The Importance of Thymus Anatomy to the Radical Resection of Thyroid Cancer Surgery and the Protection of Parathyroid Function

Sponsor
Tianjin Medical University Cancer Institute and Hospital
Study ID
NCT06851260
Status
Not Yet Recruiting

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Conditions

  • Surgery
  • Thyroid Cancer

Eligibility Criteria

Sex
ALL
Age
N/A - N/A
Healthy Volunteers
Not accepted

Interventions

  • Fine-dissection of the thymus — PROCEDURE
    In thyroid surgery, precise dissection and preservation of thymus tissue are used to improve the protection of the lower parathyroid gland function and increase the curative effect of the surgery.

Study Details

Thyroid cancer is one of the most common endocrine malignancies. In the past three decades, the incidence rate of thyroid cancer has continued to rise rapidly in many countries and regions around the world. The incidence rate of thyroid cancer in China is increasing year by year. The standardized incidence rate increased from 1.4/100000 person years in 1990 to 14.65/100000 person years in 2016. It has become the seventh malignant tumor in China with incidence rate, especially the incidence rate of women. Although differentiated thyroid cancer (DTC) has a low degree of malignancy, it still poses a threat to the life, health, and quality of life of patients. Due to its low mortality rate and long survival period, standardized diagnosis, treatment, and follow-up are even more necessary. The 5-year survival rate of thyroid cancer in China has increased significantly from 67.5% in 2003-2005 to 84.3% in 2012-2015, but still lags far behind the 98.3% in the United States. The current treatment for thyroid cancer is mainly surgical treatment. The development concept of tumor surgery is first radical, followed by functional preservation, and finally aesthetic incision. Standardized and thorough radical surgery is the most critical link to improve patient prognosis and reduce the occurrence of complications. Lymph node metastasis is a common cause of patient recurrence. According to literature reports, the central lymph node metastasis rate after DTC surgery is 24% -64%, which affects the prognosis and quality of life of patients, often requiring secondary surgery, increasing the incidence of postoperative complications and patient burden. Therefore, thyroid cancer surgery requires standardized and thorough neck lymph node dissection. Based on surgical experience and autopsy research, several pre tracheal lymph nodes are often hidden in the deep surface of the thymus from the inferior pole of the thyroid to the upper edge of the unnamed artery. Postoperative recurrence of central lymph nodes often occurs in this area. Therefore, during the initial surgery, the neck segment of the thymus must be freed and pulled away to the shallow layer to thoroughly clean the pre tracheal lymph nodes hidden in the deep surface of the thymus. A considerable number of zone VII lymph nodes can also be pulled out to make the central lymph node cleaning more thorough. However, current surgical standards and guidelines do not emphasize the importance of thymus anatomy.

Key Dates

First listed
Feb 28, 2025
Start date
Feb 20, 2025
Status verified
Feb 2025
Primary completion
Mar 20, 2026
Completion
Mar 30, 2026

Study Design

Enrollment
5 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT

Arms

  • Experimental: thymus anatomy
    Fine dissection and preservation of thymus tissue are required during surgery.
  • No Intervention: non-thymus anatomy
    Conventional surgical method for central lymph node dissection

Primary Outcome Measure

The effectiveness of surgery [ Time Frame: 13 months ]

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