Treatment strategies for low-risk papillary thyroid carcinoma: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)
Arch. endocrinol. metab. (Online)
;
66(4): 522-532, July-Aug. 2022. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1403220
ABSTRACT
ABSTRACT Increasingly sensitive diagnostic methods, better understanding of molecular pathophysiology, and well-conducted prospective studies have changed the current approach to patients with thyroid cancer, requiring the implementation of individualized management. Most patients with papillary thyroid carcinoma (PTC) are currently considered to have a low risk of mortality and disease persistence/recurrence. Consequently, current treatment recommendations for these patients include less invasive or intensive therapies. We used the most recent evidence to prepare a position statement providing guidance for decisions regarding the management of patients with low-risk PTC (LRPTC). This document summarizes the criteria defining LRPTC (including considerations regarding changes in the TNM staging system), indications and contraindications for active surveillance, and recommendations for follow-up and surgery. Active surveillance may be an appropriate initial choice in selected patients, and the criteria to recommend this approach are detailed. A section is dedicated to the current evidence regarding lobectomy versus total thyroidectomy and the potential pitfalls of each approach, considering the challenges during long-term follow-up. Indications for radioiodine (RAI) therapy are also addressed, along with the benefits and risks associated with this treatment, patient preparation, and dosage. Finally, this statement presents the best follow-up strategies for LRPTC after lobectomy and total thyroidectomy with or without RAI.
Full text:
Available
Index:
LILACS (Americas)
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Arch. endocrinol. metab. (Online)
Journal subject:
Endocrinology
/
Metabolism
Year:
2022
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Nacional do Câncer do Rio de Janeiro/BR
/
Irmandade da Santa Casa de Misericórdia de São Paulo/BR
/
Universidade Estadual de Campinas/BR
/
Universidade Federal do Rio Grande do Sul/BR
/
Universidade de São Paulo/BR
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