A study of variation in therapeutic approach to low-risk differentiated thyroid cancer in the UK.

Autor: Maniam P; Department of ENT, Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK., Ishii H; Department of ENT, Head and Neck Surgery, St George's Hospital, London, UK., Stechman MJ; Department of Endocrine Surgery, University Hospital of Wales, Cardiff, Wales, UK., Watkinson J; Department of Surgery, Great Ormond Street Hospital, London, UK., Farnell K; Butterfly Thyroid Cancer Trust, Rowlands Gill, Tyne and Wear, UK., Kim D; Department of ENT, Head and Neck Surgery, St George's Hospital, London, UK., Nixon IJ; Department of ENT, Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK.
Jazyk: angličtina
Zdroj: The Journal of laryngology and otology [J Laryngol Otol] 2024 Jan; Vol. 138 (1), pp. 83-88. Date of Electronic Publication: 2023 May 17.
DOI: 10.1017/S0022215123000841
Abstrakt: Background: The British Thyroid Association and American Thyroid Association guideline definitions for low-risk differentiated thyroid cancers are susceptible to differing interpretations, resulting in different clinical management in the UK.
Objective: To explore the national effect of these guidelines on the management of low-risk differentiated thyroid cancers.
Methods: Anonymised questionnaires were sent to multidisciplinary teams performing thyroidectomies in the UK. Risk factors that multidisciplinary teams considered important when managing low-risk differentiated thyroid cancers were established.
Results: Most surgeons (71 out of 75; 94.7 per cent) confirmed they were core multidisciplinary team members. More than 80 per cent of respondents performed at least 30 hemi- and/or total thyroidectomies per annum. A majority of multidisciplinary teams (50 out of 75; 66.7 per cent) followed British Thyroid Association guidelines. Risk factors considered important when managing low-risk differentiated thyroid cancers included: type of tumour histology findings (87.8 per cent), tumour size of greater than 4 cm (86.5 per cent), tumour stage T 3b (85.1 per cent) and central neck node involvement (85.1 per cent). Extent of thyroid surgery (e.g. hemi- or total thyroidectomy) was highly variable for low-risk differentiated thyroid cancers.
Conclusion: Management of low-risk differentiated thyroid cancers is highly variable, leading to a heterogeneous patient experience.
Databáze: MEDLINE
Externí odkaz: