title: Follicular cell-derived thyroid cancer.
abstract: Follicular cell-derived thyroid cancers are derived from the follicular cells in the thyroid gland, which secrete the iodine-containing thyroid hormones. Follicular cell-derived thyroid cancers can be classified into papillary thyroid cancer (80-85%), follicular thyroid cancer (10-15%), poorly differentiated thyroid cancer (<2%) and undifferentiated (anaplastic) thyroid cancer (<2%), and these have an excellent prognosis with the exception of undifferentiated thyroid cancer. The advent and expansion of advanced diagnostic techniques has driven and continues to drive the epidemic of occult papillary thyroid cancer, owing to overdiagnosis of clinically irrelevant nodules. This transformation of the thyroid cancer landscape at molecular and clinical levels calls for the modification of management strategies towards personalized medicine based on individual risk assessment to deliver the most effective but least aggressive treatment. In thyroid cancer surgery, for instance, injuries to structures outside the thyroid gland, such as the recurrent laryngeal nerve in 2-5% of surgeries or the parathyroid glands in 5-10% of surgeries, negatively affect quality of life more than loss of the expendable thyroid gland. Furthermore, the risks associated with radioiodine ablation may outweigh the risks of persistent or recurrent disease and disease-specific mortality. Improvement in the health-related quality of life of survivors of follicular cell-derived thyroid cancer, which is decreased despite the generally favourable outcome, hinges on early tumour detection and minimization of treatment-related sequelae. Future opportunities include more widespread adoption of molecular and clinical risk stratification and identification of actionable targets for individualized therapies.
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, University of Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, University of Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Machens
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Johanna
authors.initials: J
authors.lastname: Basa
authors.affiliation: Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Vahab
authors.initials: V
authors.lastname: Fatourechi
authors.affiliation: Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.affiliation: Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Hay
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Yuri E
authors.initials: YE
authors.lastname: Nikiforov
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
authors.forename: Furio
authors.initials: F
authors.lastname: Pacini
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Pasieka
authors.affiliation: Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Steven I
authors.initials: SI
authors.lastname: Sherman
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D011379:Prognosis; D000077273:Thyroid Cancer, Papillary; D000072637:Thyroid Epithelial Cells / Q000473:pathology*; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects