Documente Academic
Documente Profesional
Documente Cultură
*****
Information that was released by Shinichi Suzuki at the Thyroid Examination
Evaluation Subcommittee meeting held on November 11, 2014
https://www.pref.fukushima.lg.jp/uploaded/attachment/90997.pdf
Regarding Surgically Indicated Cases
Three years have passed since the disaster struck. Of 1,848 subjects that
underwent secondary examination up to June 30, 2014, 485 had cytological
examinations. Suspicious or malignant cases totaled 104, and 58 of them already
have been operated on.
Surgeries on 55 of 58 cases were conducted at the Division of Thyroid and
Endocrine Surgery, Fukushima Medical University. 3 cases were operated on at
other facilities. As 1 of 55 cases turned out to be benign nodules post-operatively,
only the 54 thyroid cancer cases were considered there.
According to the pathological evaluation, 52 cases were papillary cancer, and 2
were poorly differentiated thyroid cancer.
In pre-operative diagnosis, 42 cases (78%) had tumor diameter > 10 mm. and 12
(22%) were 10 mm in diameter. Also, of the 12 cases with tumor diameter of
10 mm, 3 (5%) were suspected to have lymph node metastasis and/or distant
metastasis. 9 (17%) cases were not suspected to have lymph node or distant
mestasis (cT1a cN0 cM0).
Of these 9 cases, 7 were suspected to be close to the trachea or the recurrent
laryngeal nerve, or have extrathyroidal extension. The remaining 2 cases were
operated on based on patients wishes, despite the recommendation of nonsurgical follow-up.
Furthermore, 17 cases (31%) were positive for lymph node metastasis, and 2
cases (4%) were suspected of multiple lung metastasis.
Surgical methods included total thyroidectomy in 5 cases (9%), and
hemithyroidectomy in 49 cases (91%). Lymph node dissection was conducted in
all cases, with 67% limited to the central compartment and 33% including lateral
compartment. As much as possible, small-size incisions of 3 cm were used.
Post-surgical pathological diagnosis revealed 15 cases (28%) with tumor
diameter 10 mm, and 3 (6%) of them had no lymph node or distant metastasis
(pT1a pN0 M0). Extrathyroidal extension, pEX1, was seen in 37%, and 74% was
positive for lymph node metastasis. No post-operative complications (postsurgical hemorrhage, permanent paralysis of recurrent laryngeal nerve,
hypoparathyroidism, or hypothyroidism after hemithyoidectomy) were observed.
*****
The 52nd Annual Meeting of Japan Society of Clinical Oncology
August 28-30, 2014
Organ Specific Symposium 03, August 28, 2014 10:00-12:00
OS3-5 Treatment of pediatric thyroid cancer in Fukshima
Shinichi Suzuki
Division of Thyroid and Endocrinology, School of Medicine, Fukushima Medical
University
Pediatric thyroid cancer has been considered rare, consisting approximately 12% of all thyroid cancer. They might appear to be advanced at first sight, with
lung metastasis or widespread lymph node metastasis discovered at the time of
diagnosis, but long-term survive is known to be extremely good.
After the Fukushima Daiichi nuclear power plant accident following the Great
East Japan earthquake and tsunami on March 11, 2011, Fukushima Prefecture
was burdened with the prospect of faces long-term radiation health effects.
Fukushima Health Management Survey was launched in Fukushima Prefecture,
with one of the surveys being thyroid ultrasound examination of residents who
were children at the time of the accident. Initial Screening has already completed,
and thyroid cancer cases have been discovered. We report our experience in
treating these aymptomatic pediatric thyroid cancers detected through ultrasound
screening, unlike the usual symptomatic thyroid cancer.
Study subjects are 269,354 children (participation rate 80.8%) who underwent
primary examination from October 2011 to December 31, 2013. Of these, 1796
required secondary examination, and 75 of them were diagnosed with malignant
or suspicious tumor as a result of fine-needle aspirational biopsy. 34 already had
surgery, and 33 were confirmed to have thyroid cancer. We are reporting here on
the 31 cases operated on in our department.
Average age at the time of surgery is 16.4 (9-20) years, the male to female ratio
is 14:17, and 9 cases were from Fiscal Year 2011 (from 13 municipalities
designated by the government to be evacuation zone), and 22 cases were from
Fiscal Year 2012.
Average tumor diameter at the time of surgery was 14.9 mm (6-13 mm). Preoperative diagnosis revealed 22 cases of T1 (7 cases of T1a and 15 cases of
T1b1), 7 cases of T2, and 2 cases of T3. 19 cases were N0, 12 cases were N1 (4
cases of N1a and 8 cases of N1b), 29 cases of M0 and 2 cases of M1 (lungs).
Surgical method was 28 cases of hemithyroidectomy and 3 cases of total
thyroidectomy, and lymph node dissection included 19 cases of central
compartment dissection, and 12 cases of lateral compartment dissection. Postoperative diagnosis revealed 24 cases of papillary thyroid cancer (conventional
variant), 3 cases of follicular-type papillary thyroid cancer, 3 cases of diffuse
sclerosing papillary thyroid cancer, and 1 case was suspicious of poorly