Papiller Tiroid Kanserinde Güncel Cerrahi Tedavı̇

Abstract

The planning of surgery methods and patient evaluation in the thyroid cancer surgery has been subjected to up to date discussions with the over again description of cytological classification after the development of high-resolution ultrasound and fine needle aspiration biopsy. Papillary carcinomas consist of nearly 85% of all thyroid cancers and of them papillary thyroid microcarcinomas (PTM) constitute 30-56%. At the late 1980s, PTM defined as the papillary thyroid carcinomas (PTC) those are ≤1 cm at the largest diameter. In the international guidelines of thyroid cancer diagnosis and management, PTM and PTC diagnosis are the main factors that effect the surgical method. The management steps of papillary thyroid cancer begin with surgical removing of the primary tumor, the part overspilling from thyroid capsule and affected lymphoid ganglions. The main principle is retaining the morbidity in minimal during surgery with the extent of surgery according withexperience of the surgeon. The main determinant for deciding continuation of treatment and follow up of the patient is making true staging. This true staging is important for many parameters as the indication of supplementary surgery and radioactive iodine ablation therapy (RAIT), recurrence follow up protocol, the degree of thyroid stimulating hormone (TSH) supression treatment. The metastatic lymphoid ganglions are the most important factors in both true staging and relapse of the disease, so one of the current controversial subject in PTM is the extent of surgery. In this review, we want to summarize the main headings of diagnosis and management of papillarythyroid cancer in the guidance of current literature and American Thyroid Association Guideline relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.