甲状腺乳頭癌周囲臓器浸潤症例の治療成績

Clinical analysis of locally invasive thyroid papillary carcinoma

Ⅰ　はじめに

　甲状腺乳頭癌は緩徐に進行し，悪性腫瘍の中で比較的予後のよい疾患である。しかしながら，しばしば反回神経，気管・喉頭，食道，総頸動脈といった周囲臓器に浸潤する症例が存在する^1）。周囲臓器浸潤は予後不良因子となるばかりでなく，音声，呼吸，嚥下機能に影響し，患者のQOL（quality of life）を低下させるため，その取り扱いには注意が必要である。今回，われわれは当科で外科的治療を行った周囲臓器浸潤症例における，浸潤部位，治療法，治療成績について検討し，文献的考察を加えて報告する。

　We investigated the clinical results of 52 patients who had thyroid carcinoma with local invasion of the surrounding organs such as the recurrent laryngeal nerve,trachea,larynx,esophagus and common carotid artery and received complete resection of locoregional disease between 1999 and 2009. The 10-year overall survival was 75％ and disease specific survival was 76％ although patients with invasion of multiple organs showed a significantly worse survival. The 10-year local control was 86％ and 92％ of patients in whom the larynx was preserved showed full oral feeding without tracheostomy. These results indicated that complete resection of local disease produced long term survival and maintained quality of life of the patients.