低风险癌症的经皮消融术。

IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Endocrine-related cancer Pub Date : 2023-02-11 Print Date: 2023-03-01 DOI:10.1530/ERC-22-0244
R Michael Tuttle, Duan Li, Fourat Ridouani
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引用次数: 0

摘要

摘要:对于选择适当的低风险甲状腺乳头状癌癌症患者,积极监测和甲状腺叶切除术等微创治疗方案越来越被接受为合理的治疗方案。利用为治疗良性甲状腺结节而开发的技术,目前正在评估超声引导下经皮热消融作为治疗小的、甲状腺内的、低风险的癌症的一种潜在的额外的微创治疗选择。已发表的5000多名接受热消融治疗的低风险癌症患者的回顾性数据表明,通过适当的培训和适当的患者选择,这些技术可以安全有效地应用于乳头状微癌。与立即手术相比,热消融的并发症发生率较低,短期复发率相似。通过使用综合成像特征、患者特征和医疗团队特征的临床框架,将患者分类为理想、合适或不适合的最小管理选项(主动监测、甲状腺叶切除术或热消融),可以促进正确的患者选择。虽然具有回顾性,缺乏随机前瞻性临床试验数据,但目前可用的数据确实支持这样一种观点,即热消融技术可以可靠地摧毁甲状腺乳头状微癌病变,并且当经验丰富的团队在适当选择的患者中进行时,与临床可接受的肿瘤学结果相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Percutaneous ablation of low-risk papillary thyroid cancer.

Abstract: Minimalistic management options such as active surveillance and thyroid lobectomy are increasingly being accepted as reasonable management options for properly selected patients with low-risk papillary thyroid cancer. Leveraging technologies developed for the treatment of benign thyroid nodules, ultrasound-guided percutaneous thermal ablation is now being evaluated as a potential additional minimalistic management option for small, intrathyroidal, low-risk papillary thyroid cancer. Published retrospective data on more than 5000 low-risk papillary thyroid cancer patients treated with thermal ablation indicate that with appropriate training and proper patient selection, these technologies can be safely and effectively applied to papillary microcarcinomas. When compared to immediate surgery, thermal ablation appears to have lower complication rates with similar short-term rates of recurrence. Proper patient selection is facilitated by the use of a clinical framework which integrates imaging characteristics, patient characteristics, and medical team characteristics to classify a patient as ideal, appropriate, or inappropriate for minimalistic management options (active surveillance, thyroid lobectomy, or thermal ablation). While retrospective in nature and lacking randomized prospective clinical trial data, currently available data do support the proposition that thermal ablation technologies reliably destroy papillary thyroid microcarcinoma lesions and are associated with clinically acceptable oncologic outcomes when done by experienced teams in properly selected patients.

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来源期刊
Endocrine-related cancer
Endocrine-related cancer 医学-内分泌学与代谢
CiteScore
7.80
自引率
2.60%
发文量
138
审稿时长
6-12 weeks
期刊介绍: Endocrine-Related Cancer is an official flagship journal of the Society for Endocrinology and is endorsed by the European Society of Endocrinology, the United Kingdom and Ireland Neuroendocrine Society, and the Japanese Hormones and Cancer Society. Endocrine-Related Cancer provides a unique international forum for the publication of high quality original articles describing novel, cutting edge basic laboratory, translational and clinical investigations of human health and disease focusing on endocrine neoplasias and hormone-dependent cancers; and for the publication of authoritative review articles in these topics. Endocrine neoplasias include adrenal cortex, breast, multiple endocrine neoplasia, neuroendocrine tumours, ovary, prostate, paraganglioma, parathyroid, pheochromocytoma pituitary, testes, thyroid and hormone-dependent cancers. Neoplasias affecting metabolism and energy production such as bladder, bone, kidney, lung, and head and neck, are also considered.
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