Kết quả phẫu thuật ung thư tuyến giáp thể biệt hóa giai đoạn T3b-T4N0M0 tại Bệnh viện Đại học Y Hà Nội

Abstract

This study aimed to evaluate the clinical and paraclinical characteristics, as well as surgical outcomes, of differentiated thyroid cancer (DTC) at stages T3b–T4N0M0. A descriptive study was conducted on 184 patients diagnosed with DTC at the aforementioned stages patients underwent surgery at Hanoi Medical University Hospital from January 2022 to March 2026. The mean age was 51.7 ± 12.5 years old, with a female-to-male ratio of 6.4:1. Tumor capsular invasion detected by ultrasound was observed in 11.4% of cases. Tumor invasion rates into the strap muscles, trachea, and recurrent laryngeal nerve were 84.8%, 9.2%, and 5.4%, respectively, with one patient (0.6%) showing simultaneous invasion of both the recurrent laryngeal nerve and the esophagus. The proportions of R0, R1, and R2 resections were 84.8%, 15.2%, and 0%, respectively. The rate of occult lymph node metastasis was 40.2%. Postoperative complications included transient hypocalcemia (manifested as extremity tetany) in 9.8%, hoarseness in 3.8%, and bleeding, infection, and chyle leak each in 0.5% of cases. No complication persisted beyond one month of treatment. These findings indicate that surgical management of T3b–T4N0M0 differentiated thyroid cancer achieves a high rate of complete resection with low complication rates, with all complications being transient.