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[不同治疗策略治疗的分化型甲状腺微小癌患者的病程]

[The course of differentiated thyroid microcarcinoma in patients treated by different therapeutic strategies].

作者信息

Grigerová Marianna, Griger Martin, Mojtová Emília, Podoba Ján

出版信息

Vnitr Lek. 2016 Fall;62(9 Suppl 3):17-21.

Abstract

Low risk differentiated thyroid microcarcinoma therapy is a controversial area of thyroid tumor management. Major international medical societies and reputable institutes consider lobectomy to be sufficient therapeutic intervention for the pT1a cN0cM0 stage of papillary thyroid microcarcinoma. However different views and therapeutic strategies exist and result in unnecessary overtreatment and worsening of patients quality of life. We researched the course of the differentiated thyroid microcarcinoma in patients using different therapeutic strategies: lobectomy, total thyroidectomy, total thyroidectomy with central compartment prophylactic lymphadenectomy and total thyroidectomy followed by radioactive iodine treatment. Apart from an excellent prognosis we did not find out any clinically significant differences in the course of the disease. We can conclude that lobectomy is sufficient therapeutic intervention for patients with differentiated thyroid microcarcinoma without known metastases.Key words: differentiated thyroid microcarcinoma - management - overtreatment - the course of the disease.

摘要

低风险分化型甲状腺微小癌的治疗是甲状腺肿瘤管理中一个存在争议的领域。主要的国际医学协会和知名机构认为,对于甲状腺乳头状微小癌的pT1a cN0cM0期,肺叶切除术是足够的治疗干预措施。然而,存在不同的观点和治疗策略,导致不必要的过度治疗以及患者生活质量的恶化。我们研究了采用不同治疗策略(肺叶切除术、全甲状腺切除术、全甲状腺切除术加中央区预防性淋巴结清扫术以及全甲状腺切除术后进行放射性碘治疗)的患者中分化型甲状腺微小癌的病程。除了预后良好外,我们未发现疾病病程中有任何具有临床意义的差异。我们可以得出结论,对于无已知转移的分化型甲状腺微小癌患者,肺叶切除术是足够的治疗干预措施。关键词:分化型甲状腺微小癌 - 管理 - 过度治疗 - 疾病病程

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