Surgical Treatment of Papillary Thyroid Cancer Diagnosed During Pregnancy

초록

Papillary thyroid cancer has the characteristic of occurring more frequently in relatively young women than other cancers. Therefore, the incidence of thyroid cancer is high in women of childbearing age, and sometimes diagnosed during pregnancy. Although there is controversy regarding the treatment of thyroid cancer diagnosed during pregnancy, we would like to report our experience in surgically treated thyroid cancer diagnosed during pregnancy. From September 2018 to December 2023, we analyzed the medical records of patients who underwent surgery for thyroid cancer at our hospital. Patients who underwent thyroid cancer surgery during pregnancy were grouped as "Pregnant" group, whereas female patients aged 20-40 years of childbearing age were grouped as "Non-pregnant group. 13 patients were in the "Pregnant" group, and 75 patients in the "Non-pregnant" group. In the pregnant group, Six were nulliparous and seven were parous in obstetric history. 10 patients underwent surgery in the second trimester and 3 patients in the third trimester. All patients had no thyroid-related diseases before pregnancy, but 3 patients were diagnosed with thyroid function-related diseases during pregnancy. Thyroid lobectomy were performed in seven, and total thyroidectomy were performed in six patients. Compared to the "Non-pregnant" group, "Pregnant" group showed shorter operation time (74.6 ÷ 47.71) vs 111.0 $ 19.84 minutes, p(0.001) and shorter hospital stay days (3.05 1.21 vs 2.62 0.65 days, p=0.077). No significant difference found in clinical, pathologic variables, and postoperative complications. Fetal health was monitored by NST before and after surgery. Babies born from all mothers were healthy with no abnormalities except for one baby had mild VH. Surgery for thyroid cancer after the second trimester of pregnancy can be done safely for mother and fetus. Treatment for thyroid cancer during pregnancy is carried out with sufficient communication between mother and doctor.