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Best Pract Res Clin Endocrinol Metab. 2019 Jun 4. pii: S1521-690X(19)30030-2. doi: 10.1016/j.beem.2019.05.005. [Epub ahead of print]

Risk-oriented concept of treatment for intrathyroid papillary thyroid cancer.

Author information

1
Gustave Roussy, Department of Head and Neck Oncology, Thyroid Surgery Unit, 114 Rue Edouard Vaillant, Villejuif, 94805, France. Electronic address: dana.hartl@gustaveroussy.fr.
2
Gustave Roussy, Nuclear Medicine and Endocrine Oncology, 114 Rue Edouard Vaillant, Villejuif, 94805, France.
3
Gustave Roussy, Department of Head and Neck Oncology, Thyroid Surgery Unit, 114 Rue Edouard Vaillant, Villejuif, 94805, France.
4
Gustave Roussy, Department of Radiology, 114 Rue Edouard Vaillant, Villejuif, 94805, France.

Abstract

Adapting treatment and follow-up according to the risk of recurrence and/or death from thyroid cancer is a relatively recent concept of "personnalized" medicine, developed particularly to avoid overtreatment of low-risk thyroid cancer which represents the majority of thyroid cancers diagnosed in the world today. For low-risk thyroid cancer, this decrease in extent of treatment involves the extent of surgery-total thyroidectomy, lobectomy or no surgery with active surveillance-but also the indications, doses and methods of stimulation when or if administering radioactive iodine (RAI), the indication for suppressive thyroxin therapy and the extent and modalities for follow-up that should be adapted to the risk of recurrence. The aim is to optimize medical resources and quality of life, particularly for low-risk patients whose life expectancy is that of the general population.

KEYWORDS:

active surveillance; dynamic risk assessment; thyroid cancer

PMID:
31208873
DOI:
10.1016/j.beem.2019.05.005

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