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July 2016

New Recommendations for Extent of Thyroidectomy and Active Surveillance for the Treatment of Differentiated Thyroid Cancer

Author Affiliations
  • 1Division of Head and Neck Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Division of Head and Neck Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland
  • 3Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Otolaryngol Head Neck Surg. 2016;142(7):625-626. doi:10.1001/jamaoto.2016.0980

Thyroid cancer has become increasingly prevalent in clinical practice, having nearly tripled in incidence during the last 4 decades in the United States.1 This increase is almost entirely attributed to a rise in the diagnosis of papillary thyroid cancer. Papillary thyroid microcarcinomas (PTMCs), which measure 1 cm or less at the largest dimension, constitute almost half of these new diagnoses. Papillary thyroid microcarcinomas typically grow very slowly and are highly unlikely to cause symptoms, much less death. Despite this evidence, the conventional management paradigm of immediate surgical resection, often followed by radioactive iodine (RAI) therapy, has essentially remained unchanged since the 1950s. These issues have recently prompted the American Thyroid Association (ATA) to reexamine treatment options for differentiated thyroid cancer (DTC).2

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