- TRAUMA CENTER SECOND OPINION INCISIONS FOR DAYS GG REDDIT HOW TO
- TRAUMA CENTER SECOND OPINION INCISIONS FOR DAYS GG REDDIT SERIES
TRAUMA CENTER SECOND OPINION INCISIONS FOR DAYS GG REDDIT SERIES
These guidelines focus on radioiodine refractory (RAI-R) TCs hence, only TCs originating from the follicular epithelium and predicted to be capable of radioiodine uptake, will be discussed.Īmong DTCs, papillary TC (PTC) is the most common type, and it is defined as a malignant epithelial tumour with evidence of follicular differentiation and a series of specific nuclear features. Familial forms are generally bilateral with multiple foci, are due to germline mutations in the RET gene and can associate with other diseases in the context of Multiple Endocrine Neoplasias, MEN 2A, and MEN 2B. It can be classified as sporadic (75% of cases), or familial MTC. Finally, medullary TC, originating from the parafollicular C cells of neuroendocrine origin, accounts for 3–5% of all TCs. Anaplastic thyroid carcinoma comprises approximately 1.7% of all cases of TC and is a very aggressive malignancy with an average survival time following diagnosis of 6 months or less. Among tumours originating from the follicular epithelium, differentiated TC (DTC) is the most common type and includes the papillary and follicular histotypes, making up about 85–95% of all TCs, whereas Hürtle cell carcinomas (HC) and poorly differentiated TC account for 2–5% each. TC includes histological types with extremely different prevalence. The 5-year relative survival of TC in Europe ranges from 80 to 90%. In particular, the highest estimated age-standardized IRR are recorded in Lithuania (15.5 cases per 100,000 person-years), Italy (13.5), Austria (12.4), Croatia (11.4), and Luxembourg (11.1). The same incidences are recorded in all developed countries, though in Europe there are wide regional differences. Women have a 3-fold higher estimated age-standardized rate of TC incidence (IRR) than men, with 9.3 and 3.1 cases per 100,000 person-years, respectively (mean 6.3 cases). In the same year, 6,300 Europeans are estimated to have died of TC. Epidemiology and Classification of TCĪccording to the European Network of Cancer Registries (, January 2017), in Europe an estimated 53,000 TC cases were newly diagnosed in 2012.
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The present guidelines are mainly based on the knowledge derived from clinical practice of a group of ETA (European Thyroid Association) experts who regularly diagnose, treat, and follow up the most aggressive forms of TC. Karger AG, Baselįew prospective studies are available on the management of patients with advanced thyroid cancer (TC), and the decision making is mostly based on the personal experience of physicians. © 2019 European Thyroid Association Published by S. Above all of them is the indication to treat and follow these patients in a specialized setting which allows the interaction between several specialists in a multidisciplinary team. Based on the available studies and on personal experience, the experts provided 39 recommendations aimed to improve the management of advanced RAI-R TCs. The appropriate relationship between the specialist and the patient/family as well as ethical issues are covered.
TRAUMA CENTER SECOND OPINION INCISIONS FOR DAYS GG REDDIT HOW TO
Systemic therapy with multikinase inhibitors is fully discussed, including recommendations on how to start it and at which dosage, on the duration of treatment, and on the management of side effects. Criteria for advanced RAI-R TC were proposed, and the most appropriate diagnostic tools and the local, systemic and palliative treatments are described. The task force started to work in September 2018 and after several revision rounds, prepared a list of recommendations to support the treatment and follow-up of patients with advanced TC. Since no European expert consensus or guidance for this challenging condition is currently available, a task force of TC experts was nominated by the European Thyroid Association (ETA) to prepare this document based on the principles of clinical evidence. Around 60–70% of this subset, hence less than 5% of all patients with TC, will become radioiodine refractory (RAI-R), with a significant negative impact on prognosis and a mean life expectancy of 3–5 years. The vast majority of thyroid cancers of follicular origin (TC) have a very favourable outcome, but 5–10% of cases will develop metastatic disease.