title: [What's new in follicular thyroid cancer management in 2014?].
abstract: The American Thyroid Association has presented new guidelines for the management of thyroid cancer. These guidelines tend to appreciate more accurately the individual risk of patients, to adapt accordingly the treatment and the follow up. The initial risk stratification has been completed, especially precising the risk of N1 patients, follicular thyroid cancers, and the prognostic impact of molecular markers. Indications, doses and modalities of radioiodine (RAI) have been reevaluated, restricting its utilization in order to avoid overtreatment of low risk patients. Moreover the response to initial treatment allows to restratify the risk of the patients, and to adapt the monitoring and the thyroid hormone therapy management. The risk of suppressive thyroid hormone therapy has also to be considered. Concerning advanced thyroid cancer, prognosis is mainly depending on its RAI sensitivity. The systemic treatment of progressive, threatening refractory cancers is nowadays based on targeted therapy. However none of these treatments has demonstrated an improvement in overall survival, and side effects are frequent. Fagin et al presented promising results concerning short term treatment with selective inhibitors of the MAPK pathway, able to partially restore RAI sensitivity of refractory lesions in murine models, and recently in human patients.
authors.affiliation: Hospices civils de Lyon, fédération d'endocrinologie, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron, Cedex, France; Université Lyon 1, faculté de médecine Lyon-Est, Lyon, France. Electronic address: juliette.abeillon@chu-lyon.fr.
authors.forename: J
authors.initials: J
authors.lastname: Abeillon-du Payrat
authors.affiliation: Service d'endocrinologie et maladies métaboliques, Pôle cardiovasculaire et métabolique, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse, Cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Caron
authors.affiliation: Hospices civils de Lyon, fédération d'endocrinologie, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron, Cedex, France; Université Lyon 1, faculté de médecine Lyon-Est, Lyon, France; INSERM U1052, centre de recherche en cancérologie, Lyon-Est, centre Léon-Bérard, bâtiment Cheney D, 28, rue Laënnec, 69373 Lyon, Cedex 08, France.
authors.forename: F
authors.initials: F
authors.lastname: Borson-Chazot
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000628:therapy; D005819:Genetic Markers; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States
chemical_list: D005819:Genetic Markers; D007457:Iodine Radioisotopes
keywords: Cancer réfractaire; Cancer thyroïdien; Guidelines; Iodide sensitivity; Iodo-sensibilité; Recommandations; Refractory cancer; Thyroid cancer