MANAGEMENT OF WELL DIFFERENTIATED THYROID CANCERS: CONTROVERSIES AND WAY FORWARD

Nosheen Fatima, Maseeh uz Zaman, Areeba Zaman, Nadeem Ahmad, Rabia Tahseen, Sidra Zaman, Unaiza Zaman

Abstract


Abstract

The American Thyroid Association (ATA) 2015 guidelines favor lobectomy for tumors 1-4 cm, recommend use of contrast enhanced CT/MRI examination for high risk patients and low or no radioiodine-131 therapy for low to intermediate risk patients. However, these guidelines have been declined by European Association of Nuclear Medicine (EANM) on a plea that these are based on conflicting weak retrospective studies and skewed interpretation of existing database. Lack of valid prospective randomized clinical trials due to tumor biology and exceedingly low event rate which need longer follow-up is the primary reason for these controversies. Currently three prospective randomized clinical trials upon low risk DTC patients are underway and hopefully their results would clarify dense smokescreen to a greater extent in years to come.

 

Key Words: Differentiated thyroid cancer; lobectomy; thyroidectomy; iodinated contrast; radioiodine-131 treatment; prospective trials

 


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