09 01 05 Entgr Management Of Well Differentiated Thyroid Cancer

Management of Well Differentiated Thyroid Cancer Vivek Ramarathnam, M.D. SIU- Otolaryngology Grand Rounds 9/1/2005

Thyroid Nodules ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thyroid Carcinoma ,[object Object],[object Object],[object Object],[object Object],[object Object]

Nodules and Carcinoma Rates ,[object Object],[object Object]

Risk Factors for Malignancy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Preoperative Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Thyroid Anatomy ,[object Object],[object Object],[object Object]

Thyroid Hormone Physiology ,[object Object],[object Object],[object Object],[object Object],[object Object]

Thyroid Hormone Regulation ,[object Object],[object Object]

Management steps with a Thyroid Nodule ,[object Object],[object Object],[object Object],[object Object]

Ultrasound Imaging and Nodules ,[object Object],[object Object],[object Object]

Management steps with a Thyroid Nodule ,[object Object],[object Object]

Evaluation of solitary nodule ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case Presentation ,[object Object],[object Object]

Fine needle aspiration ,[object Object],[object Object],[object Object]

Findings on FNA ,[object Object],[object Object],[object Object],[object Object]

Case Presentation ,[object Object],[object Object],[object Object]

Management of FNA results ,[object Object],[object Object],[object Object],[object Object],[object Object]

5 year survival rates 47.1% 45.3% Stage 4 79.4% 95.8% Stage 3 100% 100% Stage 2 100% 100% Stage 1 Follicular Cancer Papillary Cancer

Risk Analysis ,[object Object],[object Object],[object Object]

AGES ,[object Object],Papillary CA N= 860 Age= 0.5 x age Grade2 = 1 Grade3-4 =3 Extrathyroidal=1 E(distant)= 3 Size= 0.2 x cm

Surgical Management ,[object Object],[object Object]

Lobectomy vs. Total Thyroidectomy ,[object Object],[object Object],[object Object],[object Object]

Reasons for Total Thyroidectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complications of Total Thyroidectomy ,[object Object],[object Object]

Sites of Invasive Spread ,[object Object],30% Other structures 12% Larynx 53% Strap musculature 47% Recurrent laryngeal nerve 21% Esophagus 37% Trachea

Surgical Considerations ,[object Object],[object Object],[object Object],[object Object]

Esophageal Invasion ,[object Object],[object Object],[object Object]

Recurrent laryngeal nerve ,[object Object],[object Object]

Laryngeal Involvement ,[object Object],[object Object],[object Object]

Regional metastasis ,[object Object],[object Object],[object Object],[object Object]

Neck dissection ,[object Object],[object Object],[object Object],[object Object]

Postoperative treatment ,[object Object],[object Object]

Long term potential complications of Thyrotropin (TSH) Suppression ,[object Object],[object Object],[object Object],[object Object]

Radioactive Iodine Side Effects ,[object Object]

Postoperative Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object]

Postoperative followup Woodrum DT, Gauger PG Journal of Surgical Oncology 2005

Other Therapies ,[object Object],[object Object]

Conclusions ,[object Object],[object Object],[object Object],[object Object]

09 01 05 Entgr Management Of Well Differentiated Thyroid Cancer

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09 01 05 Entgr Management Of Well Differentiated Thyroid Cancer