Noguchi M, Katev N, Miyazaki I
Operation Center, Kanazawa University Hospital, School of Medicine, Kanazawa University, Japan.
Int Surg. 1996 Apr-Jun;81(2):163-7.
We reviewed the literature related to the surgical management of differentiated thyroid carcinoma (DTC), and examined ongoing controversies regarding treatment. DTC has a relatively indolent biologic behavior, but it tends to spread to the thyroid and/or regional lymph nodes even in the early stages of the disease. On the other hand, surgical resection is the most effective treatment for DTC, but the extent of surgical resection has been controversial. The impact of surgery has been considered to be only minor in the prognosis of the majority of patients, unless grossly malignant residue is left behind. Nevertheless, in some patients the disease follows an aggressive course culminating in death. For such high-risk patients, a more extensive operation should be performed. Therefore, it may be concluded that the extent of surgical resection should depend on the basis of the biologic behavior of the DTC rather than the extent of cancer involvement in the thyroid and regional lymph nodes.
我们回顾了与分化型甲状腺癌（DTC）手术治疗相关的文献，并审视了有关治疗方面持续存在的争议。DTC具有相对惰性的生物学行为，但即使在疾病早期，它也容易扩散至甲状腺和/或区域淋巴结。另一方面，手术切除是DTC最有效的治疗方法，但手术切除范围一直存在争议。除非留下肉眼可见的恶性残留，否则手术对大多数患者预后的影响一直被认为较小。然而，在一些患者中，疾病呈侵袭性病程，最终导致死亡。对于此类高危患者，应进行更广泛的手术。因此，可以得出结论，手术切除范围应基于DTC的生物学行为，而非甲状腺和区域淋巴结的癌症累及范围。
