Follow up approaches in thyroid cancer: a risk adapted paradigm.
The primary goal in the follow up of thyroid cancer patients is to identify and treat persistent and recurrent disease at a time that minimizes morbidity and disease specific mortality. This article presents a risk-adapted follow-up paradigm to guide both intensity and methodology of follow-up testing based on initial risk stratification, ongoing risk stratification, and secondary risk stratification that incorporates each of the well-known risk factors for recurrence and death from thyroid cancer, with a response to therapy variable as well as duration of disease-free survival. With a proper understanding of the biology of the disease and with accurate assessments of response to therapy, clinicians are better able to tailor a risk-appropriate follow-up approach to individual patients, minimizing excessive testing while still providing adequate testing to detect clinically significant disease recurrence in a timely fashion.
Tuttle
R Michael
RM
Department of Medicine, Joan and Sanford I Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA. tuttlem@mskcc.org
Leboeuf
Rebecca
R
D000465:Algorithms; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000517:prevention & control*; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000401:mortality / Q000628:therapy*