Lymphatic dissection for thyroid cancer surgery still makes sense
September 27, 2018 Source: Health News Author: Wang shadow
Window._bd_share_config={ "common":{ "bdSnsKey":{ },"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":" 0","bdSize":"16"},"share":{ }};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')) .src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];Recently, a multi-center prospective study initiated by Professor Huang Wei from the Union Hospital of Huazhong University of Science and Technology showed that the rate of lymph node metastasis in patients with thyroid cancer in China is high, and the preoperative diagnosis rate is low. Preventive cleaning is an important remedy. Although preventive resection of lymph nodes has not been recommended in the US guidelines, it is still important for Chinese patients to adhere to preventive dissection of cervical lymph nodes.
According to Huang Wei, thyroid cancer is the fastest growing solid malignant tumor. Women and middle-aged people have become the "hardest hit areas" for thyroid cancer. In 2014, the incidence of thyroid cancer in women in China was as high as 18.99/100,000. In order to accumulate data on thyroid cancer in China and promote the development of clinical research on thyroid cancer in China, the top ten medical centers in the United States have completed the “DART Multi-Center Real-World Research on Chinese Thyroid Cancerâ€, the DTCC study.
In the DTCC study, a total of 2013 patients with thyroid cancer were enrolled. 99% of the patients underwent lymph node dissection at the time of surgery, and 82.3% of the patients had lymph node metastasis after surgery. However, preoperative cervical ultrasonography revealed a suspicious lymph node ratio of only 32.4%. The results of this study confirmed that the lymph node metastasis rate in our patients is quite high, and the preoperative diagnosis rate is low. Preventive cleaning is an important remedy. Huang Wei pointed out that if the preoperative ultrasound compliance rate needs to be improved, if the US guidelines are copied, more patients with thyroid cancer surgery will have recurrence and metastasis.
As for the high rate of lymph node metastasis in patients with thyroid cancer in China, the analysis of jaundice may be related to three reasons: First, patients and doctors in China attach great importance to lymph node metastasis, and the rate of preventive cleaning is high. Second, Chinese doctors routinely use during surgery. Frozen disease examination, the rate of diagnosis is high, the rate of therapeutic clearance is high; the third is that the diagnosis and treatment of patients in China is relatively late, resulting in a high rate of lymph node metastasis.
Huang Wei also pointed out that the diagnosis and treatment of thyroid cancer in China is gradually standardized, but there is still no standardized process and tools for long-term follow-up after operation. The quality of follow-up of primary medical units is not high. The postoperative follow-up of thyroid cancer is that patient compliance is not high. The proportion of patients on time is still less than 50%, and the relevant medical team, patient education, and tool platform construction are all in need of improvement.
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