Controversies in primary treatment of low-risk papillary thyroid cancer

McLeod, Donald S. A., Sawka, Anna M. and Cooper, David S. (2013) Controversies in primary treatment of low-risk papillary thyroid cancer. Lancet, 381 9871: 1046-1057. doi:10.1016/S0140-6736(12)62205-3


Author McLeod, Donald S. A.
Sawka, Anna M.
Cooper, David S.
Title Controversies in primary treatment of low-risk papillary thyroid cancer
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
1474-547X
Publication date 2013-03-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/S0140-6736(12)62205-3
Open Access Status Not yet assessed
Volume 381
Issue 9871
Start page 1046
End page 1057
Total pages 12
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Language eng
Abstract In many parts of the world, incidence of papillary thyroid cancer is increasing faster than any other malignancy. Most papillary thyroid cancers that are diagnosed are small and are generally regarded as being low risk, with little or no effect on mortality. Papillary thyroid cancer is a clinical challenge because it is difficult to prove benefit from the traditional therapeutic triad for this disorder (ie, total thyroidectomy with or without prophylactic central neck dissection, radioiodine remnant ablation, and suppression of serum thyroid-stimulating hormone with levothyroxine). However, risk of disease recurrence might be reduced by these therapies in a subset of patients with more aggressive disease. In the past decade, professional societies and other groups have established evidence-based clinical practice guidelines for management of papillary thyroid cancer, but these efforts have been made difficult by a paucity of randomised controlled trials. In this review, we summarise epidemiological data for disease incidence, discuss some controversies in disease management, and outline a therapeutic framework founded in the best available medical evidence and existing recommendations from clinical practice guidelines.
Keyword Thyrotropin-suppressive therapy
Lymph-node dissection
Quality-of-life
Randomized controlled-trial
Exogenous subclinical hyperthyroidism
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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