Standard and emerging therapeutic approaches for thyroid malignancies

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy. The standard treatment for DTC includes surgery, radioiodine ablation, and thyroid hormone-suppressive therapy. With this approach, overall survival is excellent. Still, controversy exists when tailoring therapy according to an individual's chance of developing metastases. Patients with genetic and environmental risk factors, those at the extremes of age, and those with comorbid conditions require special consideration. The most effective method to monitor patients for disease recurrence and the most optimal treatment for those who recur are debated. New understandings about the genetic aberrations underlying thyroid cancer have led to novel therapeutic options for patients with metastatic disease. The traditional approach to DTC treatment with an emphasis on topics of continued uncertainty will be discussed. In addition, emerging therapies for DTC will be reviewed. © 2008 Elsevier Inc. All rights reserved.