Treatment of Thyroid Tumor: Japanese Clinical Guidelines

Front Matter....Pages i-xviii
Front Matter....Pages 13-13
Introduction....Pages 1-11
CQ1. What Are the Risk Factors for Thyroid Cancer?....Pages 15-18
CQ2. Is There a Difference in Prognosis Between Adult Thyroid Cancer and Juvenile Thyroid Cancer or Juvenile Follicular Cancer?....Pages 19-21
Column 1. Genetics of Thyroid Cancer....Pages 23-25
Column 2. Prevalence of Various Histological Types of Thyroid Cancer....Pages 27-28
Column 3. Anaplastic Transformation of Differentiated Carcinoma....Pages 29-30
Column 4. Incidence, Morbidity, and Mortality of Thyroid Carcinoma in Japan....Pages 31-36
Front Matter....Pages 37-37
CQ3. What Is the Frequency (Probability of Cancer Before Examination) of Thyroid Cancer....Pages 39-42
CQ4. What Are the Factors That Increase the Likelihood of Malignancy and What Is the Odds Ratio and Risk Ratio?....Pages 43-46
CQ5. What Are the Physical Signs and Symptoms That Increase the Likelihood of Thyroid Cancer and What Are the Sensitivity and Specificity?....Pages 47-49
CQ6. What Are the Imaging Studies Most Suitable for the Diagnosis of Thyroid Carcinoma and What Are Their Sensitivity, Specificity, and Likelihood Ratio?....Pages 51-55
CQ7. What Are the Blood Chemistry Data That Increase the Likelihood of Thyroid Malignancy and What Are Their Sensitivity, Specificity, and Likelihood Ratio?....Pages 57-60
CQ8. What Are the Sensitivity and Specificity of Aspiration Cytology?....Pages 61-63
CQ9. What Are the Sensitivity and Specificity of Ultrasonography, CT, MRI, Laryngoscopy, and Bronchoscopy in the Preoperative Evaluation of Thyroid Cancer Invasion to the Trachea, Esophagus, and the Recurrent Laryngeal Nerve?....Pages 65-68
CQ10. How Is the Natural History of Nodules Diagnosed as Benign (Growth and Reduction Rates)?....Pages 69-72
CQ11. Does TSH Suppression Therapy Reduce the Size of Tumors Diagnosed as Benign?....Pages 73-78
CQ12. What Is the Intra-Observer Variation in the Pathological Diagnosis of Follicular Carcinoma?....Pages 79-81
CQ13. What Is the Efficacy of Percutaneous Ethanol Injection Therapy for Autonomously Functioning Thyroid Nodules?....Pages 83-86
CQ14. Do Cystic Nodules Decrease in Volume by Aspiration and Drainage of Content Fluid and Percutaneous Ethanol Injection Therapy?....Pages 87-89
CQ15. What Is the Likelihood That Multinodular Goiter Will Be Surgically Resected After Observation?....Pages 91-93
Front Matter....Pages 37-37
Column 5. Indication for Surgery of Nodular Goiter....Pages 95-96
Column 6. Diagnosis of Anaplastic Carcinoma....Pages 97-99
Front Matter....Pages 101-101
CQ16. What Is the Most Appropriate and Convenient Risk Classification System for Predicting the Prognosis of Patients with Papillary Carcinoma?....Pages 103-106
CQ17. Does Total (or Near Total) Thyroidectomy Improve the Prognosis of Papillary Carcinoma Patients Compared to Lobectomy or Lobectomy Isthmectomy?....Pages 107-110
CQ18. Does Central Compartment Dissection Improve the Prognosis of Papillary Carcinoma Patients?....Pages 111-113
CQ19. Does Dissection of the Lateral Compartment Improve the Prognosis of Papillary Carcinoma Patients?....Pages 115-117
CQ20. When Can Papillary Microcarcinoma (Papillary Carcinoma Measuring 1 cm or Less) Be Observed Without Immediate Surgery?....Pages 119-122
Column 7. What Is the Acceptable Incidence for Persistent Recurrent Laryngeal Nerve Paralysis and Persistent Hypoparathyroidism as Complications of Thyroid Surgery?....Pages 123-125
Column 8. The Controversy Regarding the Extent of Thyroidectomy for Papillary Carcinoma and Actual Practice in Japan....Pages 127-129
Column 9. Lobectomy and Paratracheal Node Dissection....Pages 131-131
Front Matter....Pages 133-133
Introduction....Pages 135-136
CQ21. Is It Possible to Diagnose Follicular Carcinoma on Preoperative FNA or Intraoperative Frozen Section Diagnosis?....Pages 137-139
CQ22. Does Classification of Follicular Carcinoma According to the Degree of Invasiveness (Widely Invasive and Minimally Invasive Types) Reflect the Prognosis?....Pages 141-143
CQ23. When Is Completion Total Thyroidectomy Recommended as a Second Surgery for Patients Who Underwent Hemithyroidectomy and Were Diagnosed as Having Follicular Carcinoma on Postoperative Pathological Examination?....Pages 145-147
CQ24. Does Total Thyroidectomy with Radioactive Iodine Ablation and TSH Suppression Therapy Improve Patient Prognosis with Widely Invasive Follicular Carcinoma Compared to Only Limited Thyroidectomy?....Pages 149-151
CQ25. Does Prognosis of Oxyphilic (Hurthle Cell) Follicular Carcinoma Differ from That of Conventional Follicular Carcinoma?....Pages 153-155
Front Matter....Pages 157-157
CQ26. What Is the Usefulness of RET Gene Mutation Analysis for Medullary Carcinoma?....Pages 159-162
CQ27. What Are the Incidences of Diseases Associated with Hereditary Medullary Carcinoma?....Pages 163-165
