Contemporary Debates in Adult Papillary Thyroid Cancer Management

DOI PDF PDF 1 Citations
  • Donald S A McLeod
    Department of Endocrinology and Diabetes, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
  • Ling Zhang
    Department of Head and Neck Surgery, Fudan University Cancer Center, Shanghai, People’s Republic of China
  • Cosimo Durante
    Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
  • David S Cooper
    Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland

Abstract

<jats:title>Abstract</jats:title><jats:p>An ever-increasing population of patients with papillary thyroid cancer is engaging with health care 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, who comprise most new patients. At the same time, new therapies for patients with advanced disease 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 vs total thyroidectomy); (iii) the role of postoperative remnant ablation with radioiodine; (iv) optimal follow-up strategies in patients, especially those who have only undergone lobectomy; and (v) new therapies for advanced disease. Although 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 outcomes in those with distant metastatic disease.</jats:p>

Journal

  • Endocrine Reviews

    Endocrine Reviews 40 (6), 1481-1499, 2019-07-19

    The Endocrine Society

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