Treatment of thyroid microcarcinoma        DAI Wen-jie, ZHU Hua-qiang, JIANG Hong-chi. Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Corresponding author: DAI Wen-jie,, E-mail: wenjdai@yahoo.com.cn
Abstract    Objective    To study on the treatment of thyroid microcarcinoma. Methods    Retrospective study was performed on the treatment of 141 cases of thyroid microcarcinoma admitted between January 2002 and January 2007 at the First Affiliated Hospital of Harbin Medical University. Different extent of thyroidectomy and lymphadenectomy were performed on different patients according to their diagnostic procedures. Therapeutic effect of different treatments and the factors associated with the presence of lymph node metastases were analyzed. Results    One hundred and seventeen cases were diagnosed preoperatively or intraoperatively, and were treated with ipsilateral total lobectomy +isthmusectomy + contralateral subtotal lobectomy, or bilateral total / near-total / subtotal thyroidectomy.  Four of them recurred (3.4%). Twenty-one cases were diagnosed as benign thyroid diseases preoperatively and intraoperatively, but incidentally detected as malignancy after the operation. They were firstly treated with ipsilateral subtotal lobectomy. Reoperation was not performed because all of them were single focal without capsular or vascular effraction. None of them recurred. Lymphadenectomy was performed in 27 cases with lymphadenectasis, and 3 of them recurred (11.1% ). Lymphadenectomy was not performed in another 114 cases without lymphadenectasis, and only 2 of them recurred (1.8%). Conclusion The surgical treatment of thyroid microcarcinoma should be individualized based on the patient and tumour. Lymph node metastases are common in thyroid microcarcinoma patients. The factors correlated with the presence of lymph node metastases were multifocal, capsular effraction, and tumor size (≥5mm). Lymphadenectomy is necessary for patients with lymphadenectasis, but is unnecessary for patients without lymphadenectasis.