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Guideline for the Surgical Management of Locally Invasive Differentiated Thyroid Cancer From the Korean Society of Head and Neck Surgery

김희진|정은경|이동현|조재근|박성준|김현범|김민수|박영민|김주현|김연수|김도훈|이동근|박기남|이영찬|정은재|김상연|신성찬|이형신|권순영|지용배|백승국|최효근|장전엽|석준걸|김보해|김근전|주영훈|오경호|홍용태|안동빈|홍현준|반명진|원호륜|박준욱
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2023.02|Clinical and Experimental Otorhinolaryngology|제16권 제1호|pp. 1-19|DOI https://doi.org/10.21053/ceo.2022.01732

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참고문헌

키워드

GuidelinesThyroidectomyEsophagusTracheaRecurrent Laryngeal NerveLymph Nodes

초록

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients withlocally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invadingsurrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, theoptimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. OnOctober 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers werereviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Developmentand Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommenda-tions. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an inter-vention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completingthe draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgicalextent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework,trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-basedguidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatmentof patients with locally invasive DTC.

Abstract

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients withlocally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invadingsurrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, theoptimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. OnOctober 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers werereviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Developmentand Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommenda-tions. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an inter-vention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completingthe draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgicalextent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework,trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-basedguidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatmentof patients with locally invasive DTC.

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