Management of Differentiated Thyroid Carcinoma - American Thyroid Association Guidelines and Data from Kaohsiung Chang Gung Memorial Hospital

Pei-Wen Wang

《Formosan Journal of Endocrinology and Metabolism》 5卷1期 (2014/06) Pp. 1-13

https://doi.org/10.6856/FJEM.201406_5(1).0001

摘要

Background. Most thyroid cancers are differentiated thyroid cancers, which include papillary and follicular carcinomas. Differentiated thyroid cancer, arising from thyroid follicular epithelial cells, is a common malignancy encountered in endocrinology clinics and has increasing incidence in recent years. An overview of the management of differentiated thyroid cancer is provided in this review. Findings. Adequate surgery is the most important initial management of differentiated thyroid cancers. Radioactive iodine treatment, suppression of thyroid-stimulating hormone, and external beam irradiation play the adjunctive roles. Long-term management should provide accurate surveillance for possible recurrence in patients with differentiated thyroid carcinomas. Neck ultrasounds to evaluate the thyroid bed and central and lateral cervical nodal compartments should be performed periodically, depending on the patient's risk for recurrent disease and serum thyroglobulin status. For metastatic or recurrent tumors, several treatment modalities such as watch-and-wait, local therapy, and experimental trials can be considered. Conclusion. The management of well-differentiated thyroid cancer requires a multidisciplinary approach. The majority of patients with differentiated thyroid cancers are alleviated with standard treatments. A small proportion of patients with metastatic or recurrent disease have few treatment options.

關鍵字

disease management ； practice guideline ； thyroid gland ； thyroid neoplasms