CQ28. Do Total Thyroidectomy and Lymph Node Dissection for Sporadic and Hereditary Medullary Carcinoma Improve the Prognosis?....Pages 167-170
CQ29. Is Chemotherapy Effective for Advanced or Relapsed Medullary Carcinoma?....Pages 171-174
Front Matter....Pages 157-157
CQ30. What Are Prognostic Factors of Medullary Carcinoma?....Pages 175-181
Front Matter....Pages 183-183
CQ31. What Is the Definition of Poorly Differentiated Carcinoma? What Is Its Prevalence and Prognosis?....Pages 185-187
CQ32. Can Poorly Differentiated Carcinoma Be Diagnosed Preoperatively?....Pages 189-190
CQ33. Do Total Thyroidectomy and Prophylactic Lymph Node Dissection Improve the Prognosis of Patients with Poorly Differentiated Carcinoma?....Pages 191-192
CQ34. Does Additional Surgery Improve the Prognosis of Patients Who Underwent Hemithyroidectomy Under a Diagnosis of Papillary or Follicular Carcinoma, But Who Are Later Diagnosed as Having Poorly Differentiated Carcinoma on Postoperative Pathological Examination?....Pages 193-194
CQ35. Do Therapies Other Than Surgery Improve the Prognosis for Patients with Poorly Differentiated Carcinoma?....Pages 195-197
Column 10. Carcinoma Showing Thymus-Like Differentiation/Intrathyroidal Epithelial Thymoma....Pages 199-200
Front Matter....Pages 201-201
Introduction....Pages 203-204
CQ36. Does Surgical Treatment for Anaplastic Carcinoma Improve Prognosis?....Pages 205-207
CQ37. Do Adjuvant Therapies Improve the Prognosis of Anaplastic Carcinoma in Patients Who Underwent Curative Surgery?....Pages 209-211
CQ38. Does Combined Modality Therapy for Anaplastic Carcinoma Improve Prognosis?....Pages 213-216
CQ39. Should Relapsed Lesions of Differentiated Carcinoma That Were Diagnosed as Anaplastic Carcinoma Be Treated as Anaplastic Carcinoma?....Pages 217-219
Column 11. When Should Palliative Care Be Considered? Is the Prognosis Explained to Patients?....Pages 221-223
Column 12. Squamous Cell Carcinoma of the Thyroid Is Currently Classified as a Different Histology from Anaplastic Carcinoma. Are Therapeutic Strategies and Prognosis of Squamous Cell Carcinoma Similar to Those of Anaplastic Carcinoma?....Pages 225-227
Front Matter....Pages 229-229
CQ40. What Are Applications and Roles of Ablation?....Pages 231-233
CQ41. Is Iodine Restriction Necessary Before Ablation?....Pages 235-236
CQ42. What Is the Appropriate Dose of 131 I?....Pages 237-238
CQ43. What Is the Benefit of RAI Therapy for Local Recurrence, Lymph Node Metastasis and Distant Metastasis of Differentiated Thyroid Carcinoma?....Pages 239-241
CQ44. What Is the Application, Effect and Safety of Recombinant Human Thyroid Stimulating Hormone (rhTSH)?....Pages 243-246
Column 13. Comments on RAI Therapy Including the Actual Situation in Japan....Pages 247-249
Front Matter....Pages 229-229
Column 14. Applications for External Beam Radiotherapy for Differentiated Thyroid Carcinoma....Pages 251-253
Column 15. Is it Appropriate to 131 I Scintigraphy Before RAI Therapy? What Is the Dose?....Pages 255-257
Column 16. What Is the Actual Status of Radiotherapy (External Beam Radiotherapy and 131 I MIBG Therapy)?....Pages 259-261
Column 17. What Are the Side Effects of RAI Therapy and What Is Their Frequency?....Pages 263-265
Front Matter....Pages 267-267
CQ45. What Is the Indication for Resection of the Recurrent Laryngeal Nerve for Cases Extending There?....Pages 269-271
CQ46. Is Phonetic Function Improved by Reconstruction of the Recurrent Laryngeal Nerve?....Pages 273-275
CQ47. For Cases Extending to the Trachea, Does Sleeve Resection of the Trachea Improve the Survival Rate Compared to Partial Resection (Wedge Resection or Window Resection)?....Pages 277-279
CQ48. Does Tracheal Resection Improve the Survival Rate Compared with No Resection?....Pages 281-283
Column 18. Treatment and Management Approaches for Cases Extending to the Trachea with Larynx, Esophagus, or Mediastinum Involvement....Pages 285-286
Front Matter....Pages 287-287
CQ49. Does TSH Suppression Therapy After Surgery for Differentiated Thyroid Carcinoma Improve Survival?....Pages 289-290
CQ50. Is Serum Thyroglobulin Measurement Useful as a Marker of Carcinoma Recurrence After Surgery?....Pages 291-292
CQ51. Are Measurements of Calcitonin and CEA Useful as Markers of Recurrence After Surgery for Medullary Carcinoma?....Pages 293-294
CQ52. What Are Useful Imaging Studies to Detect Lesions of Recurrence for Medullary Carcinoma with Elevation of Postoperative Calcitonin Level?....Pages 295-297
CQ53. Is Chemotherapy for Advanced Thyroid Carcinoma Effective?....Pages 299-300
CQ54. Is Percutaneous Ethanol Injection Therapy Effective for Local or Lymph Node Recurrence and Bone Metastasis?....Pages 301-302
CQ55. Are Alternate Therapies Effective for Thyroid Carcinoma?....Pages 303-304
Column 19. How Long Should Patients with Differentiated Thyroid Carcinoma Be Followed After Surgery?....Pages 305-306
Back Matter....Pages 307-310