López Fernando, Al Ghuzlan Abir, Zafereo Mark, Vander Poorten Vincent, Robbins K Thomas, Hamoir Marc, Nixon Iain J, Tufano Ralph P, Randolph Gregory, Pace-Asciak Pia, Angelos Peter, Coca-Pelaz Andrés, Khafif Avi, Ronen Ohad, Rodrigo Juan Pablo, Sanabria Álvaro, Palme Carsten E, Mäkitie Antti A, Kowalski Luiz P, Rinaldo Alessandra, Ferlito Alfio
Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain.
Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, University of Oviedo, CIBERONC, 330011 Oviedo, Spain.
Cancers (Basel). 2023 Feb 16;15(4):1255. doi: 10.3390/cancers15041255.
Lymph node metastases in non-well differentiated thyroid cancer (non-WDTC) are common, both in the central compartment (levels VI and VII) and in the lateral neck (Levels II to V). Nodal metastases negatively affect prognosis and should be treated to maximize locoregional control while minimizing morbidity. In non-WDTC, the rate of nodal involvement is variable and depends on the histology of the tumor. For medullary thyroid carcinomas, poorly differentiated thyroid carcinomas, and anaplastic thyroid carcinomas, the high frequency of lymph node metastases makes central compartment dissection generally necessary. In mucoepidermoid carcinomas, malignant peripheral nerve sheath tumors, sarcomas, and malignant thyroid teratomas or thyroblastomas, central compartment dissection is less often necessary, as clinical lymphnode involvement is less common. We aim to summarize the medical literature and the opinions of several experts from different parts of the world on the current philosophy for managing the neck in less common types of thyroid cancer.
在低分化甲状腺癌（non-WDTC）中，淋巴结转移很常见，既可见于中央区（Ⅵ区和Ⅶ区），也可见于侧颈部（Ⅱ区至Ⅴ区）。淋巴结转移对预后有负面影响，应进行治疗以最大程度地实现局部区域控制，同时将发病率降至最低。在non-WDTC中，淋巴结受累率各不相同，取决于肿瘤的组织学类型。对于甲状腺髓样癌、低分化甲状腺癌和未分化甲状腺癌，淋巴结转移的高发生率通常使得中央区清扫成为必要。在黏液表皮样癌、恶性外周神经鞘瘤、肉瘤以及恶性甲状腺畸胎瘤或甲状腺母细胞瘤中，由于临床淋巴结受累较少见，中央区清扫通常不太必要。我们旨在总结医学文献以及来自世界不同地区的几位专家对当前少见类型甲状腺癌颈部处理理念的看法。
