The Management of Differentiated Thyroid Carcinoma: Multidisciplinary Decisions

Abstract

With the increase of physical screening and health awareness in the public, the incidence of well differentiated thyroid carcinoma (DTC) is increasing. However, owing to the early diagnosis and appropriate treatment, the recurrence and mortality rates of patients with DTC have decreased in the past decades. Controversy remains because of the unique biological behavior of DTC, this needs a multidisciplinary team to provide a rational, patient focused management protocol including initial surgery, adjuvant therapies, subsequently thyrotropin suppression, and long-term follow-up and surveillance. In Europe and northern America, consensus reports (guidelines) in the clinical management of DTC were provided by organizations of related disciplines comprised surgeon, endocrinologist, oncologist and nuclear medicine physician with the support from pathologist, biochemist, radiologist and special nurse to deal controversial issues in this aspect. The guidelines help patients understand WDT well, be treated appropriately, get better care and life quality and subsequently improve survival. Taking advantage of previous reports and available guidelines, we summarized data in incidence, recurrence and distal metastasis, and regimens in appropriate treatment of patients with DTC.