Contemporary debates in adult papillary thyroid cancer management.

Contemporary debates in adult papillary thyroid cancer management. Endocr Rev. 2019 Jul 19;: Authors: McLeod DSA, Zhang L, Durante C, Cooper DS Abstract An ever-increasing population of patients with differentiated thyroid cancer is engaging with healthcare systems around the world. Numerous questions about optimal management have arisen that challenge conventional paradigms. This is particularly the case for patients with low-risk disease, which comprise the majority of new patients. At the same time, new therapies for patients with advanced disease all are also being introduced, which may have the potential to prolong life. This review discusses selected controversial issues in adult papillary thyroid cancer management at both ends of the disease spectrum. These topics include: [i] the role of active surveillance for small papillary cancers; [ii] the extent of surgery in low-risk disease (lobectomy versus total thyroidectomy); [iii] the role of postoperative remnant ablation with radioiodine; [iv] optimal follow-up strategies in patients, especially those that have only undergone lobectomy; and [v] new therapies for advanced disease. While our current management is hampered by the lack of large randomized controlled trials, we are fortunate that data from ongoing trials will be available within the next few years. This information should provide additional evidence that will decrease morbidity in low-risk patients and improve outco...
Source: Endocrine Reviews - Category: Endocrinology Tags: Endocr Rev Source Type: research