Département de Médecine Nucelaire et Cancerologie Endocrinienne, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
Eur J Endocrinol. 2020 May;182(5):D1-D16. doi: 10.1530/EJE-19-0960.
Each year, the proportion of thyroid cancer patients presenting with low-risk disease is increasing. The shift in the landscape of thyroid cancer presentation is forcing clinicians to re-evaluate not only management but also surveillance paradigms. During the follow-up, patients are stratified considering their response to treatment and classified into one of the following response categories: excellent, biochemical incomplete, structural incomplete, or indeterminate. These categories reflect a real-time prognosis and thereby substantially influence and personalise disease management. Although at present, no guideline recommends stopping differentiated thyroid carcinoma (DTC) surveillance at any particular time point, the relatively low prevalence of treatment failures in low-risk patients may prompt early discontinuation of surveillance in this subgroup. Therefore, this debate will present an overview of the controversies surrounding the surveillance of low-risk patients with DTC.
每年，呈现低危疾病表现的甲状腺癌患者比例在增加。甲状腺癌表现形式的变化迫使临床医生不仅要重新评估管理方法，还要重新评估监测模式。在随访期间，根据患者对治疗的反应对其进行分层，并将其分类为以下反应类别之一：极好、生化不完全、结构不完全或不确定。这些类别反映了实时预后，因此极大地影响和个性化了疾病管理。尽管目前没有指南建议在任何特定时间点停止分化型甲状腺癌（DTC）的监测，但低危患者的治疗失败率相对较低，可能促使这一亚组提前停止监测。因此，本次辩论将概述围绕 DTC 低危患者监测的争议。
