Risk-adapted management of thyroid cancer Journal Article


Author: Tuttle, R. M.
Article Title: Risk-adapted management of thyroid cancer
Abstract: Objective: To describe a risk-adapted management paradigm for patients with differentiated thyroid cancer. Methods: A risk-stratification approach is described that combines the standard clinical factors available during the initial evaluation with response-to-therapy variables to predict risk of death from thyroid cancer, risk of recurrence, and risk of failing initial therapy. This classic oncologic approach views risk stratification as an active, ongoing process in which risks are adjusted on the basis of accumulated clinical data, rather than considered as a static initial assessment that does not change. Results: From a clinical standpoint, accurate realtime assessment of risk can be used to guide both the initial treatment recommendations (extent of thyroid surgical resection, role of radioiodine ablation, and degree of thyrotropin suppression) and the follow-up management paradigm (intensity of testing and modalities used to detect recurrent disease). Conclusion: By thinking like oncologists and individualizing therapy on the basis of initial and ongoing risk assessments, we can maximize the beneficial effects of aggressive therapy in patients with thyroid cancer who are likely to benefit from it, while minimizing potential complications and side effects in low-risk patients destined to have a full healthy productive life after minimal therapeutic intervention. © 2008 AACE.
Keywords: review; cancer recurrence; cancer staging; follow up; medical decision making; risk factors; pathology; cancer therapy; risk factor; risk assessment; radioactive iodine; thyroid cancer; thyroid neoplasms; thyroid tumor; thyrotropin; risk management; thyroid surgery
Journal Title: Endocrine Practice
Volume: 14
Issue: 6
ISSN: 1530-891X
Publisher: American Association of Clinical Endocrinologists  
Date Published: 2008-09-01
Start Page: 764
End Page: 774
Language: English
PUBMED: 18996800
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 17" - "Export Date: 17 November 2011" - "CODEN: EPNRA" - "Source: Scopus"
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MSK Authors
  1. Robert M Tuttle
    483 Tuttle
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