Department of Surgery, The University of Hong Kong, Pok Fu Lam, Hong Kong.
Methods Mol Biol. 2022;2534:39-56. doi: 10.1007/978-1-0716-2505-7_4.
Papillary thyroid carcinoma is the most common endocrine malignancy and accounts for the overwhelming majority of thyroid carcinoma. This recent dramatic increase in incidence is almost exclusively attributed to the incidental detection of small papillary thyroid carcinoma or microcarcinoma. Surgical management of thyroid carcinoma has been evolving to avoid overtreating patients by adopting the appropriate risk-based approach including the recommendation of hemithyroidectomy for low-risk carcinoma, the avoidance of routine prophylactic central nodal dissections, a higher threshold in using postoperative radioiodine ablation after total thyroidectomy, and the active observation or surveillance of papillary microcarcinoma as a viable alternative option instead of immediate surgical treatment.
甲状腺乳头状癌是最常见的内分泌恶性肿瘤,占甲状腺癌的绝大多数。这种发病率的急剧上升几乎完全归因于偶然发现的小甲状腺乳头状癌或微小癌。甲状腺癌的外科治疗方法一直在不断发展,通过采用适当的基于风险的方法来避免过度治疗患者,包括推荐对低危癌行甲状腺叶切除术,避免常规预防性中央淋巴结清扫术,在全甲状腺切除术后使用放射性碘消融的门槛更高,以及积极观察或监测甲状腺微小乳头状癌作为一种可行的替代选择,而不是立即手术治疗。