Larin O. Surgical treatment of thyroid cancer concerning prognostic factors, clinical and morphologic variants

Thesis is devoted studying the problem of surgical treatment of patients with thyroid cancer on the basement of system approach using the new pathogenetically grounded operations and combined therapy. Clinical material of study is comprised of 2097 patients with thyroid cancer, including 1797 primary cases, 163 repeated operations on local relapses or unradically treated patients, 137 patients operated on regional metastases. Clinical, hormonal and genetic (including Ret rearrangements, BRAF mutations, Act expression) peculiarities of different morphologic forms of thyroid cancer were investigated to determinate unfavorable prognosis of treatment. Firstly in Ukraine the complex study of nearest and long-term outcomes of surgical treatment of patients with different morphologic forms of thyroid cancer was carried out. This study pioneered the using of recombinant human thyrotropin in preparation of patients with differentiated carcinomas to radioiodine treatment or scanning. The tactics of surgical treatment of different forms of thyroid cancer was standardized and methodic of thyroidectomy and neck dissection was improved, including implementation of intraoperative nerve-integrity monitoring. The differentiated algorithm of diagnostics and surgical treatment of patients with various forms of thyroid cancer was worked out.