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Thyroid cancer: Surgery for the primary tumor

机译：甲状腺癌：原发肿瘤手术

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Surgery is the mainstay of therapy for most patients who present with thyroid cancer. The surgeon must select an appropriate procedure based upon pre operative factors such as tumor histology, extent of primary disease, the presence of regional or distant metastases, associated disease in the contralateral thyroid lobe and the potential for post operative adjuvant therapy. Preservation of the vital structures in the central neck, including the recurrent and superior laryngeal nerves and the parathyroid glands is critical as is the maintenance of absolute hemostasis. In this review article we describe the management of Well Differentiated Thyroid Cancer (WDTC) presenting as a solitary nodule, WDTC in a background of multinodular disease and the management of WDTC presenting as advanced local disease. We go onto discuss the impact that regional and distant metastases have on the choice of surgical approach. The focus of this article is WDTC, however the principles of management of the primary in medullary and anaplastic carcinoma are also discussed.
机译：对于大多数患有甲状腺癌的患者，手术是治疗的主要手段。外科医生必须根据术前因素，例如肿瘤组织学，原发疾病的程度，局部或远处转移灶的存在，对侧甲状腺叶中的相关疾病以及术后辅助治疗的可能性，选择适当的程序。保留中央颈部的重要结构，包括喉返神经和喉上神经以及甲状旁腺，与维持绝对止血一样至关重要。在这篇综述文章中，我们描述了呈现为单个结节的高分化甲状腺癌（WDTC）的管理，多结节性疾病背景下的WDTC以及呈现为晚期局部疾病的WDTC的管理。我们继续讨论区域转移和远处转移对手术方式选择的影响。本文的重点是WDTC，但同时也讨论了髓样和间变性癌的原发性处理原则。

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