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- Title
Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective.
- Authors
Martin Schlumberger; Gertrud Berg; Ohad Cohen; Leonidas Duntas; Francois Jamar; Barbara Jarzab; Eduard Limbert; Peter Lind; Furio Pacini; Christoph Reiners; Franco Sanchez Franco; Anthony Toft; Wilmar M Wiersinga
- Abstract
OBJECTIVE: Because differentiated (follicular and papillary) thyroid cancer (DTC) may recur years after initial treatment, the follow-up of patients with DTC is long term. However, this population has changed, with more individuals being discovered at an earlier stage of the disease, so that previous follow-up protocols based mostly on data from high-risk patients no longer apply. We sought to develop an improved protocol for the follow-up of low-risk patients with DTC based on the findings of recent studies. METHODS: We analysed recent literature on the follow-up of DTC. RESULTS: Recent large studies have produced three important findings: (i) in patients with low-risk DTC with no evidence of disease up to the 6- to 12-month follow-up, diagnostic whole-body scan adds no information when serum thyroglobulin (Tg) is undetectable and interference from anti-Tg antibodies is absent; (ii) use of recombinant human thyroid-stimulating hormone to aid Tg measurement is effective and provides greater safety, quality-of-life and work productivity than does levothyroxine withdrawal with its attendant hypothyroidism; and (iii) ultrasonography performed by an experienced operator is the most sensitive means of detecting neck recurrences of DTC. CONCLUSIONS: We present a revised follow-up protocol for low-risk patients taking into account the above findings. This protocol should help clinicians enter a new era of monitoring characterized by greater safety, simplicity, convenience and cost savings.
- Subjects
THYROID cancer; HEALTH risk assessment; ULTRASONIC imaging; BLOOD plasma
- Publication
European Journal of Endocrinology, 2004, Vol 150, Issue 2, p0105
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/eje.0.1500105