Surgical management of differentiated papillary and follicular thyroid cancer
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Hellenic Journal of Surgery (2015) 87:1, 38-40
Surgical Management of Differentiated Papillary and Follicular Thyroid Cancer I. Koutelidakis, A. Ananiadis, V. Papaziogas, J. Makris
Abstract The incidence of thyroid cancer has increased in Greece and also in other countries of Europe. These developments led the Greek Society of Endocrine Surgeons to establish practice guidelines defining the optimal surgical treatment options that are available for the various disease entities and tumour classifications. These guidelines are the outcome of everyday practice with our patients and have been publicised by several surgical societies around the world from 2006 until the present day. The guidelines were developed on the basis of clinical findings in comparison with international treatment recommendations over the past eight years. Published treatment recommendations for thyroid cancer where reviewed and analyzed, taking into consideration the specificities of each country and continent. The practice guidelines for the surgical management of differentiated papillary and follicular thyroid cancer include recommendations for the preoperative evaluation and classification, surgical strategies, extent of thyroidectomy, clinical and histopathological features, extent of lymph node dissection and postoperative follow-up. These evidencebased recommendations for surgical management of differentiated papillary and follicular thyroid cancer, according to tumour type, stage, progression, and inherent surgical risk, are treatment pillars for the endocrine surgeon and all multidisciplinary teams. Key words: Differentiated thyroid cancer; surgical treatment; follicular thyroid cancer
Introduction Thyroid cancer accounts for only 0.5-1.5% of all malignancies, but its incidence is increasing in European countries more rapidly than other cancers, [11] and it requires a multidisciplinary approach, including endocrinology, nuclear medicine, oncology and endocrine surgery. Epidemiology may differ among European countries according to different environments, probably implicating different clinical practice or pathogenetic factors which change management accordingly. In recent decades, the clinical presentation of differentiated thyroid cancer has changed from advanced cases requiring intense treatment and surveillance to cancers detected by fortuitous neck ultrasonography (US) requiring less aggressive treatment and follow-up. Diagnostic and treatment tools have also improved allowing less invasive and uncomfortable procedures for the patients. These considerations present the need for more effective, less invasive and expensive procedures capable of guaranteeing the best
I. Koutelidakis, A. Ananiadis, V. Papaziogas, J. Makris 2nd Department of Surgery, Medical School, Aristoteleio University of Thessaloniki, Greece Department of Endocrinology, Red Cross Hospital, Athens, Greece Corresponding author: I. Koutelidakis e-mail: [email protected] Received 10 May 2014; Accepted 30 Oct 2014
Hellenic Journal of Surgery 87
management and quality
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