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自2014年英国甲状腺协会 (BTA) 准则以来,对差异化甲状腺癌的治疗实践模式

P Maniam¹, S Y Hey¹, N Evans-Harding¹

¹Department of Otolaryngology Head and Neck Surgery, St John's Hospital, Livingston, UK.

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

|October 11, 2023

概括

2014年英国甲状腺协会的指导方针促进了对差异化甲状腺癌 (DTC) 的保守管理. 英国的中心显示,整体甲状腺切除术和放射性的使用减少了,但对于低风险的DTC,整体甲状腺切除术仍然存在.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
手术瘤学手术瘤学

背景情况:

2014年英国甲状腺协会 (BTA) 的指导方针主张采取风险适应的,保守的方法来管理差异化甲状腺癌 (DTC).
治疗缓解,远离传统的全甲状腺切除术和放射性,越来越多地支持低风险的DTC.

研究的目的:

评估2014年更新的BTA指南对英国区域中心内DTC患者管理的影响.
在指南实施之前和之后,分析DTC手术和放射性治疗的趋势.

主要方法:

从英国区域多学科团队 (MDT) 数据库中对差异化甲状腺癌 (DTC) 病例的回顾性分析.
数据收集时间从2009年1月到2020年12月,包括瘤治疗和临床病理特征.

主要成果:

在2015年后,甲状腺切除术 (87.1%至76.8%) 和放射性 (RAI) 使用 (73.1%至62.1%) 显著下降.
2015年后的队列显示了不良组织学特征的增加,包括甲状腺外延伸,淋巴血管入侵和多中心性.
尽管保守的趋势,全甲状腺切除仍然是65.3%的低风险T1/2 N0 M0 DTC病例的选择,原因包括不良组织学和良性指示等因素.

结论:

该研究证实了英国向更保守的DTC管理转变,与BTA 2014指南和全球趋势保持一致.
全甲状腺切除术仍然经常用于低风险的T1/2 N0 M0 DTC,由各种临床和患者特异性因素驱动.

关键词:

关于BTA的指南有差异化的甲状腺癌.练习模式实践模式

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