Abstract: Interpretation of surgical update in 2018 Japanese Clinical Practice Guidelines for Thyroid Tumors                        DONG Wen-wu，ZHANG Hao. Department of Thyroid Surgery，the First Hospital of China Medical University，Shenyang 110001，China
Corresponding author：ZHANG Hao，E-mail：haozhang@cmu.edu.cn
Abstract    The incidence of thyroid cancer has increased all over the world in recent years，which has become a hot issue of widespread concern.Surgery is an important means for the treatment of thyroid cancer.Standard surgical treatment can effectively improve the prognosis and quality of life of patients，while non-standard surgical treatment can increase the risk of recurrence，reduce the survival rate，and bring serious physiological，psychological and economic burden to patients.In order to standardize the diagnosis and treatment of thyroid cancer and improve the prognosis of patients，many guidelines have been issued at home and abroad.With the application of new therapies and the emergence of new clinical evidences，guidelines are constantly updated in various countries，the most representative of which are the guidelines issued by the American Thyroid Association and the National Comprehensive Cancer Network.In the past，surgeons paid more attention to the European and American guidelines，but little was known about the treatment of thyroid cancer in neighbouring Japan. Following the publication of the first edition of Japanese Clinical Practice Guidelines for Thyroid Tumors in 2010，Japan formally released a revised edition of the old edition of the guidelines in 2018. Compared with the old version，the recommendations of the new version are more comprehensive and accurate，including risk stratification of papillary cancer and indications of primary lesion resection and lymph node dissection in patients with different risk stratification，principles of primary and complementary surgery for follicular carcinoma of different histological types，and principles of treatment for hereditary and sporadic medullary carcinoma，etc.

Key words: thyroid neoplasm, surgery, guideline

摘要： 近年来甲状腺癌的发病率在世界各地均呈上升趋势，成为人们广泛关注的热点问题。外科手术是治疗甲状腺癌的重要手段，规范的手术治疗可有效改善病人预后和生活质量，而不规范的手术治疗则会增加复发风险，降低存活率，给病人带来严重的生理、心理和经济负担。国内外为了规范甲状腺癌的诊疗、改善病人预后，颁布了很多指南，而且随着新的治疗方法的应用和临床证据的出现，各国指南也在不断更新，其中最具代表性的是美国甲状腺学会和美国国家综合癌症网络颁布的指南。既往外科医生对欧美指南的关注度更大，而对邻国日本甲状腺癌的治疗情况了解甚少。日本继2010年发布第一版《甲状腺肿瘤诊疗指南》之后，也于2018年正式发布了旧版指南的修订版。与旧版指南相比，新版指南推荐意见更加全面和确切，包括乳头状癌的危险分层及不同危险分层病人原发灶切除范围和淋巴结清扫的指征、不同组织学分型滤泡状癌初次手术和补充手术的处理原则以及遗传性和散发性髓样癌处理原则等。

关键词: 甲状腺肿瘤, 手术, 指南