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Differentiated Thyroid Cancer: Management and Treatment in a Community Hospital and Guidelines to Lower Morbidity
Journal article   Open access

Differentiated Thyroid Cancer: Management and Treatment in a Community Hospital and Guidelines to Lower Morbidity

Hamed H Tewfik, Ferial A Tewfik, Thomas Viner, Dwayne Capper and John M Buatti
Archives of Otorhinolaryngology-Head & Neck Surgery, Vol.4(1), pp.5-9
2020
DOI: 10.24983/scitemed.aohns.2020.00126
url
https://doi.org/10.24983/scitemed.aohns.2020.00126View
Published (Version of record) Open Access

Abstract

Introduction: Well differentiated thyroid cancer (DTC) includes papillary and follicular cancer and has an excellent prognosis (>95% 10-year survival). Its incidence has increased in recent decades. These tumors originate from follicular thyroid cells. For DTC, surgery and adjuvant radioiodine therapy (RIT) followed by levothyroxine administration to suppress the thyroid stimulating hormone (TSH) continues to be standard treatment. Methods: We retrospectively reviewed a series of 119 consecutive patients treated for DTC in a community hospital by the same team of physicians from 2002 to 2016 with follow-up ranging from 2 years to 16 years. Papillary and papillary follicular subtypes account for the majority of cases. Outcomes and treatments were determined by chart review. Results: Most patients were treated with total thyroidectomy followed by radioiodine ablation of the thyroid remnant to facilitate serologic surveillance and reduce recurrence risk. Local control was achieved in 97% of patients after initial treatment. Four patients had recurrence. Conclusion: The risks and benefits of de-intensification strategies with decreased surgery or radioiodine dose are discussed. Strategies to individualize therapy are suggested.

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