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Aktuelle Behandlungskonzepte des papillären Schilddrüsenmikrokarzinoms

Current treatment strategies for papillary thyroid microcarcinoma

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Zusammenfassung

Das Schilddrüsenkarzinom zeigt eine steigende Inzidenz, gleichzeitig aber eine stabile oder sogar leicht rückgängige Mortalitätsrate. Dieses Phänomen liegt in einer erhöhten Inzidenz der papillären Mikrokarzinome (Schilddrüsenkarzinome mit einer Ausdehnung von weniger als 1 cm), die vermutlich auf der verbesserten Diagnostik durch die hochauflösende Sonographie und der Feinnadelaspirationsbiopsie basiert. Die amerikanische und die europäische Gesellschaft für Schilddrüsenerkrankungen haben vor Kurzem neue Leitlinien zur Diagnostik und Therapie des differenzierten Schilddrüsenkarzinoms veröffentlicht mit dem Ziel, diagnostische und therapeutische Maßnahmen ohne Verlust an Effektivität zu minimieren. Dieses Ziel ist insbesondere für das papilläre Mikrokarzinom wichtig, welches für die Patienten eine exzellente Prognose und eine fast normale Lebenserwartung bedeutet. Dieser Artikel beschreibt zusammenfassend die Geschichte der Schilddrüsenchirurgie und stellt mit dem papillären Mikrokarzinom ein wichtiges Thema der aktuellen Onkologie der Schilddrüse vor. Darüber hinaus werden die aktuellen Methoden der Diagnostik, Therapie und die Nachsorge der Erkrankung diskutiert.

Abstract

The increase in the incidence of thyroid cancer is accompanied by a mortality rate that is stable or perhaps even slightly decreasing. This phenomenon is due to the increased frequency of papillary microcarcinomas (thyroid tumors with a diameter of less than 1 cm), which is presumably attributable to the improved diagnosis enabled by high resolution ultrasound and fine needle aspiration cytology. The American and European Thyroid Associations have recently published new guidelines for the diagnosis and therapy of differentiated thyroid tumors. These guidelines are aimed at minimizing the diagnostic and therapeutic procedures without reducing their effectiveness. This goal is particularly important for papillary thyroid microcarcinoma patients, who have an excellent prognosis and almost normal life expectancy. This article summarizes the history of thyroid surgery and introduces papillary thyroid microcarcinoma—an important topic in modern thyroid oncology. Current methods for diagnosis, treatment and follow-up care of this disease are discussed.

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Danksagung

An Professor Dr. med. Abbas Agaimy (Pathologisches Institut, Universitätsklinikum Erlangen, Direktor: Prof. Dr. med. A. Hartmann) für die freundliche Bereitstellung des histologischen Bildes.

Die Studie wurde durch das Gesundheitsministerium der Tschechischen Republik unterstützt: No. NT13488, UNCE 204013, PRVOUK 27-1, SVV260-510.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06, Prag 5, Tschechische Republik

    J. Plzák M.D., Ph.D., P. Laštůvka & J. Betka

  2. Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Na Homolce, Prag, Tschechische Republik

    J. Astl

  3. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Erlangen, Deutschland

    G. Psychogios & J. Zenk

Authors
  1. J. Plzák M.D., Ph.D.
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  2. J. Astl
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  3. G. Psychogios
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  4. J. Zenk
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  5. P. Laštůvka
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  6. J. Betka
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Corresponding author

Correspondence to J. Plzák M.D., Ph.D..

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Plzák, J., Astl, J., Psychogios, G. et al. Aktuelle Behandlungskonzepte des papillären Schilddrüsenmikrokarzinoms. HNO 61, 300–305 (2013). https://doi.org/10.1007/s00106-013-2679-2

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  • DOI: https://doi.org/10.1007/s00106-013-2679-2

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