Recurrent Differentiated Thyroid Cancer: The Current Treatment Options

• Type of Material: Article
• Authors: Andrés Coca-Pelaz, University of Oviedo; Juan Pablo Rodrigo, University of Oviedo; Jatin P Shah, Memorial Sloan Kettering Cancer Center; Iain J Nixon, University of Edinburgh; Dana M Hartl, Institut Gustave Roussy; Thomas K Robbins, Southern Illinois University; Luiz P Kowalski, A C Camargo Cancer Center; Antti A Mäkitie, University of Helsinki; Marc Hamoir, UC Louvain, St Luc University Hospital and King Albert II Cancer Institute; Fernando Lopez, University of Oviedo; Nabil Saba, Emory University; Sandra Nuyts, University Hospital Leuven; Alessandra Rinaldo, Policlinico Città di Udine; Alfio Ferlito, Coordinator of the International Head and Neck Scientific Group
• Language: English
• Date: 2023-05-10
• Publisher: MDPI
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023 by the authors.
• Final Published Version (URL): http://dx.doi.org/10.3390/cancers15102692
• Title of Journal or Parent Work: CANCERS
• Volume: 15
• Issue: 10
• Grant/Funding Information: This research received no external funding.
• Keywords: CENTRAL COMPARTMENT DISSECTION; Science & Technology; Oncology; NECK RECURRENCE; radioiodine therapy; CARCINOMA; ASSOCIATION GUIDELINES; tyrosine kinase inhibitors; Life Sciences & Biomedicine; RADIOIODINE; MANAGEMENT; RADIOACTIVE IODINE; salvage surgery; EFFICACY; IODINE REMNANT ABLATION; differentiated thyroid cancer; DISTANT METASTASES; targeted therapy
• Research Categories: Health Sciences, Oncology

Abstract

Differentiated thyroid carcinomas (DTC) have an excellent prognosis, but this is sometimes overshadowed by tumor recurrences following initial treatment (approximately 15% of cases during follow-up), due to unrecognized disease extent at initial diagnosis or a more aggressive tumor biology, which are the usual risk factors. The possible sites of recurrence are local, regional, or distant. Local and regional recurrences can usually be successfully managed with surgery and radioiodine therapy, as are some isolated distant recurrences, such as bone metastases. If these treatments are not possible, other therapeutic options such as external beam radiation therapy or systemic treatments should be considered. Major advances in systemic treatments have led to improved progression-free survival in patients previously considered for palliative treatments; among these treatments, the most promising results have been achieved with tyrosine kinase inhibitors (TKI). This review attempts to give a comprehensive overview of the current treatment options suited for recurrences and the new treatments that are available in cases where salvage surgery is not possible or in cases resistant to radioiodine.