patients with thyroid cancer were established within the head and neck tumors department (2000). 4. After the surgery, depending on the risk group and the histological form of thyroid cancer, all patients receive suppressive or supporting levothyroxine therapy. 5. Earlier, the patients in the high-risk groups (III-IV stages) were sent for a radioiodine therapy to MRRC RAMS (Obninsk), since 2014, they are treated in the department of radionuclide therapy at RCOD. 6. Dispensary observation of patients with TC is being conducted in a specialized clinic office at RCOD with the use of the full range of diagnostic methods (radioimmune, radioisotope laboratory, ultrasound, CT, PET/CT, and others). A retrospective analysis of the surgical treatment of 1613 patients with thyroid cancer at the head and neck department at TCC during the last 16 years was conducted. The majority of the patients (91.8%) had the highly differentiated thyroid cancer. 34.8% were in the first stage, 11.7% ― in the second, 29.7% ― in the third, 20.1% had the stage 4A, 3.6% had respectively the 4B and the 4C. Organ-preserving operations were performed in 23% of patients, thyroidectomy (extirpation of the thyroid gland) in 73%. A momentary lymphadenectomy (central and neck) was performed in 70%. The transient hypoparathyroidism was observed in 20% of patients, the paresis of the larynx in 3%. No lethality was observed.
Conclusions. At the Tatarstan Cancer Center, the treatment and observation of the TC patients is adequate, corresponding with the international and national standards and involving a wide range of experts and the use of modern diagnostic and laboratory equipment.
Key words: thyroid cancer, standards of treatment, thyroidectomy, neck lymph node dissection, radioiodine therapy, tumor markers.