Fisher Sarah B, Wang Tracy S
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
Ann Surg Oncol. 2025 May 9. doi: 10.1245/s10434-025-17419-1.
Surgical resection remains the mainstay of curative intent therapy for patients with differentiated thyroid cancer, with radioactive iodine ablation and/or TSH suppression commonly employed in the adjuvant setting. Alternative strategies such as active surveillance and ablation are potentially available for patients with very low risk disease, although data regarding long term oncologic outcomes are limited. While only a small subset of patients with DTC will require systemic therapy, an increased understanding of tumor mutation profiles and available targeted therapies may facilitate multidisciplinary treatment of patients with locally advanced and/or unresectable DTC. This landmark series will summarize key studies that shape current guidelines in the surgical management of DTC and its adjuncts, with particular attention to current controversies and novel therapeutics that impact surgical management.
手术切除仍然是分化型甲状腺癌患者根治性治疗的主要手段,放射性碘消融和/或促甲状腺激素抑制常用于辅助治疗。对于极低风险疾病的患者,主动监测和消融等替代策略可能可行,尽管关于长期肿瘤学结果的数据有限。虽然只有一小部分分化型甲状腺癌患者需要全身治疗,但对肿瘤突变谱和可用靶向治疗的进一步了解可能有助于局部晚期和/或无法切除的分化型甲状腺癌患者的多学科治疗。这一具有里程碑意义的系列将总结塑造当前分化型甲状腺癌手术管理及其辅助治疗指南的关键研究,特别关注影响手术管理的当前争议和新疗法。