Current management of papillary thyroid microcarcinoma in Canada

Journal of Otolaryngology-Head & Neck Surgery

David P Goldstein¹  Anna M Sawka²  Shereen Ezzat²  Lorne Rotstein⁵  Jeremy Freeman³  John De Almeida¹  Antoine Eskander¹  Mazin Merdad⁴ 

[1] Department of Otolaryngology ¿ Head and Neck Surgery, University Health Network, Princess Margaret Hospital, University of Toronto, Rm 3-952, 610 University Ave, Toronto M5G 2M9, Ontario, Canada;Division of Endocrinology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada;Department of Otolaryngology ¿ Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;Department of Otolaryngology ¿ Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia;Department of General Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada

关键词: Questionnaire;    Survey;    Well-differentiated thyroid cancer;    Papillary thyroid cancer;    Microcarcinoma;    Thyroid cancer;   

Others  :  1143929
DOI  :  10.1186/s40463-014-0032-8

 received in 2014-02-18, accepted in 2014-07-18,  发布年份 2014

【 摘 要 】

Introduction

The detection of papillary thyroid microcarcinoma (PTMC) is on the rise and its optimal management remains controversial. Our aim was to determine the current self-reported management of PTMC amongst Canadian otolaryngologist-head and neck surgeons (OHNS) and endocrinologists and to identify factors influencing their management decisions.

Methods

A nine item web-based questionnaire was distributed to Canadian OHNS and endocrinologists. The three main domains were demographics, current management of PTMC scenarios, and factors influencing the decisions.

Results

One hundred and thirteen OHNS and endocrinologists completed the survey. Respondents were closely divided between recommending hemithyroidectomy (47%) or total thyroidectomy (43%) for a newly diagnosed PTMC in a low risk patient. Observation was the preferred method for managing PTMC detected incidentally after hemithyroidectomy (76%). Respondents chose more aggressive treatment for male patients compared to female patients. A positive history of thyroid cancer or previous radiation exposure was the most important factor influencing the management of PTMC.

Conclusion

The current practices of Canadian OHNS and endocrinologist largely coincide with available guidelines. The slight variation in practice might be explained by the opposing evidence supporting different management options. Given the dramatic increase in the incidence of PTMC we suggest future guidelines address the management of PTMC independently.

【 授权许可】

   
2014 Merdad et al.; licensee BioMed Central Ltd.

【 图 表 】

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