This week is International Thyroid Knowledge Awareness Week, and national cancer statistics released in 2022 show that thyroid cancer mortality is showing Continuing the upward trend, the 5-year survival rate of 84.3% of Chinese thyroid cancer patients is still 14% behind that of advanced developed countries. Professor Wang Yu, director of head and neck surgery at Fudan University Affiliated Cancer Hospital, appealed to increase early screening of high-risk groups, actively implement standardization of diagnosis and treatment, and continue to tackle key problems in refractory thyroid cancer.
14% gap, due to two reasons
2022 China Cancer Center release The report shows that the standardized incidence of thyroid cancer in my country has risen from 1.4/100,000 person-years in 1990 to 14.65/100,000 person-years in 2016. National cancer statistics released in 2022 show that the 5-year survival rate of 84.3% of thyroid cancer patients in China is still 14% behind the 98% in advanced developed countries. There are two main reasons for this disparity. “The low rate of early diagnosis and the non-standard clinical diagnosis and treatment of advanced thyroid cancer have led to an increase in the incidence of iodine-refractory, locally advanced and advanced thyroid cancer.” Professor Wang Yu, director of head and neck surgery at Fudan University Affiliated Cancer Hospital, called for further Raise public health awareness and conduct regular physical examinations, especially for people with high risk factors such as family history of thyroid cancer and radiation exposure history, they should go to the hospital for screening regularly; Cancer research continues to improve the quality of life of these patients and reduce their mortality.
Individualized plan, the curative effect is equal to the international advanced level
Head and Neck Surgery, Fudan Cancer Hospital Surgical treatment of thyroid cancer includes open surgery, laparoscopic surgery, and robotic surgery. Which procedure is right for the patient? Professor Wang Yu pointed out that we will give each patient who comes for treatment an individualized plan with the best prognosis and aesthetics.
“The standard of treatment is the first, and the curative effect and prognosis are the fundamental.” In clinical practice, the indications of endoscopic thyroid surgery and robotic surgery need to be strictly controlled. The Head and Neck Surgery Department of the Cancer Hospital has carried out robotic surgery for two years and completed more than 250 cases, and has become one of the largest centers for robotic thyroid surgery in China. Robotic thyroid cancer surgery has great advantages in the protection of recurrent laryngeal nerve, parathyroid gland, superior laryngeal nerve and other functional protection, and the occurrence of recurrent laryngeal nerve injury, hypocalcemia and choking has great advantages compared to traditional open surgery . The approach selection of robotic surgery can avoid the neck, which is more aesthetic than traditional open surgery. “However, robotic surgery is not suitable for patients with large primary tumors, invasion of surrounding tissues, and extensive tumor metastasis.” Professor Wang Yu pointed out that the premise of the clinical application of new technologies for thyroid cancer is adequate and complete individualized evaluation, including various surgical procedures. Pre-examination, combined with comprehensive evaluation of the nature of thyroid cancer, pathological type, disease stage, gender, age, previous diseases, personal needs, etc., to formulate individualized treatment plans for patients.
In addition, head and neck surgery, as a national-level training and training base for minimally invasive tumor intervention, routinely carries out ablation of benign thyroid nodules under B-ultrasound localization. The development of this technology provides another personalized treatment method for patients with benign thyroid nodules. At present, the 5-year survival rate of thyroid cancer in Fudan University Affiliated Cancer Hospital is 98.5% and the 10-year survival rate is 94.9%, which is on par with the international advanced developed countries.
Breakthrough, advanced refractory thyroid cancer
Compared with other malignant tumors, thyroid cancer is a slow-progressing solid tumor, known as “lazy cancer”. It is the cancer with higher survival rate and cure rate among all malignant tumors at present, and the relative survival rate of early 5-year However, 5% of patients with locally advanced thyroid cancer still face the problems of inoperability and high local recurrence rate, which has become the main reason for the increase in the mortality rate of thyroid cancer.
To this end, Fudan University Affiliated Cancer Hospital has established a comprehensive diagnosis and treatment process for advanced thyroid cancer. From October 2019 to present, it has treated patients with advanced and refractory thyroid cancer. A total of more than 300 people. Professor Wang Yu said frankly that many patients with complex and refractory thyroid cancer who came to our outpatient clinic have traveled to major hospitals across the country. The starting point of “new life”.
It is reported that the department has carried out extensive clinical research on various types of advanced thyroid cancer, covering targeted and immunotherapy. For the first time, the newly developed targeted and immune drugs that are in line with international standards have been used, and many patients who have failed third-line treatment have been reborn in clinical trials.
The clinical results of a clinical study on the efficacy and safety of neoadjuvant therapy for locally advanced thyroid cancer, led by Professor Wang Yu, are the first in the world to publish neoadjuvant therapy for thyroid cancer Results of a systematic prospective clinical study. The study confirmed the antitumor activity of anlotinib in the neoadjuvant treatment of thyroid cancer, and most patients achieved R0/1 resection. These results suggest that neoadjuvant therapy with anlotinib may be a new option for the treatment of locally advanced thyroid cancer.
Correspondents Wang Yihui Wang Yunjun Xinmin Evening News reporter Zuo Yan