5. 수술방법으로는 수술불가능한 예에서 생검만을 시행하였던 경우에서부터 갑상선 전절제술 내지는 경부곽청술에까지 여러 방법이 있었는테 이중 갑상선 아절절재술 내지는국소적 임파선 절제술을 추가한 경우가 가장 많았다.
6. 전 병기를 통한 생존율은 5년 생존율이 89%, 10년 생존율이 70.6%, 15년 생존율이 44.4%였다.
7. 병기에 따른 생존율은 병기 Ⅰ의 10년 생존율이 81.8%, 15년 생존율이 50%였고 병기 Ⅱ의 10년 생존율은 66.7%, 15년 생존자는 없었으며 병기 Ⅲ과 Ⅳ에서는 10년이상 생존자가 없었고 5년 생존율이 각각 58.3% 및 50%였다.
8. 암종에 따른 생존율은 유두상암의 10년 생존율이 84.5 %, 15년 생존율은 50%였으며여포성암의 10년 생존율은 80% 및 50%로 나타나 양쪽군에서 생존율의 차이는 볼 수 없었다.
9. 병기 Ⅰ에서 연령에 따른 생존율은 39세 이하군의 10년 생존율이 92.3%, 15년 생존율은 60%였으며 40세 이상군의 10년 생존율은 66.7%, 15년 생존율이 33.3%로 나타나 저연령층이 더 높은 생존율을 보였다.
10. 병기 Ⅰ에서 성별에 따른 생존율은 남자의 경우 10년 생존율이 77.8%, 15년 생존율이 84.6%, 15년 생존율이 60%로 나타나 성별에 따른 생존율은 볼 수 없었다.
[영문]
Cancer of the thyroid gland is rare. Its incidence is estimated at slightly less than 4 per 100,000 population per year, but is probably in increasing tendency. This incidence appears to be confined to those patients under the age of 50 years. The spectrum of the disease extends from the most common, slowly glowing, and well differentiated tumors to the rare, highly lethal, anaplastic cancers. Evidences for transmutation from less to more aggressive forms and for the high incidence of multif
ocal disease within the gland and for the frequency of regional lymph node metastas is exist.
All this bears upon the selection of the type and extent of treatment. Since the natural history of the disease, even untreated, is often measured in decades and since minor variations in treatment result in little change in survival statistics, it is difficult, if not impossible, to document the clear superiority of one surgical approach over another. In general, it is said that prognosis is affected by several factors such as age, sex, cell type, size of tumor, extent of lesion and operative procedure utilized.
This report is a retrospective review of 102 thyroid cancers treated in the department of surgery, Yonsei University College of Medicine from Jan. 1960 to Dec. 1974. The long-term follow-up data of 73 patients among 102 patients and several important factors affecting the prognosis are analyzed. The results are as follows:
1. Histologically, 77.9% of all lesions were papillary cancer and 16.5% were follicular cancer.
2. The peak incidence occurred in the 4rd and 5th decades of life, accounting for 49.3% of all patients.
3. The ratio of male to female patients is 1:2.7.
4. 65.6% of patients had single nodule, and 34.4% had multiple nodule clinically.
5. As to the extent of the lesion, 49.3% were stage Ⅰ. 28.8% stage Ⅱ, 16.4% stage Ⅲ, and 5.5% stage Ⅳ.
6. Our most common operative procedure was subtotal thyroidectomy with or without individual node dissection. Total thyroidectomy were performed in 7 cases, and radical neck dissection or modified radical neck dissection in Ⅱ cases.
7. Overall survival rates without regarding to stage were as follows; 10-year survival rate was 89%, 10-year survival 70.6%, and 15-year survival 44.4%.
8. As to survival rate according to extent of the lesions, the 5-year, 10-year and 15-year survival rates were 100%, 82% and 50% respectively for patients with stage Ⅰ. 5-year and 10-year survival rates were 95.2% and 66.7% respectively for stage
Ⅱ, 5-year survival rate was 58.3% for stage Ⅲ and 50% for stage Ⅳ.
9. Papillary Ca had 100%, 82% and 50% chances of 5-year, 10-year and 15-year survival rate respectively as compared with 100%, 80% and 50% for follicular Ca in stage Ⅰ.
10. As to survival rate according to age, the age group below 39 years showed better prognosis with 92% of 10-year survival than those ever 40 years with 67% of 10-year survival.
11. Female had 85% and 60% chance in 5-year and 10-year survival as compared with 78% and 33% for female.
12. We couldn't find the statistical differences in survival rate between single and multiple nodule.