THYROID TUMOR: CLINICAL EVALUATION AND SURGICAL MANAGEMENT

Abstract

Thyroid cancer is a pathology that affects the thyroid gland, a structure located in the cervical region responsible for the production of hormones that regulate various functions of the body. In recent decades, there has been a significant increase in the incidence of this type of cancer throughout the world. Early diagnosis and the choice of appropriate surgical management play a fundamental role in the effective management of this cancer, directly influencing patients' results and quality of life. Objective: was to examine and synthesize the available evidence related to clinical assessment and surgical management in the treatment of thyroid cancer. The main focus was to investigate the accuracy of diagnostic methods, including ultrasound and fine-needle aspiration biopsy (FNAB), and how these assessments influenced treatment decisions. Furthermore, the review sought to analyze the results associated with different surgical approaches, such as total and partial thyroidectomy, in terms of recurrence, complications and patients' quality of life. Methodology: This review followed the protocol established by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist to ensure transparency and quality in the process. Renowned databases, including PubMed, Scielo and Web of Science, were consulted to identify relevant studies. The descriptors used included: "thyroid cancer," "thyroid neoplasm," "clinical evaluation," "surgical management," and "diagnostic accuracy." The inclusion criteria considered studies published in English that investigated clinical assessment and surgical management in thyroid cancer, with full access to the text. Irrelevant studies or studies with small samples that did not adequately represent the target population were excluded. Results: 15 articles were selected. The results of this review highlighted the crucial importance of accurate clinical assessment, including ultrasound and FNAC, in identifying and characterizing thyroid tumors. This careful assessment allowed the differentiation between benign and malignant nodules, guiding therapeutic decisions. Regarding surgical management, several reviewed studies indicated that total thyroidectomy is frequently performed in cases of thyroid cancer, especially in larger and more aggressive tumors. This surgical approach aims to completely remove the thyroid gland, reducing the risk of cancer recurrence. However, the choice of extent of surgery may vary according to the stage of the disease and the patient's individual assessment. Conclusion: Accurate clinical assessment and appropriate surgical management are essential for effective treatment of thyroid cancer. This systematic review provided a comprehensive overview of the available evidence, emphasizing the need for personalized and multidisciplinary approaches to optimize outcomes and quality of life for patients with thyroid cancer.