Publication
German Association of Endocrine Surgeons practice guideline for the surgical management of malignant thyroid tumors
Journal Paper/Review - Mar 3, 2013
Dralle Henning, Trupka Arnold, Zielke Andreas, Karges Wolfram, Luster Markus, Schmid Kurt W, Vordermark Dirk, Schmoll Hans-Joachim, Mühlenberg Reinhard, Schober Otmar, Rimmele Harald, Machens Andreas, Schabram Peter, Nies Christoph, Lorenz Kerstin, Musholt Thomas J, Schabram Jochen, Steinmüller Thomas, Frilling Andreja, Simon Dietmar, Goretzki Peter E, Niederle Bruno, Scheuba Christian, Clerici Thomas, Hermann Michael, Kussmann Jochen, German Societies of General and Visceral Surgery; Endocrinology; Nuclear Medicine; Pathology; Radiooncology; Oncological Hematology; and the German Thyroid Cancer Patient Support Organization Ohne Schilddrüse leben e.V
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Brief description/objective
INTRODUCTION
Over the past years, the incidence of thyroid cancer has surged not only in Germany but also in other countries of the Western hemisphere. This surge was first and foremost due to an increase of prognostically favorable ("low risk") papillary thyroid microcarcinomas, for which limited surgical procedures are often sufficient without loss of oncological benefit. These developments called for an update of the previous practice guideline to detail the surgical treatment options that are available for the various disease entities and tumor stages.
METHODS
The present German Association of Endocrine Surgeons practice guideline was developed on the basis of clinical evidence considering current national and international treatment recommendations through a formal expert consensus process in collaboration with the German Societies of General and Visceral Surgery, Endocrinology, Nuclear Medicine, Pathology, Radiooncology, Oncological Hematology, and a German thyroid cancer patient support organization.
RESULTS
The practice guideline for the surgical management of malignant thyroid tumors includes recommendations regarding preoperative workup; classification of locoregional nodes and terminology of surgical procedures; frequency, clinical, and histopathological features of occult and clinically apparent papillary, follicular, poorly differentiated, undifferentiated, and sporadic and hereditary medullary thyroid cancers, thyroid lymphoma and thyroid metastases from primaries outside the thyroid gland; extent of thyroidectomy; extent of lymph node dissection; aerodigestive tract resection; postoperative follow-up and surgery for recurrence and distant metastases.
CONCLUSION
These evidence-based recommendations for surgical therapy reflect various "treatment corridors" that are best discussed within multidisciplinary teams and the patient considering tumor type, stage, progression, and inherent surgical risk.