Risk-oriented concept of treatment for intrathyroid papillary thyroid cancer

Best Pract Res Clin Endocrinol Metab. 2019 Aug;33(4):101281. doi: 10.1016/j.beem.2019.05.005. Epub 2019 Jun 4.


Adapting treatment and follow-up according to the risk of recurrence and/or death from thyroid cancer is a relatively recent concept of "personnalized" medicine, developed particularly to avoid overtreatment of low-risk thyroid cancer which represents the majority of thyroid cancers diagnosed in the world today. For low-risk thyroid cancer, this decrease in extent of treatment involves the extent of surgery-total thyroidectomy, lobectomy or no surgery with active surveillance-but also the indications, doses and methods of stimulation when or if administering radioactive iodine (RAI), the indication for suppressive thyroxin therapy and the extent and modalities for follow-up that should be adapted to the risk of recurrence. The aim is to optimize medical resources and quality of life, particularly for low-risk patients whose life expectancy is that of the general population.

Keywords: active surveillance; dynamic risk assessment; thyroid cancer.

Publication types

  • Review

MeSH terms

  • Disease Management
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Risk Assessment
  • Thyroid Cancer, Papillary / drug therapy
  • Thyroid Cancer, Papillary / radiotherapy*
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Hormones / therapeutic use
  • Thyroid Neoplasms / drug therapy
  • Thyroid Neoplasms / radiotherapy*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / methods


  • Iodine Radioisotopes
  • Thyroid Hormones