Who should treat thyroid cancer? A UK surgical perspective.

摘要

Who should treat thyroid cancer? The obvious answer is a multidisciplinary, appropriately trained team in a suitable setting, but life is not as simple as this [5,6]! Thyroid cancer is rare, with an annual incidence in the UK of 2.6 per 100 000 [7]. Recent data suggest a 20-year doubling time for both the UK and the USA, although this is not matched by increasing mortality [7,8]. This rise in incidence is probably related to increases in ultrasound scanning, subsequent surgery, accurate staging, and the discovery of more micro-carcinomas and pTl lesions [9]. In addition, other small incidental cancers are found after surgery for presumed benign multinodular goitre. The most common presentation for thyroid malignancy is as a solitary thyroid nodule in a euthyroid patient, and the incidence of malignancy in these nodules approaches 7-10% [10]. Other less common presentations include signs and symptoms of cervical metastases, local invasion and distant spread.