30年来对低风险甲状腺癌的积极监测,经验教训和未来的方向
Anabella Smulever1,2, Fabian Pitoia3
1Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Córdoba, Buenos Aires, 2351, Argentina. asmulever@intramed.net.
Reviews in endocrine & metabolic disorders
|October 13, 2023
概括
积极监测是低风险的乳头甲状腺癌的安全,非侵入性策略,显示的瘤变化最小. 尽管它取得了30年的成功,但有限的采用源于错误信息和最大主义的方法.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 积极监测是对低风险的乳头甲状腺癌的最小侵入性策略.
- 这种方法可以识别可能进展并需要最终治疗的患者.
- 几十年的数据表明,在选定的患者中,它的安全性和可行性.
研究的目的:
- 审查30年来在乳头甲状腺癌的积极监测经验.
- 提供有关临床结果和实施策略的最新见解.
- 强调精确的患者选择,并提供新的视角.
主要方法:
- 三十年来积极监控试验的文献综述.
- 对临床结果的分析,包括瘤进展和淋巴结转移.
- 开发一个系统的方法来实施.
主要成果:
- 乳头甲状腺瘤在监测期间显示最小的尺寸变化,增长缓慢或减少.
- 淋巴结转移率很低,可以通过救援手术来控制,而不会影响死亡率.
- 尽管安全性得到证实,但采用被错误信息和最大主义态度所限制.
结论:
- 积极监测是小心挑选的低风险乳头甲状腺癌患者的安全有效策略.
- 克服障碍需要准确的信息传播和从最大主义方法转变.
- 精确的患者选择和系统的实施对于更广泛的采用至关重要.
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