Price Daniel L, Wong Richard J, Randolph Gregory W
Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Otolaryngol Clin North Am. 2008 Dec;41(6):1155-68, ix-x. doi: 10.1016/j.otc.2008.08.002.
Well-differentiated thyroid cancer most commonly presents as an intrathyroidal tumor; however, extrathyroidal extension occurs in approximately 6% to 13% of patients and carries a significant negative impact on survival. Extrathyroidal disease may involve critical structures in the central neck, including the recurrent laryngeal nerves, trachea, esophagus, and larynx, requiring surgery extending significantly beyond the thyroid gland. Appropriate surgical management is of great importance and can normalize survival curves, whereas gross residual disease postoperatively may lead to recurrence and decreased survival. Adjuvant postoperative therapies for thyroid cancers with extrathyroidal extension include thyroid hormone suppression, radioactive iodine therapy, and external beam radiotherapy. This summary reviews approaches to the management of invasive thyroid cancers involving the aerodigestive tract.
高分化甲状腺癌最常见的表现为甲状腺内肿瘤；然而，约6%至13%的患者会出现甲状腺外侵犯，这对生存有显著的负面影响。甲状腺外病变可能累及颈部中央的关键结构，包括喉返神经、气管、食管和喉部，需要进行远超甲状腺的手术。恰当的手术管理非常重要，可使生存曲线正常化，而术后肉眼残留病灶可能导致复发和生存率降低。甲状腺外侵犯的甲状腺癌术后辅助治疗包括甲状腺激素抑制、放射性碘治疗和外照射放疗。本综述探讨了累及气道消化道的侵袭性甲状腺癌的管理方法。
