Considerations for personalized surgery in patients with papillary thyroid cancer.
BACKGROUND
Personalizing treatment for papillary thyroid cancer (PTC) requires a multidisciplinary approach. The surgical management of PTC has long been based on retrospective studies focusing on endpoints that are of debatable significance. There is considerable debate in the literature regarding the optimal initial treatment for PTC. Many of these issues are discussed in this review. These debates have hindered the development of a tailored treatment strategy.


CONCLUSIONS
The ability to optimally personalize a surgical plan for the treatment of PTC is ultimately dependent on an understanding of the biological behavior of that individual patient's tumor. We are at the genesis of an age where molecular biology advances endeavor to profile a patient's tumor behavior. This review summarizes current strategies for managing PTC, where we are with personalizing surgery for these patients, and where we hope to go. Thyroid surgery is one of the newest fields for the application of minimally invasive techniques and can now be accomplished endoscopically or with robotic assistance in many patients who therefore may benefit from these alternative approaches.


CONCLUSIONS
When treating a patient with PTC, it seems prudent to weigh the many factors discussed in this review to individualize the most optimal surgical plan.
Tufano
Ralph P
RP
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21287-0910, USA. rtufano1@jhmi.edu
Kandil
Emad
E
D001365:Axilla; D002291:Carcinoma, Papillary / Q000601:surgery*; D000075202:Contraindications; D004724:Endoscopy / Q000379:methods; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local; D057285:Precision Medicine / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012371:Robotics; D013964:Thyroid Neoplasms / Q000601:surgery*; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D020535:Video-Assisted Surgery