Low Risk Thyroid Cancer

  • سال انتشار: 1398
  • محل انتشار: پنجمین همایش بین المللی و هفتمین همایش سراسری تازه های غدد و متابولیسم
  • کد COI اختصاصی: ICEMU05_024
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 420
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نویسندگان

Hossein Gharib,

M.D.Professor of Medicine Mayo Clinic College of Medicine, Rochester MN, U.S.A

چکیده

• To review different types of low risk thyroid cancer • Discuss PTMC, NIFTP, lobectomy vs thyroidectomy, new TNM staging, radioiodine remnant ablation (RRA) & management of low-risk PTC in children & adults• Review recent data that show recurrence and survival in children and adults in a report from Mayo Clinic over 6 decades including more than 4,400 patients for low risk tumors, CSM• Applying risk management in selecting patients for treatment The incidence of thyroid cancer is increasing in this country, and we expect thyroid cancer will be #2 in women & #3 in men by 2030, with the annual projected stable death rate around 2,000. Follicular cell-derived thyroid carcinomas, PTC & FTC, comprise up to 95% of all thyroid tumors; MTC & APC the remaining 5%.Medical management of PTMC has emerged as an attractive alternative to thyroid surgery. We will discuss who and how should be included in this program. NIFTP is a premalignant condition that is diagnosed only after lobectomy and needs no RAI or LT4 suppression. Lobectomy, or minimal-risk surgery, seems an appropriate treatment for most low risk tumors. A practical approach after lobectomy will be reviewed. We will review new TNM classification and major changes in the 8th edition of AJCC. Assessing response to therapy is important in offering a window into prognosis and major parameters will be discussed. Finally, I will discuss a recent report of presentations and outcomes of PTC in more than 4,000 patients from a single institution followed for 4-6 decades. Indications for and ways to achieve RRA will be also reviewed. The take home message should be that low risk thyroid cancers are associated with excellent outcomes and frequently require thyroidectomy only.

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