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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  123. Kongress der Deutschen Gesellschaft für Chirurgie; 20060502-20060505; Berlin; DOC06dgch5803 /20060502/
    Publication Date: 2006-05-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3804 /20050615/
    Publication Date: 2005-06-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3166 /20050615/
    Publication Date: 2005-06-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 67 (1996), S. 788-806 
    ISSN: 1433-0385
    Keywords: Key words: Thyroid cancer ; Lymph node metastasis ; Lymphadenectomy. ; Schlüsselwörter: Schilddrüsencarcinom ; Lymphknotenmetastasen ; Lympadenektomie.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die lange Zeit umstrittene, in den vergangenen zehn Jahren jedoch in den meisten multivariaten Studien nachgewiesene prognostische Bedeutung der Lymphknotenmetastasierung zumindest beim papillären und medullären Schilddrüsencarcinom stellt die Rationale für ein standardisiertes, an der Lymphknotengruppeneinteilung der UICC (1993) orientiertes Lymphadenektomiekonzept dar. Ausgehend von der Häufigkeit des Lymphknotenbefalls im ipsilateralen cervicozentralen Compartment von 42–86 %, im ipsilateralen cervicolateralen von 32–68 %, im kontralateral-cervicolateralen von 12–24 % und im mediastinalen Compartment von 3–20 % können diese Compartments als Lymphknotenstationen 1., 2., 3. und 4. Ordnung angesehen werden. Während die cervicozentrale systematische Lymphadenektomie obligater Bestandteil der En-bloc-Resektion von Primärtumor-tragendem Organ und 1. Lymphknotenstation bei jedem Schilddrüsencarcinom sein sollte, werden die cervicolaterale und mediastinale Lymphadenektomie mit Ausnahme des medullären Carcinoms befallsorientiert, d. h. bei multiplen Lymphknotenmetastasen systematisch, bei Solitärmetastasen auch selektiv durchgeführt. Beim nodal-positiven MTC wird die Viercompartment-Lymphadenektomie empfohlen. Unter Anwendung einer schonenden operativen Technik (Lupenbrille, bipolare Coagulation) führt die systematische Lymphadenektomie nicht zu einer Erhöhung der Komplikationsrate, sie senkt die Rezidivrate und kann die Überlebensrate verbessern.
    Notes: Summary. The prognostic value of lymph node metastases in thyroid cancer has been a matter of controversy for many years. However, during the past decade most multivariate analyses have shown a prognostic influence of lymph node metastases in papillary as well as medullary thyroid carcinoma constituing the basis for a standardized concept of lymphadenectomy oriented to the lymph node classification of the UICC (1993). Due to the frequency of lymph node metastases in the ipsilateral cervicocentral compartment (42–86 %), in the ipsilateral cervicolateral compartment (32–68 %), in the contralateral cervicolateral compartment (12–24 %), and in the mediastinal compartment (3–20 %), these compartments can be defined as the lymph node regions of the first, second, third and fourth order, respectively. Cervicocentral systematic lymphadenectomy should be part of the en bloc resection of the thyroid gland and the first lymph node region in any thyroid cancer. Cervicolateral as well as mediastinal lymphadenectomy should be performed according to the extent of lymph node involvement, i. e. systematically when multiple lymph node metastases are present, otherwise selectively. One exception is in medullary thyroid carcinoma, where a four-compartment lymphadenectomy is recommended in any patient with positive lymph nodes. Performing a gentle technique using magnifying glasses and bipolar coagulation forceps, systematic lymphadenectomy does not increase the rate of complications, can decrease the recurrence rate and improve survival.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 384 (1999), S. 16-23 
    ISSN: 1435-2451
    Keywords: Key words C-cell cancer ; Medullary thyroid carcinoma ; Prevention ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Introduction: C-cell cancer of the thyroid or medullary thyroid carcinoma (MTC) exists in a sporadic and a hereditary form, the latter of which is part of the multiple endocrine neoplasia type-2 (MEN-2) syndromes. Discussion: MTC metastasises early to local (lymph nodes) and distant sites (liver, lung, bone). Therefore, early detection is mandatory to enable a chance of cure. In sporadic MTC, the sensitive tumour marker calcitonin enables detection of the disease at an early stage. In hereditary MTC, more than 95% of the patients have germline RET mutations. Thus, MEN-2 has become the paradigm for the practice of molecular medicine, and gene carriers can be identified before MTC even occurs. Surgery is the only chance of cure and recently developed surgical techniques provide the therapeutic prerequisite to achieve calcitonin normalisation in both sporadic and hereditary MTC.
    Type of Medium: Electronic Resource
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