关键词: 分化型甲状腺癌, 局部晚期甲状腺癌, 外科治疗, 多学科综合治疗, 姑息治疗

Abstract:

Treatment strategy of thyroid cancer with trachea, larynx, and major vessels involvement        ZHU Yi-ming, LIU Shao-yan, XU Zhen-gang. Department of Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences，National Cancer Center，Beijing 100021，China
Corresponding author: XU Zhen-gang，E-mail：xuzhg06@126.com
Abstract    Surgical treatment of thyroid cancer with surrounding structures involved remains a challenge for physicians.Trachea and larynx are common affected organs，and complete resection can bring the greatest survival benefit.However，postoperative quality of life may be greatly affected. It is necessary to improve the quality of life of patients by stage I or Ⅱ reconstruction. The case of papillary thyroid carcinoma invading the internal jugular vein or with internal jugular vein tumor thrombus can still be safely and completely removed.Some cases with carotid artery invasion could benefit from radical resection，in which case vascular reconstruction should be done simultaneously.Multidisciplinary treatment should be emphasized for the locally advanced cases. Postoperative radioactive iodine therapy，external beam radiotherapy，endocrine therapy should be considered to reduce local recurrence. For inoperable patients，participating a clinical trial or trying targeted therapy could be good choices. Patients with poor general condition may be given palliative care to alleviate the symptoms.

Key words: differentiated thyroid cancer, locally advanced thyroid cancer, surgical treatment, multidisciplinary treatment, palliative treatment