Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109.
Division of Endocrine Surgery, Department of Surgery, Duke University, Durham, North Carolina 27710.
Endocr Rev. 2017 Aug 1;38(4):351-378. doi: 10.1210/er.2017-00067.
Controversy exists over optimal management of low-risk differentiated thyroid cancer. This controversy occurs in all aspects of management, including surgery, use of radioactive iodine for remnant ablation, thyroid hormone supplementation, and long-term surveillance. Limited and conflicting data, treatment paradigm shifts, and differences in physician perceptions contribute to the controversy. This lack of physician consensus results in wide variation in patient care, with some patients at risk for over- or undertreatment. To reduce patient harm and unnecessary worry, there is a need to design and implement studies to address current knowledge gaps.
关于低危分化型甲状腺癌的最佳治疗管理仍存在争议。这种争议存在于管理的各个方面，包括手术、放射性碘用于残余消融、甲状腺激素补充和长期监测。有限和相互矛盾的数据、治疗模式的转变以及医生观念的差异导致了争议的产生。这种缺乏医生共识的情况导致了患者治疗的广泛差异，一些患者存在过度或治疗不足的风险。为了减少患者的伤害和不必要的担忧，需要设计和实施研究来解决当前的知识空白。
