Surgical Treatment for Papillary Thyroid Carcinoma in Japan: Differences from Other Countries
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Papillary thyroid carcinoma (PTC) is the most representative carcinoma among thyroid malignancies. The treatment strategy, especially surgery, in Japan traditionally differs from that in other countries, including Korea. Total thyroidectomy has been less frequently adopted, but lymph node dissection has been more actively performed in Japan than in other countries. Based on our data, total thyroidectomy is not necessary for low-risk patients, while it is, of course, mandatory for patients with high-risk features. Prophylactic central node dissection may not prolong patients’ survival, but we routinely perform it because reoperation for recurrence to this compartment is troublesome. In the past, Japanese endocrine surgeons actively performed prophylactic lateral node dissection, but indications are narrowing. However, it may be better to perform prophylactic modified radical neck dissection for patients exhibiting certain characteristics to reduce the rate of lymph node recurrence. I hope that surgical strategies in Japan and other countries will fuse with each other in order to identify the best treatments for PTC patients throughout the world.
Abstract
Papillary thyroid carcinoma (PTC) is the most representative carcinoma among thyroid malignancies. The treatment strategy, especially surgery, in Japan traditionally differs from that in other countries, including Korea. Total thyroidectomy has been less frequently adopted, but lymph node dissection has been more actively performed in Japan than in other countries. Based on our data, total thyroidectomy is not necessary for low-risk patients, while it is, of course, mandatory for patients with high-risk features. Prophylactic central node dissection may not prolong patients’ survival, but we routinely perform it because reoperation for recurrence to this compartment is troublesome. In the past, Japanese endocrine surgeons actively performed prophylactic lateral node dissection, but indications are narrowing. However, it may be better to perform prophylactic modified radical neck dissection for patients exhibiting certain characteristics to reduce the rate of lymph node recurrence. I hope that surgical strategies in Japan and other countries will fuse with each other in order to identify the best treatments for PTC patients throughout the world.
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