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International Bulletin of Otorhinolaryngology

Risk Adapted Strategies in the Management of Thyroid Cancer

Jatin P. Shah, Cristina Valero Mayor


There is a rising incidence of thyroid cancer world wide in the past four decades. Such a rise is observed most often in patients between the ages of 50-65. However, a majority of these newly discovered cancers are small, less than 2 cm in size, intrathyroidal papillary carcinomas. Understanding the tumor progression model of follicular cell derived cancers and appreciating the impact of prognostic factors allows the development of risk group stratification
at initial diagnosis and after surgical treatment. Employing risk group stratification permits discretion in selection of surgical treatment, in the use of adjuvant therapies, and the subsequent follow up strategies. Molecular analysis of aggressive cancers opens a path to the use of targeted therapies in patients with iodine resistant recurrent or metastatic thyroid cancers. A great majority of thyroid cancer patients fall into the low and intermediate risk groups, and their long-term outcomes remain excellent. Therefore, in conclusion, understanding the biology of thyroid cancer and appreciation of prognostic factors and employing risk group stratification is crucial for cost effective treatment of cancer of the thyroid gland.

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