Houten Pepijn van, Netea-Maier Romana T, Smit Johannes W
Department of Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Department of Internal Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Best Pract Res Clin Endocrinol Metab. 2023 Jan;37(1):101687. doi: 10.1016/j.beem.2022.101687. Epub 2022 Aug 12.
Differentiated thyroid carcinoma (DTC) is the most common endocrine cancer. Particularly the incidence of small clinically indolent tumors has been increasing significantly during the last decades because of increased diagnostic scrutiny, while the DTC-related mortality remained unchanged. In light of the increased awareness of the significant risk of detecting clinically indolent tumors and the potential harm and burden associated with overly diagnosis and the treatment, the approach towards management of DTC recently underwent a critical appraisal. The focus lays on reducing the unnecessary burden for patients with very low risk DTC and the correct identification of those who require treatment that is more intensive and/or follow-up. Management of DTC includes a range of different modalities, making multidisciplinary collaboration expedient. In this review, we elaborate on the recent developments in diagnosis, staging and management of DTC with specific focus on the more individualized risk assessment-based approach.
分化型甲状腺癌(DTC)是最常见的内分泌癌。特别是在过去几十年中,由于诊断检查的增加,临床上惰性小肿瘤的发病率显著上升,而与DTC相关的死亡率保持不变。鉴于人们越来越意识到检测临床上惰性肿瘤的重大风险以及过度诊断和治疗带来的潜在危害和负担,DTC的管理方法最近受到了批判性评估。重点在于减轻极低风险DTC患者的不必要负担,并正确识别那些需要更强化治疗和/或随访的患者。DTC的管理包括一系列不同的方式,这使得多学科协作变得很有必要。在这篇综述中,我们阐述了DTC诊断、分期和管理方面的最新进展,特别关注基于更个体化风险评估的方法。