Division of Endocrine Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA.
Curr Opin Oncol. 2011 Jan;23(1):1-6. doi: 10.1097/CCO.0b013e32833fc9c4.
To examine the most recent changes in published guidelines by various organizations for the treatment of patients with differentiated thyroid cancer. This document provides a comparison of recommendations for common topics currently found in available thyroid cancer care guidelines.
Recent changes to guidelines have focused on controversial topics, including extent of thyroidectomy based on tumor size, prophylactic central neck dissection, use of radioactive iodine, and degree of thyrotropin suppression. Regional variations between guidelines exist. Adherence to thyroid cancer guidelines at national levels is less than ideal.
Guidelines for the management of differentiated thyroid cancer should continue to reflect minor regional variations in thyroid cancer treatment based on factors unique to that population while remaining otherwise similar to ensure optimal state-of-the-art patient care and outcomes. In the future, individual patient molecular information will likely play an important role in assessing the risk of tumor recurrence and overall survival. Consideration of multiple patient and tumor factors will allow thyroid cancer specialists to use a risk-adapted approach to patient care, from both a surgical and medical standpoint, to ensure optimal patient outcomes on an individual basis and at a disease level.
检查不同组织发布的分化型甲状腺癌治疗指南中的最新变化。本文比较了目前在甲状腺癌治疗指南中常见主题的推荐意见。
指南的最新变化集中在有争议的话题上，包括基于肿瘤大小的甲状腺切除术范围、预防性中央颈淋巴结清扫术、放射性碘的使用以及促甲状腺激素抑制的程度。指南之间存在区域性差异。国家层面上对甲状腺癌指南的遵循情况并不理想。
分化型甲状腺癌的管理指南应继续反映基于该人群特有的因素的甲状腺癌治疗的细微区域差异，同时保持相似性，以确保最佳的最新患者护理和结果。未来，个体患者的分子信息可能在评估肿瘤复发和总体生存的风险方面发挥重要作用。考虑到多个患者和肿瘤因素，甲状腺癌专家可以从手术和医学角度采用风险适应的方法来护理患者，以确保每个患者的最佳结果，并在疾病层面上达到最佳效果。
