Tình trạng di căn hạch cổ và kết quả sớm phẫu thuật ung thư tuyến giáp thể nhú biến thể xơ hóa lan tỏa tại Bệnh viện K

Abstract

Diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) is a rare subtype of papillary thyroid cancer. This study aimed to evaluate cervical lymph node metastasis and early surgical outcomes in patients with papillary thyroid carcinoma of the diffuse sclerosing variant treated at K Hospital. A retrospective–prospective descriptive study was conducted on 72 patients who underwent surgery from January 2016 to January 2025. 54.2% of patients had tumors staged pT3–pT4 after surgery, and 84.7% had cervical lymph node metastasis with distant metastasis at 4.2%. Lateral neck lymph node metastasis was more common in patients aged ≤ 30 years old, with bilateral thyroid involvement, and with tumors staged pT3–pT4 (p < 0,05). Total thyroidectomy was performed in 97.2% of patients, 75% underwent lateral neck dissection, and 94.4% received adjuvant radioiodine (I131) therapy. The mean hospital stay was 5.9 ± 1.4 days. Common postoperative complications included transient hypoparathyroidism (29.2%) and transient recurrent laryngeal nerve palsy (13.9%). In conclusion, papillary thyroid carcinoma of the diffuse sclerosing variant has a high rate of cervical lymph node metastasis, particularly in younger patients and those with advanced-stage tumors; total thyroidectomy combined with appropriate neck dissection and adjuvant I¹³¹ therapy is an effective treatment strategy with acceptable early outcomes.