结合2015版ATA指南浅谈分化型甲状腺癌外科治疗领域新动向
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摘要
规范的分层个体化治疗是分化型甲状腺癌(differentiated thyroid carcinoma,DTC)治疗的新趋势,而外科规范化治疗中存在颇多争议问题。美国甲状腺协会(American Thyroid Association,ATA)指南作为规范治疗细节的重要参考而被广泛应用,并于2015年更新,在许多热点问题上,指南对推荐意见进行了修改,给出了新的解释。笔者曾参加美国耳鼻咽喉头颈外科协会(American Academy of Otolaryngology-Head and Neck Surgery Foundation,AAOHNSF)在指南更新的2015年的学术年会,聆听了世界各国专家对新指南以及DTC规范化治疗中相关要点问题的见解。本文浅谈分化型甲状腺癌外科治疗领域的新动向,并结合新版ATA指南浅谈自己的体会,望与同道分享。
Standardized hierarchical individualized therapy is a new trend of differentiated thyroid cancer( DTC) treatment. But a series of controversial issues were present in standardized surgical treatment. American Thyroid Association( ATA) guideline was regarded as an important reference about standardized details of treatment,which has been widely used and just updated in 2015. On many hot issues,recommendations from new guideline have been modified,and given new interpretations. The author attended the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation( AAO-HNSF) in 2015 with updated guidelines. In this paper,new trends in surgical treatment of differentiated thyroid cancer are discussed,and combined with the new edition of ATA guidelines,my own experience is discussed,I hope to share with colleagues.
Standardized hierarchical individualized therapy is a new trend of differentiated thyroid cancer( DTC) treatment. But a series of controversial issues were present in standardized surgical treatment. American Thyroid Association( ATA) guideline was regarded as an important reference about standardized details of treatment,which has been widely used and just updated in 2015. On many hot issues,recommendations from new guideline have been modified,and given new interpretations. The author attended the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation( AAO-HNSF) in 2015 with updated guidelines. In this paper,new trends in surgical treatment of differentiated thyroid cancer are discussed,and combined with the new edition of ATA guidelines,my own experience is discussed,I hope to share with colleagues.
引文
[1]Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:The A-merican Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J].Thyroid,2016,26(1)∶1-133.
[2]Tufano RP,Teixeira GV,Bishop J,et al.BRAF mutation in papillary thyroid cancer and its value in tailoring initial treatment:Asystematic review and meta-analysis[J].Medicine,2012,91(5)∶274-286.
[3]Witt RL,Ferris RL,Pribitkin EA,et al.Diagnosis and management of differentiated thyroid cancer using molecular biology[J].Laryngoscope,2013,123(4)∶1059-1064.
[4]Segel JM,Duke WS,White JR,et al.Outpatient thyroid surgery:Safety of an optimized protocol in more than 1,000 patients[J].Surgery,2016,159(2)∶518-523.
[5]Tufano RP.Advantages and disadvantages of outpatient thyroid surgery[J].JAMA Otolaryngol Head Neck Surg,2014,140(11)∶1076-1077.
[6]Duke WS,White JR,Waller JL,et al.Six-year experience with endoscopic thyroidectomy:Outcomes and safety profile[J].Ann Otol Rhinol Laryngol,2015,124(11)∶915-920.
[7]Kandil E,Hammad AY,Walvekar RR,et al.Robotic thyroidectomy versus nonrobotic approaches:A meta-analysis examining surgical outcomes[J].Surg Innov,2016,23(3)∶317-325.
[8]孙荣昊,李超,樊晋川,等.不同术式初治分化型甲状腺癌复发率及并发症比较的Meta分析[J].中华耳鼻咽喉头颈外科杂志,2013,48(10):834-839.
[9]中国抗癌协会头颈肿瘤专业委员会.分化型甲状腺癌诊治指南(初稿)[J].肿瘤预防与治疗,2011,24(1)∶55-68.
[10]Shah JP,Loree TR,Dharker D,et al.lobectomy vs total thyroidectomy for differentiated carcinoma of the thyroid:A matched pair analysis[J].Am J Surg,1993,166(4)∶331-335.
[11]孙荣昊,李超,樊晋川.对分化型甲状腺癌临床指南的比较和思考[J].中华内分泌外科杂志,2013,8(7)∶284-290.
[12]Madenci AL,Caragacianu D,Boeckmann JO,et al.Lateral neck dissection for well-differentiated thyroid carcinoma:A systematic review[J].Laryngoscope,2014,124(7)∶1724-1734.
[13]Stack BC Jr,Ferris RL,Goldenberg,et al.American thyroid association consensus review and statement regarding the anatomy,terminology,and rationale for lateral neck dissection in differentiated thyroid cancer[J].Thyroid,2012,22(5)∶501-508.
[14]孙荣昊,李超,樊晋川等.中央区淋巴清扫术对初治分化型甲状腺癌临床价值的Meta分析[J].中华耳鼻咽喉头颈外科学杂志,2014;49(2)∶157-164.
[15]Holostenco V,Khafif A.The upper limits of central neck dissection[J].JAMA Otolaryngol Head Neck Surg.2014,140(8)∶731-735.
[16]Wu CW,Chai YJ,Dionigi G,et al.Recurrent laryngeal nerve safety parameters of the harmonic focus during thyroid surgery:Porcine model using continuous monitoring[J].Laryngoscope,2015,125(11)∶2838-2845.
[17]Rosenthal LH,Benninger MS,Deeb RH.Vocal fold immobility:A longitudinal analysis of etiology over 20 years[J].Laryngoscope,2007,117(10)∶1864-1870.
