Under what circumstances does thyroid cancer require surgery

Under what circumstances does thyroid cancer require surgery? Although surgery is the main way to treat cancer diseases such as thyroid cancer, certain factors are still required for surgical treatment of thyroid cancer. So under what circumstances does thyroid cancer require surgery? Let's take a look at the introduction of the article to answer this question.

Compared with other malignant tumors, the reoperation rate of thyroid cancer is higher. Usually 30 to 40 percent of thyroid cancer patients will undergo reoperation. There are two reasons for this.

One is the recurrence of thyroid cancer;

The second is that the first surgical procedure was inappropriate, resulting in residual or suspicious cancer lesions.

So, under what circumstances is another surgery necessary? Let’s take a look.

1. Residual primary cancer: Improper first surgical method or insufficient resection may lead to residual primary lesions.

Patients who underwent lumpectomy, partial lobectomy, or subtotal lobectomy in the first surgery had a higher residual cancer rate than those who underwent total lobectomy. Therefore, the decision to perform another surgery should be made based on the pathological condition of the tumor at the time of the first surgery, that is, a second surgery should be performed selectively. Patients whose tumor diameter is greater than 4 cm, has invaded the thyroid capsule, or has multiple primary lesions at the time of the first surgery should undergo another surgery. Otherwise, another surgery should not be performed in a hurry, and close follow-up observation can be performed.

2. Residual cervical lymph node metastasis According to statistics, the cervical lymph node metastasis rate of differentiated thyroid cancer is about 60%. If the cervical lymph node dissection is not thorough during the first operation (for example, only enlarged lymph nodes are removed) or the first operation is performed by mistake for a benign disease, it is possible that cervical lymph node metastasis will remain.

Indications for additional lymph node dissection in reoperation are:

1. During the first operation, only the enlarged lymph nodes were removed, and postoperative pathology confirmed that the degree of metastasis of the removed lymph nodes was 100%.

2. The tumor diameter is larger than 4 cm at the first surgery, invading the thyroid capsule or extracapsular tissue, and the tumor is poorly differentiated and no neck lymph node dissection has been performed. Because most literature reports that the high-risk factors for thyroid cancer cervical lymph node metastasis are: large tumor diameter, poor differentiation, invasion of the thyroid capsule or extracapsular tissue, obvious clinical symptoms, male sex, and patients over 40 years old.

Reoperation for thyroid cancer is difficult and has a high complication rate. Therefore, it is necessary to understand some issues about when thyroid cancer requires reoperation.