REVIEW  DIFFERENTIATED THYROID CANCER: NEW PERSPECTIVES FROM GENETICS TO THE CLINIC 

Minerva Endocrinology 2021 March;46(1):62-89

DOI: 10.23736/S2724-6507.20.03342-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Personalized treatment for differentiated thyroid cancer: current data and new perspectives

Carla COLOMBO ^{1, 2} ✉, Noemi GIANCOLA ¹, Laura FUGAZZOLA ^{1, 2}

¹ Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy; ² Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

More conservative and personalized treatment options have been developed in recent years to face the rising diagnosis of low-risk differentiated thyroid carcinoma (DTC). The present review describes the change towards a more risk-adapted management either in the treatment or in the follow-up of DTC. Particular attention is given to the innovations introduced by the latest guidelines for low-risk tumors, starting from the most appropriate extension of surgery up to the postoperative management. The emerging role of active surveillance for low-risk microcarcinoma is discussed, as well as the development of percutaneous strategies in the setting of malignant thyroid disease. The recent use of approved new systemic target therapies for advanced radioiodine refractory thyroid cancer is reported, together with the description of new compounds in trial. Finally, we provide some considerations to improve the risk evaluation in a presurgical setting, especially related to the rising role of genetics, to enable better risk-based cancer management and personalized treatment choices.

KEY WORDS: Thyroid neoplasms; Anterior temporal lobectomy; Review