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Reviews in Endocrine and Metabolic Disorders

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23-11-2023 | Radioiodine Therapy

Current practice in intermediate risk differentiated thyroid cancer – a review

Authors: Rosalia do Prado Padovani, Fernanda Barbosa Duarte, Camila Nascimento

Published in: Reviews in Endocrine and Metabolic Disorders | Issue 1/2024

Abstract

Although the overall prognosis for differentiated thyroid cancer (DTC) is excellent, a subset of patients will experience disease recurrence or may not respond to standard treatments. In recent years, DTC management has become more personalized in order to enhance treatment efficacy and avoid unnecessary interventions.

In this context, major guidelines recommend post-surgery staging to assess the risk of disease persistence, recurrence, and mortality. Consequently, risk stratification becomes pivotal in determining the necessity of postoperative adjuvant therapy, which may include radioiodine therapy (RIT), the degree of TSH suppression, additional imaging studies, and the frequency of follow-up.

However, the intermediate risk of recurrence is a highly heterogeneous category that encompasses various risk criteria, often combined, resulting in varying degrees of aggressiveness and a recurrence risk ranging from 5 to 20%. Furthermore, there is not enough long-term prognosis data for these patients. Unlike low- and high-risk DTC, the available literature is contradictory, and there is no consensus regarding adjuvant therapy.

We aim to provide an overview of intermediate-risk differentiated thyroid cancer, focusing on criteria to consider when deciding on adjuvant therapy in the current context of personalized approach, including molecular analysis to enhance the accuracy of patient management.

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Title: Current practice in intermediate risk differentiated thyroid cancer – a review
Authors: Rosalia do Prado Padovani
Fernanda Barbosa Duarte
Camila Nascimento
Publication date: 23-11-2023
Publisher: Springer US
Keywords: Radioiodine Therapy
Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Thyroidectomy
Thyroidectomy
Published in: Reviews in Endocrine and Metabolic Disorders / Issue 1/2024
Print ISSN: 1389-9155
Electronic ISSN: 1573-2606
DOI: https://doi.org/10.1007/s11154-023-09852-y

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