Simon D, Goretzki P E, Röher H D
Klinik für Allgemeine und Unfallchirurgie, Heinrich-Heine-Universität Düsseldorf.
Praxis (Bern 1994). 1998 Mar 11;87(11):383-8.
The incidence of malignant thyroid tumors in Germany is about 1-2 cases per 100,000 inhabitants and year with a preponderance of female to male 3:1. Thus malignant thyroid tumors are rare and account for about 0.5% to 1% of all malignancies. Special consideration, however, has to be paid to the fact, that thyroid lesions associated with the risk of malignancy are much more frequent. Therefore identification of patients with particular risk for thyroid malignancy out of the 15% to 20% of the German population with thyroid lesions has to be the main scope. Prognosis of differentiated thyroid carcinomas is excellent and requires operative procedures adapted to histological tumor type and tumor stage. Hemithyroidectomy for small papillary tumors can be as adequate as total thyroidectomy including bilateral neck dissection plus mediastinal lymph node dissection in medullary thyroid carcinoma. Generally radical resection of tumor is the aim. Palliative modalities in distant metastatic disease or undifferentiated tumors are indicated to optimize additive or adjuvant therapy resp. to improve prognosis.
德国甲状腺恶性肿瘤的发病率约为每10万居民每年1 - 2例，女性与男性的比例为3:1。因此，甲状腺恶性肿瘤较为罕见，约占所有恶性肿瘤的0.5%至1%。然而，必须特别考虑到与恶性风险相关的甲状腺病变更为常见这一事实。因此，从德国15%至20%有甲状腺病变的人群中识别出具有甲状腺恶性肿瘤特定风险的患者应成为主要目标。分化型甲状腺癌的预后良好，需要根据组织学肿瘤类型和肿瘤分期采取相应的手术方法。对于小的乳头状肿瘤，半甲状腺切除术可能与甲状腺全切除术一样充分，而甲状腺髓样癌则需要进行双侧颈部清扫加纵隔淋巴结清扫。一般来说，肿瘤的根治性切除是目标。对于远处转移性疾病或未分化肿瘤，采用姑息治疗方式以优化辅助或新辅助治疗，从而改善预后。
