Contemporary Debates in Adult Papillary Thyroid Cancer Management

Abstract

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.

Impacts of the American Joint Committee on Cancer (AJCC) 8th edition tumor, node, metastasis (TNM) staging system on outcomes of differentiated thyroid cancer in Thai patients

“…The current therapeutic strategies are rapidly evolving towards less aggressive treatments. Nevertheless, up to 25% of patients will develop recurrence in both locoregional and distant sites [6]. Therefore, staging system should also stratify the risk of recurrence to provide guidance for treatment planning.…”

Eradication of Papillary Thyroid Carcinoma In A Patient Receiving Pemetrexed and Bevacizumab

“…The standard therapy of near-total or total thyroidectomy was not possible due to her recurrent HGSC-O (2,3,5). Thus, she continued several chemotherapies that are far from common practice for PTC treatment (4,6). When our patient was fit for surgical intervention, her thyroid pathology revealed evidence of PTC resolution.…”

Emerging roles of a pivotal lncRNA SBF2-AS1 in cancers

“…The biological characteristics of PTC are highly diverse, ranging from nonprogressive to invasive metastatic carcinoma. Although there are various treatment modalities available for papillary thyroid cancer, researchers are still searching for an optimal treatment [ 90 , 91 ]. Wen et al found that SBF2-AS1 expression increased distinctly in PTC cells and strongly affected tumor progression.…”