Controversies in the follow-up and management of well-differentiated thyroid cancer.
Thyroid cancer is a common malignancy with an apparent increasing incidence and a wide spectrum of clinical behavior and therapeutic responsiveness. Recent advances in diagnosis, primary treatment, and long-term monitoring have led to enhanced detection of primary and recurrent disease and improvements in therapy. Controversy still surrounds several issues: the most accurate predictive staging system and histological subclassification scheme, optimal preoperative assessment and surgical extent, appropriate use of radioiodine for remnant ablation, goal for thyrotropin-suppressive thyroid hormone therapy, best practices in immediate postoperative and long-term monitoring, and approach to the patient with thyroglobulin evidence of residual disease. In this paper, recent data related to these controversial issues are critically reviewed.
Ringel
M D
MD
Divisions of Endocrinology and Oncology, Ohio State University, Columbus, Ohio, USA.
Ladenson
P W
PW
D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D009367:Neoplasm Staging; D012333:RNA, Messenger / Q000032:analysis; D013954:Thyroglobulin; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D013972:Thyrotropin / Q000627:therapeutic use
D007457:Iodine Radioisotopes; D012333:RNA, Messenger; D013972:Thyrotropin; D013954:Thyroglobulin