title: Small differentiated thyroid cancer: time to reconsider clinical management and treatment.
abstract: The incidence of differentiated thyroid cancer (DTC) is increasing worldwide, especially among small (≤2 cm) tumors. Overall, small DTC have an excellent prognosis and low mortality rate. Still, a proportion of these patients will experience recurrent/persistent disease. Careful risk stratification makes it possible to individualize treatment, avoiding unnecessary procedures and guarantees a good long-term prognosis with low recurrence risk. Recent studies evaluated the impact of the extent of surgery and radioiodine therapy, providing new evidence regarding treatment approach. Therefore, is time to reconsider clinical management and treatment of small DTC. Based on current data, in patients with small tumors and no additional risk factors, a conservative surgical approach without radioiodine therapy might be appropriated. More extensive surgery and radioiodine therapy could be proposed for small tumors exhibiting more aggressive features, such as lymph node metastasis, multifocality, vascular involvement, extra-thyroidal invasion or unfavorable molecular biology.
authors: Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Eduardo Guinle, 20/904, 22260-090 Rio de Janeiro, Brazil. dmomesso@terra.com.br
authors: Denise Prado
authors: DP
authors: Momesso
authors: Fernanda
authors: F
authors: Vaisman
authors: Cencita Hosanah
authors: CH
authors: Cordeiro de Noronha Pessoa
authors: Rossana
authors: R
authors: Corbo
authors: Mario
authors: M
authors: Vaisman
mesh_terms: D018288:Carcinoma, Small Cell / Q000473:pathology / Q000628:therapy*; D002454:Cell Differentiation; D019468:Disease Management; D006801:Humans; D013964:Thyroid Neoplasms / Q000473:pathology / Q000628:therapy*