Endocrine Abstracts

Thyroid cancer is one of the most rapidly increasing cancer diagnoses worldwide. Thyroid cancers exhibit the full range of cancer behavior from the relatively indolent occult papillary thyroid cancer to the uniformly aggressive and lethal undifferentiated thyroid cancers. Surgical resection is the principal treatment for thyroid cancer and there are several important areas of controversy in the surgical management of thyroid cancer. Some of these controversies have arisen due to the increasing incidence of thyroid cancer, the variable biologic behavior of low-risk differentiated thyroid cancer, and because of the improved detection of persistent/recurrent disease. International Surgical and Medical Societies and Association have proposed guidelines to the surgical management of thyroid cancer and the level of evidence for these guidelines will be reviewed. Three critical areas in the surgical management of differentiated thyroid cancer remain controversial: the extent of thyroidectomy for differentiated thyroid cancer, need for prophylactic central neck lymph node dissection in patients with papillary thyroid cancer, and the need for completion thyroidectomy in patients who initially undergo hemithyroidectomy. A clinical, pathologic and molecular based approach to address these three controversial areas in the surgical management of differentiated thyroid cancer will be proposed to personalize surgical management decisions in patients with differentiated thyroid cancer.