J.Jpn. Surg. Soc.. 113(6): 507-511, 2012

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Feature topic

GUIDELINES FOR THE MANAGEMENT OF THYROID TUMORS

The treatment strategy for differentiated thyroid carcinoma in Japan is different from that in Western countries in terms of postoperative radioactive iodine (RAI) utilization, and therefore the publication of thyroid tumor guidelines has been shelved. However, an "endocrine-thyroid surgery specialist" system was established in 2008 in which the Japan Association of Endocrine Surgeons and Japanese Society of Thyroid Surgery played a key role. Subsequently, the need for thyroid tumor guidelines was increasingly felt, and the guidelines on the "Japan type" were published in 2010. In those guidelines, total thyroidectomy is recommended as the initial treatment of papillary carcinoma in high-risk groups such as patients with tumors larger than 5cm, obvious tumor invasion of other organs, or large lymph node metastases in lateral compartments. However, less extensive surgery is acceptable for other patients with papillary carcinomas. The indications for total thyroidectomy in papillary carcinoma are narrower than in the Western guidelines. RAI ablation after total thyroidectomy is also recommended for differentiated thyroid carcinoma with aggressive clinicopathologic features. The guidelines reflect the current standard Japanese treatment for thyroid carcinoma. An English version of the guidelines was published in the summer of 2012, making the Japanese treatment strategy available to the world. We hope that these guidelines will contribute to standardization of the treatment of thyroid carcinoma.

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