elective neck dissection

选择性颈清扫术
  • 文章类型: Consensus Development Conference
    本指南的目的是为乳头状颈部转移瘤患者的手术治疗提供具体建议,卵泡,甲状腺髓样癌.
    建议是根据国际医学专业协会发布的科学论文研究(优先考虑荟萃分析)和指南制定的。美国医师学会指南分级系统用于确定证据水平和建议等级。回答了以下问题:A)选择性颈淋巴结清扫术是否适用于乳头状治疗,卵泡,和甲状腺髓样癌?B)什么时候应该中央,横向,
    建议1:cN0分化良好的甲状腺癌患者或具有非侵入性T1和T2肿瘤的患者不需要进行选择性中央颈清扫术,但可以在T3-T4肿瘤或颈部外侧区室存在转移的情况下考虑。建议2:甲状腺髓样癌建议选择性中央颈清扫术。建议3:II-V级选择性颈淋巴结清扫术应用于治疗甲状腺乳头状癌的颈部转移,一种降低复发风险和死亡率的方法.建议4:选择性或治疗性颈淋巴结清扫术后淋巴结复发的治疗需要采用房室颈清扫术;不建议使用“浆果节点摘除”。建议5:目前没有关于使用分子检测指导甲状腺癌颈部清扫程度的建议。
    UNASSIGNED: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas.
    UNASSIGNED: Recommendations were developed based on research of scientific articles (preferentially meta-analyses) and guidelines issued by international medical specialty societies. The American College of Physicians\' Guideline Grading System was used to determine the levels of evidence and grades of recommendations. The following questions were answered: A) Is elective neck dissection indicated in the treatment of papillary, follicular, and medullary thyroid carcinoma? B) When should central, lateral, and modified radical neck dissection be performed? C) Could molecular tests guide the extent of the neck dissection?
    UNASSIGNED: Recommendation 1: Elective central neck dissection is not indicated in patients with cN0 well-differentiated thyroid carcinoma or in those with noninvasive T1 and T2 tumors but may be considered in T3-T4 tumors or in the presence of metastases in the lateral neck compartments. Recommendation 2: Elective central neck dissection is recommended in medullary thyroid carcinoma. Recommendation 3: Selective neck dissection of levels II-V should be indicated to treat neck metastases in papillary thyroid cancer, an approach that decreases the risk of recurrence and mortality. Recommendation 4: Compartmental neck dissection is indicated in the treatment of lymph node recurrence after elective or therapeutic neck dissection; \"berry node picking\" is not recommended. Recommendation 5: There are currently no recommendations regarding the use of molecular tests in guiding the extent of neck dissection in thyroid cancer.
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  • 文章类型: Consensus Development Conference
    The eighth international symposium for sentinel node biopsy (SNB) in head and neck cancer was held in 2018. This consensus conference aimed to deliver current multidisciplinary guidelines. This document focuses on the surgical aspects of SNB for oral cancer.
    Invited expert faculty selected topics requiring guidelines. Topics were reviewed and evidence evaluated where available. Data were presented at the consensus meeting, with live debate from panels comprising expert, nonexpert, and patient representatives followed by voting to assess the level of support for proposed recommendations. Evidence review, debate, and voting results were all considered in constructing these guidelines.
    A range of topics were considered, from patient selection to surgical technique and follow-up schedule. Consensus was not achieved in all areas, highlighting potential issues that would benefit from prospective studies. Nevertheless these guidelines represent an up-to-date pragmatic recommendation based on current evidence and expert opinion.
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