저위험 미세갑상선유두암의 진단과 치료 (Diagnosis and treatment of low-risk papillary thyroid microcarcinoma)

서지정보

· 발행기관 : 대한의사협회
· 수록지 정보 : 대한의사협회지 / 61권 / 4호 / 232 ~ 240페이지
· 저자명 : 문재훈, 박영주

초록

Recent guidelines for the treatment of thyroid nodules and differentiated thyroid cancer include active surveillance as an alternative option for the treatment of low-risk papillary thyroid microcarcinoma (PTMC). PTMC is defined as having a tumor diameter of ≤1 cm, and low-risk PTMC is defined as PTMC without currently known risk factors (e.g., metastases, local invasion, or cytologic evidence of aggressive disease). Some researchers have suggested that active surveillance can be the first-line treatment of low risk PTMC based on reports showing that the oncological outcomes of active surveillance and immediate surgery were similarly excellent and that immediate surgery can occasionally be accompanied by surgical complications. Nonetheless, many concerns still exist about the full implementation of active surveillance in current clinical practice because the biology of PTMC still has not been fully elucidated and there is little evidence regarding the long-term prognosis of active surveillance. In this review, we discuss the current concept of low-risk PTMC and its treatment modalities, comparing immediate surgery and active surveillance in terms of clinical applications, prognosis, adverse effects, quality of life, and medical costs. This review aims to enable healthcare providers to provide patients with well-balanced information about immediate surgery and active surveillance for the treatment of low-risk PTMC.

영어초록

Recent guidelines for the treatment of thyroid nodules and differentiated thyroid cancer include active surveillance as an alternative option for the treatment of low-risk papillary thyroid microcarcinoma (PTMC). PTMC is defined as having a tumor diameter of ≤1 cm, and low-risk PTMC is defined as PTMC without currently known risk factors (e.g., metastases, local invasion, or cytologic evidence of aggressive disease). Some researchers have suggested that active surveillance can be the first-line treatment of low risk PTMC based on reports showing that the oncological outcomes of active surveillance and immediate surgery were similarly excellent and that immediate surgery can occasionally be accompanied by surgical complications. Nonetheless, many concerns still exist about the full implementation of active surveillance in current clinical practice because the biology of PTMC still has not been fully elucidated and there is little evidence regarding the long-term prognosis of active surveillance. In this review, we discuss the current concept of low-risk PTMC and its treatment modalities, comparing immediate surgery and active surveillance in terms of clinical applications, prognosis, adverse effects, quality of life, and medical costs. This review aims to enable healthcare providers to provide patients with well-balanced information about immediate surgery and active surveillance for the treatment of low-risk PTMC.

참고자료

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