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Nat Rev Endocrinol. 2018 Sep;14(9):538-551. doi: 10.1038/s41574-018-0068-3.

Follow-up of differentiated thyroid cancer - what should (and what should not) be done.

Author information

1
Dipartimento di Medicina Interna e Specialità Mediche, Università di Roma "Sapienza", Rome, Italy.
2
Department of Biostatistic and Epidemiology, Gustave Roussy and University Paris-Saclay, Villejuif, France.
3
Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France. martin.schlumberger@gustaveroussy.fr.

Abstract

The treatment paradigm for thyroid cancer has shifted from a one-size-fits-all approach to more personalized protocols that range from active surveillance to total thyroidectomy followed by radioiodine remnant ablation. Accurate surveillance tools are available, but follow-up protocols vary widely between centres and clinicians, owing to the lack of clear, straightforward recommendations on the instruments and assessment schedule that health-care professionals should adopt. For most patients (that is, those who have had an excellent response to the initial treatment and have a low or intermediate risk of tumour recurrence), an infrequent assessment schedule is sufficient (such as a yearly determination of serum levels of TSH and thyroglobulin). Select patients will benefit from second-line imaging and more frequent assessments. This Review discusses the strengths and weaknesses of the surveillance tools and follow-up strategies that clinicians use as a function of the initial treatment and each patient's risk of recurrence.

PMID:
30069030
DOI:
10.1038/s41574-018-0068-3
[Indexed for MEDLINE]

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