Comparative study of 15 thyroid carcinoma patients with mediastinum involvement:

Abstract

We analyzed 15 patients with thyroid carcinomas with mediastinum involvement treated by our department between 1991 and 2006. These patients consisted of six males and nine females. The average age was 60 years old. Five patients had primary diseases, and ten patients had relapse diseases. Fourteen patients presented mediastinal lymph node metastases from thyroid carcinomas and one patient presented an extended primary tumor involving the mediastinum. Seven patients underwent mediastinum dissection via median sternotomy. Both 5-year and 10-year survival rates of the patients who underwent mediastinum dissection were 85.7%. Six of the remaining eight cases did not undergo mediastinum dissection due to inoperabilities. All cases died within four years. The remaining two cases did not undergo mediastinum dissection due to patients' refusal of mediastinal surgery. One of these refusal cases lived with carcinoma for 89 months after the diagnosis. The other refusal case lived with carcinoma for 120 months after the diagnosis. As complications of the mediastinum dissection, mediastinitis and recurrent laryngeal nerve paralysis were seen in one patient respectively. For advanced thyroid carcinomas with mediastinum involvement, mediastinum dissection via median sternotomy by a medical treatment team of head and neck surgeons and thoracic surgeons is useful for improving the prognosis, and can be conducted safely.