Management of Recurrent Well-Differentiated Thyroid Carcinoma in the Neck: A Comprehensive Review

Author:

Cavalheiro Beatriz G.1ORCID,Shah Jatin P.2ORCID,Randolph Gregory W.3ORCID,Medina Jesus E.4,Tufano Ralph P.5,Zafereo Mark6ORCID,Hartl Dana M.7ORCID,Nixon Iain J.8,Guntinas-Lichius Orlando9,Vander Poorten Vincent10ORCID,López Fernando1112ORCID,Khafif Avi Hefetz13,Owen Randall P.14,Shaha Ashok15,Rodrigo Juan P.1112ORCID,Rinaldo Alessandra16ORCID,Mäkitie Antti A.17ORCID,Silver Carl E.18,Sanabria Alvaro19ORCID,Kowalski Luiz P.2021ORCID,Ferlito Alfio22ORCID

Affiliation:

1. Cancer Institute of São Paulo State, Department of Head and Neck Surgery, University of São Paulo Medical School, Sao Paulo 01246-903, Brazil

2. Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA

3. Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, MA 02115, USA

4. Department of Otolaryngology and Head and Neck Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA

5. Multidisciplinary Thyroid and Parathyroid Center, Head and Neck Endocrine Surgery, Sarasota Memorial Health Care System, Sarasota, FL 34239, USA

6. Department of Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX 77030, USA

7. Department of Surgery, Gustave Roussy, 94800 Villejuif, France

8. Department of Otolaryngology Head and Neck Surgery, NHS Lothian, University of Edinburgh, Edinburgh EH8 9YL, UK

9. Department of Otorhinolaryngology-Head and Neck Surgery, Jena University Hospital, 07747 Jena, Germany

10. Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium

11. ENT and Head and Neck Department, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, 33011 Oviedo, Spain

12. Centro de Investigación Biomédica en Red de Cancer (CIBERONC), 28029 Madrid, Spain

13. Assuta Medical Center, Ben-Gurion University of the Negev, Tel Aviv 8436322, Israel

14. Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Mount Sinai Hospital, Icahn School of Medicine, New York, NY 10029, USA

15. Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA

16. School of Medicine, University of Udine, 33100 Udine, Italy

17. Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland

18. Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ 85724, USA

19. Department of Surgery, School of Medicine, University of Antioquia, Medellín 0500100, Colombia

20. Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, Sao Paulo 01509-001, Brazil

21. Department of Head and Neck Surgery, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil

22. Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy

Abstract

Surgery has been historically the preferred primary treatment for patients with well-differentiated thyroid carcinoma and for selected locoregional recurrences. Adjuvant therapy with radioactive iodine is typically recommended for patients with an intermediate to high risk of recurrence. Despite these treatments, locally advanced disease and locoregional relapses are not infrequent. These patients have a prolonged overall survival that may result in long periods of active disease and the possibility of requiring subsequent treatments. Recently, many new options have emerged as salvage therapies. This review offers a comprehensive discussion and considerations regarding surgery, active surveillance, radioactive iodine therapy, ultrasonography-guided percutaneous ablation, external beam radiotherapy, and systemic therapy for well-differentiated thyroid cancer based on relevant publications and current reference guidelines. We feel that the surgical member of the thyroid cancer management team is empowered by being aware and facile with all management options.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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