European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the Use of Minimally Invasive Treatments in Malignant Thyroid Lesions
| Autor: | Laszlo Hegedüs, Oliver Dudeck, Göran Wallin, Enrico Papini, Roberto Luigi Cazzato, Giovanni Mauri, Gilles Russ, Steven Bandula, Laura Fugazzola, Romana T. Netea-Maier, Agnieszka Czarniecka |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Papillary thyroid microcarcinoma Radiofrequency ablation Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Guidelines Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] Thyroid cancer law.invention Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Laser therapy law medicine Microwaves Ultrasonography medicine.diagnostic_test business.industry Microwave ablation Thyroidectomy Interventional radiology Neck dissection Guideline medicine.disease Thermal ablation Thyroid cancer metastases 030220 oncology & carcinogenesis Radiology business |
| Zdroj: | Mauri, G, Hegedüs, L, Bandula, S, Cazzato, R L, Czarniecka, A, Dudeck, O, Fugazzola, L, Netea-Maier, R, Russ, G, Wallin, G & Papini, E 2021, ' European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the Use of Minimally Invasive Treatments in Malignant Thyroid Lesions ', European Thyroid Journal, vol. 10, no. 3, pp. 185-197 . https://doi.org/10.1159/000516469 European Thyroid Journal, 10, 3, pp. 185-197 Eur Thyroid J European Thyroid Journal, 10, 185-197 |
| ISSN: | 2235-0640 |
| DOI: | 10.1159/000516469 |
| Popis: | The growing detection of papillary thyroid microcarcinomas (PTMCs) is paralleled by an increase in surgical procedures. Due to the frequent indolent nature, cost, and risk of surgery, active surveillance (AS) and ultrasound-guided minimally invasive treatments (MITs) are in suitable cases of incidental PTMC proposed as alternatives to thyroidectomy. Surgery and radioiodine are the established treatments for relapsing cervical differentiated thyroid carcinoma (DTC) metastases. But radioiodine refractoriness, risk of surgical complications, adverse influence on quality of life, or declining repeat surgery have led to AS and MIT being considered as alternatives for slow-growing DTC nodal metastases. Also, for distant radioiodine-refractory metastases not amenable to surgery, MIT is proposed as part of a multimodality therapeutic approach. The European Thyroid Association and the Cardiovascular and Interventional Radiological Society of Europe commissioned these guidelines for the appropriate use of MIT. Based on a systematic PubMed search, an evidence-based approach was applied, and both knowledge and practical experience of the panelists were incorporated to develop the manuscript and the specific recommendations. We recommend that when weighing between surgery, radioiodine, AS, or MIT for DTC, a multidisciplinary team including members with expertise in interventional radiology assess the demographic, clinical, histological, and imaging characteristics for appropriate selection of patients eligible for MIT. Consider TA in low-risk PTMC patients who are at surgical risk, have short life expectancy, relevant comorbidities, or are unwilling to undergo surgery or AS. As laser ablation, radiofrequency ablation, and microwave ablation are similarly safe and effective thermal ablation (TA) techniques, the choice should be based on the specific competences and resources of the centers. Use of ethanol ablation and high-intensity focused ultrasound is not recommended for PTMC treatment. Consider MIT as an alternative to surgical neck dissection in patients with radioiodine refractory cervical recurrences who are at surgical risk or decline further surgery. Factors that favor MIT are previous neck dissection, presence of surgical complications, small size metastases, and |
| Databáze: | OpenAIRE |
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