THYROID
CANCER – CLINICAL SIGNIFICANCE AND PRACTICAL IMPLICATIONS OF POSTOPERATIVE
STAGING / RISK STRATIFICATION
Postoperative
staging for thyroid cancer is of paramount clinical importance in order to:
(I)provide
prognostic information (regarding disease persistence/recurrence)
(II)select
optimal and individualized surveillance of the patient
(III)facilitate
selection of therapeutic strategies
(IV)enable
risk-stratified description of patients for communication among health care
professionals, tracking by cancer registries, and research purposes
In general,
patients can be classified into the following three groups regarding risk of
disease recurrence:
HIGH RISK
-Gross
extrathyroidal extension
-Incomplete
tumor resection
-Distant
metastases
-Lymph
nodes > 3 cm
INTERMEDIATE
RISK
-Aggressive
histology
-Minor
extrathyroidal extension
-Vascular
invasion
- More than
5 involved lymph nodes (0.2 – 3 cm)
LOW RISK
-Intrathyroidal
differentiated thyroid cancer
- Less than
5 lymph node micrometastases (< 2 mm)
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