[18]Potenza AS,Phelan EA,Cernea CR,et al.Normative intra-operative electrophysiologic waveform analysis of superior laryngeal nerve external branch and recurrent laryngeal nerve in patients undergoing thyroid surgery[J].World J Surg,2013,37(10)∶2336-2342.
[19]Noureldine SI,Genther DJ,Lopez M,et al.Early predictors of hypocalcemia after total thyroidectomy:An analysis of 304 patients using a short stay monitoring protocol[J].JAMA Otolaryngol Head Neck Surg,2014,140(11)∶1006-1013.
[20]Rosa KM,Matos LL,Cernea CR,et al.Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy[J].Arch Endocrinol Metab,2015,59(5)∶428-433.
[21]Falcone TE,Stein DJ,Jumaily JS,et al.Correlating pre-operative vitamin D status with post-thyroidectomy hypocalcemia[J].Endocr Pract,2015,21(4)∶348-354.
[22]孙荣昊,李超,樊晋川.外科手段初治分化型甲状腺癌后主要并发症及辅助治疗研究进展[J].中华全科医师杂志,2013,12(12)∶974-976.
[2]Tufano RP,Teixeira GV,Bishop J,et al.BRAF mutation in papillary thyroid cancer and its value in tailoring initial treatment:Asystematic review and meta-analysis[J].Medicine,2012,91(5)∶274-286.
[3]Witt RL,Ferris RL,Pribitkin EA,et al.Diagnosis and management of differentiated thyroid cancer using molecular biology[J].Laryngoscope,2013,123(4)∶1059-1064.
[4]Segel JM,Duke WS,White JR,et al.Outpatient thyroid surgery:Safety of an optimized protocol in more than 1,000 patients[J].Surgery,2016,159(2)∶518-523.
[5]Tufano RP.Advantages and disadvantages of outpatient thyroid surgery[J].JAMA Otolaryngol Head Neck Surg,2014,140(11)∶1076-1077.
[6]Duke WS,White JR,Waller JL,et al.Six-year experience with endoscopic thyroidectomy:Outcomes and safety profile[J].Ann Otol Rhinol Laryngol,2015,124(11)∶915-920.
[7]Kandil E,Hammad AY,Walvekar RR,et al.Robotic thyroidectomy versus nonrobotic approaches:A meta-analysis examining surgical outcomes[J].Surg Innov,2016,23(3)∶317-325.
[8]孙荣昊,李超,樊晋川,等.不同术式初治分化型甲状腺癌复发率及并发症比较的Meta分析[J].中华耳鼻咽喉头颈外科杂志,2013,48(10):834-839.
[9]中国抗癌协会头颈肿瘤专业委员会.分化型甲状腺癌诊治指南(初稿)[J].肿瘤预防与治疗,2011,24(1)∶55-68.
[10]Shah JP,Loree TR,Dharker D,et al.lobectomy vs total thyroidectomy for differentiated carcinoma of the thyroid:A matched pair analysis[J].Am J Surg,1993,166(4)∶331-335.
[11]孙荣昊,李超,樊晋川.对分化型甲状腺癌临床指南的比较和思考[J].中华内分泌外科杂志,2013,8(7)∶284-290.
[12]Madenci AL,Caragacianu D,Boeckmann JO,et al.Lateral neck dissection for well-differentiated thyroid carcinoma:A systematic review[J].Laryngoscope,2014,124(7)∶1724-1734.
[13]Stack BC Jr,Ferris RL,Goldenberg,et al.American thyroid association consensus review and statement regarding the anatomy,terminology,and rationale for lateral neck dissection in differentiated thyroid cancer[J].Thyroid,2012,22(5)∶501-508.
[14]孙荣昊,李超,樊晋川等.中央区淋巴清扫术对初治分化型甲状腺癌临床价值的Meta分析[J].中华耳鼻咽喉头颈外科学杂志,2014;49(2)∶157-164.
[15]Holostenco V,Khafif A.The upper limits of central neck dissection[J].JAMA Otolaryngol Head Neck Surg.2014,140(8)∶731-735.
[16]Wu CW,Chai YJ,Dionigi G,et al.Recurrent laryngeal nerve safety parameters of the harmonic focus during thyroid surgery:Porcine model using continuous monitoring[J].Laryngoscope,2015,125(11)∶2838-2845.
[17]Rosenthal LH,Benninger MS,Deeb RH.Vocal fold immobility:A longitudinal analysis of etiology over 20 years[J].Laryngoscope,2007,117(10)∶1864-1870.
[18]Potenza AS,Phelan EA,Cernea CR,et al.Normative intra-operative electrophysiologic waveform analysis of superior laryngeal nerve external branch and recurrent laryngeal nerve in patients undergoing thyroid surgery[J].World J Surg,2013,37(10)∶2336-2342.
[19]Noureldine SI,Genther DJ,Lopez M,et al.Early predictors of hypocalcemia after total thyroidectomy:An analysis of 304 patients using a short stay monitoring protocol[J].JAMA Otolaryngol Head Neck Surg,2014,140(11)∶1006-1013.
[20]Rosa KM,Matos LL,Cernea CR,et al.Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy[J].Arch Endocrinol Metab,2015,59(5)∶428-433.
[21]Falcone TE,Stein DJ,Jumaily JS,et al.Correlating pre-operative vitamin D status with post-thyroidectomy hypocalcemia[J].Endocr Pract,2015,21(4)∶348-354.
[22]孙荣昊,李超,樊晋川.外科手段初治分化型甲状腺癌后主要并发症及辅助治疗研究进展[J].中华全科医师杂志,2013,12(12)∶974-976.