Optimal management of a biochemical incomplete response to therapy in differentiated thyroid cancer: aggressive treatment or cautious observation?

Abstract

The last 10 years has seen a renewed interest in a risk adapted management approach to differentiated thyroid cancer. We now view risk stratification as an ongoing, dynamic process that begins with initial estimates of the risk of death from thyroid cancer and risk of recurrent/ persistent disease for each patient [1]. These initial risk estimates are used to guide early management decisions and plan follow-up studies that allow us to define the response to initial therapy for each patient. As information is accumulated during follow-up, we actively modify the initial risk estimates based on the clinical course of the disease and the patient’s individual response to therapy. To facilitate classification and communication, we have previously proposed a nomenclature that can be used to describe response to therapy as either [1–3]