Tarasova V D, Tuttle R M
Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Clin Oncol (R Coll Radiol). 2017 May;29(5):290-297. doi: 10.1016/j.clon.2016.12.009. Epub 2017 Jan 10.
Each year, the proportion of thyroid cancer patients presenting with low risk disease is increasing. Moreover, the definition of low risk thyroid cancer is expanding and several histological subtypes beyond papillary microcarcinomas are now classified as low risk disease. This shift in the landscape of thyroid cancer presentation is forcing clinicians to critically re-evaluate whether or not traditional management paradigms that were effective in treating intermediate and high risk disease are applicable to these low risk patients. Here we review the definition of low risk disease, examine the various histological subtypes that are considered low risk in the 2015 American Thyroid Association guidelines for the management of thyroid nodules and thyroid cancer, and review our current approach to the management of these low risk tumours.
每年,表现为低风险疾病的甲状腺癌患者比例都在增加。此外,低风险甲状腺癌的定义正在扩大,除了乳头状微小癌之外的几种组织学亚型现在也被归类为低风险疾病。甲状腺癌呈现格局的这种转变迫使临床医生认真重新评估,对治疗中高风险疾病有效的传统管理模式是否适用于这些低风险患者。在此,我们回顾低风险疾病的定义,审视2015年美国甲状腺协会甲状腺结节和甲状腺癌管理指南中被视为低风险的各种组织学亚型,并回顾我们目前对这些低风险肿瘤的管理方法。