my country's first "expert consensus on neoadjuvant therapy for locally advanced thyroid cancer" released
Recently, my country's first "Chinese Expert Consensus on Neoadjuvant Treatment for Locally Advanced Thyroid Cancer" was officially released. This marks that my country has independently formulated new standards for the treatment of patients with locally advanced thyroid cancer, providing a new option for precision treatment of such patients.
It is reported that the "consensus" was led by the Department of Head and Neck Surgery of Fudan University Cancer Hospital, the Thyroid Surgeons Committee of the Surgeons Branch of the Chinese Medical Doctor Association, the Thyroid Disease Professional Committee of the Chinese Association of Research Hospitals, the General Surgery Branch of the China Association for the Promotion of International Healthcare Exchange and China Developed jointly by the Thyroid Cancer Professional Committee of the Anti-Cancer Association.
Professor Wang Yu, director of the Department of Head and Neck Surgery at Fudan University Cancer Hospital, said that locally advanced thyroid cancer can exist in various pathological types of thyroid cancer, which is specifically defined as “tumors that obviously invade surrounding structures and organs, such as the recurrent laryngeal nerve, trachea, esophagus, Larynx, surrounding large blood vessels in the neck, mediastinal blood vessels, and thyroid cancer that extensively invades the skin, subcutaneous soft tissue and muscles." This type of thyroid cancer accounts for about 5-10% of all thyroid cancer cases.
Compared with early-stage thyroid cancer, locally advanced thyroid cancer has a wider surgical scope, greater trauma, and higher local recurrence rate. It is one of the main causes of death in patients with thyroid cancer. At present, the 5-year survival rate of thyroid cancer patients in my country is 84.3%. The medical community needs to pay more attention to patients with advanced thyroid cancer and strive to improve the survival rate.
How can we reduce the risk of death and improve the overall treatment effect of patients with near locally advanced thyroid cancer?
Professor Tian Wen from the First Medical Center of the General Hospital of the Chinese People's Liberation Army said that in recent years, with the progress of systemic treatment of thyroid cancer, many studies have confirmed that neoadjuvant therapy, especially neoadjuvant targeted therapy, can treat some locally advanced stages of thyroid cancer. The shrinkage of thyroid cancer tumors gives patients the opportunity for surgery and even complete tumor resection, which significantly improves the prognosis of these patients.
The new comprehensive treatment model has also become a new treatment option for patients with locally advanced thyroid cancer. However, in the field of diagnosis and treatment of thyroid cancer in my country, there was no consensus on neoadjuvant treatment for locally advanced stages based on the Chinese patient population, and widespread promotion of this treatment model has brought certain difficulties.
The Department of Head and Neck Surgery at Fudan University Cancer Hospital combined with experts from multiple disciplines including surgery, radiotherapy, chemotherapy, pathology, and imaging, combined with the current status of neoadjuvant treatment for locally advanced thyroid cancer at home and abroad, formulated the "Chinese Experts on Neoadjuvant Treatment for Locally Advanced Thyroid Cancer" consensus". The "Consensus" has formed a total of 21 recommended terms from four aspects: the timing of neoadjuvant treatment for locally advanced thyroid cancer, protocol selection, evaluation of neoadjuvant treatment, and follow-up treatment of neoadjuvant treatment, aiming to further improve the neoadjuvant treatment of thyroid cancer. Its effectiveness and safety provide reference for the treatment of patients with locally advanced thyroid cancer in my country and promote the development of precise comprehensive treatment of thyroid cancer.
According to the new version of the "Consensus", when selecting neoadjuvant treatment options, clinicians need to take into account the pathological types and genetic mutations of locally advanced thyroid cancer, as well as the effectiveness, accessibility, safety and cost-effectiveness of the drug. Find the best option for your patient.
After neoadjuvant treatment, it is necessary to comprehensively evaluate the efficacy of neoadjuvant treatment from imaging, pathology, surgical margins, etc., and formulate a comprehensive treatment plan to improve the clinical treatment effect. For example, the overall 5-year survival rate of thyroid cancer patients treated at Fudan University Cancer Hospital can reach 98.5%.
The "Consensus" specifically pointed out: Due to the lack of clinical evidence at present, it is still difficult to grasp the indications for neoadjuvant treatment, individualize the selection of drugs guided by molecular testing, select the timing and scope of surgery after neoadjuvant treatment, and follow-up treatment methods and intensity. Further clinical exploration is needed and the guidelines will be updated in due course. Professor Wang Yu reminded that neoadjuvant treatment of locally advanced thyroid should be carried out by a multidisciplinary team with rich clinical experience in thyroid cancer to ensure the standardization of treatment.
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