Current Status of Surgical Treatment of Well-Differentiated Thyroid Cancer

Thyroid cancer remains one of the most relevant challenges in contemporary endocrine surgery due to its increasing incidence, the high prevalence of well-differentiated forms, and persistent controversies regarding the optimal treatment strategies. The majority of cases consist of papillary and follicular thyroid carcinomas, which are generally associated with a favorable prognosis; however, they retain the capacity for regional metastasis and recurrence, underscoring the importance of determining the appropriate extent of surgery and the need for lymphadenectomy. Modern diagnostics for well-differentiated thyroid cancer are based on a combination of clinical examination, ultrasound imaging, and fine-needle aspiration biopsy (FNAB). Ultrasound imaging is the primary modality for initial visualization and risk stratification, while FNAB remains the principal method for preoperative morphological assessment of thyroid nodules. However, even with the use of contemporary diagnostic algorithms, challenges in the interpretation of cytological findings persist, particularly in cases of follicular neoplasms, which often necessitate surgical verification. Surgical treatment remains the principal method for radical intervention in thyroid cancer. The choice between hemithyroidectomy and total thyroidectomy remains controversial and should be individualized, considering the morphological subtype of the tumor, its size, localization, presence of multifocal growth, extrathyroidal extension, regional metastases, patient age, and risk factors for recurrence. Minimally invasive, video-assisted, and endoscopic techniques are of considerable clinical interest due to reduced surgical trauma and improved cosmetic outcomes. However, their application in malignant tumors requires strict patient selection and careful evaluation, as technical advantages must not compromise the oncological radicality of the procedure. Among minimally invasive approaches, cervical mini-incision techniques and video-assisted procedures appear to be the most justified, while remote accesses techniques are associated with greater technical complexity, a larger dissection area, and limited oncological versality. Thus, thyroid cancer surgery continues to evolve actively; however, the choice of surgical extent and specific approach should be determined primarily by oncological appropriateness and safety considerations. Prospects for further advancements in treatment are linked to more precise risk stratification, standardization of diagnostic approaches, and accumulation of data on the long-term effectiveness of modern minimally invasive technologies.

Ҳали таржима қилинмаган