Management of Recurrent/Persistent Nodal Disease in Patients with Differentiated Thyroid Cancer: A Critical Review of the Risks and Benefits of Surgical Intervention Versus Active Surveillance

“…Tumors with !1-2 cm or low tumor burden, in most cases, should be followed actively without additional therapy (Cooper et al 2009). Several studies suggest that small (!1 cm) metastatic lymph nodes and also thyroid bed nodules can be safely followed for years with ultrasound (Rondeau et al 2011, Guy et al 2014, Urken et al 2014, Tufano et al 2015. Small soft tissue metastasis can also be followed with cross-sectional images.…”

Section: Active Surveillancementioning

confidence: 99%

A new appraisal of iodine refractory thyroid cancer

Vaisman¹,

Carvalho²,

Vaisman³

2015

Endocrine-Related Cancer

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Thyroid cancer incidence is increasing all over the world -mostly due to an increase in the detection of small tumors that were previously undetected. A small percentage of these tumors lose the ability to uptake and/or to respond to radioiodine (RAI) therapy, especially in metastatic patients. There are several new therapeutic options that have emerged in the last 5 years to treat RAI refractory thyroid cancer patients, however, it is very important to properly identify RAI refractory patients and to clarify those appropriate for these treatments. In this review, we discuss the RAI refractory definitions and the criteria that have been suggested based on RAI uptake in the post therapy scan, as well as the response after RAI therapy and the possible molecular mechanisms involved in this process. We offer a review of the therapeutic options available at the moment and the therapeutic considerations based on a patient's individualized personal characteristics, primary tumor histology, tumor burden and location and velocity of lesion growth.

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“…[1][2][3][4] Previous studies have shown that even though differentiated thyroid cancer demonstrates a low mortality rate, long-term recurrence after initial treatment can be common occurring in up to 35% of cases, with lymph nodes being the most frequent site of recurrence. [7][8][9][10] In consideration of these findings, removal of clinically apparent lymph node metastases identified by imaging would be of great importance. [7][8][9][10] In consideration of these findings, removal of clinically apparent lymph node metastases identified by imaging would be of great importance.…”

Section: Introductionmentioning

confidence: 99%