Risk Stratification in Differentiated Thyroid Cancer

  • Risk stratification in differentiated thyroid cancer has traditionally used a relatively small set of clinical and pathological factors to create models that predict disease-specific mortality or overall survival:
    • Although clinically useful, these models provided static estimates of risk with information available within the first few months of initial therapy and demonstrated suboptimal, long-term outcome predictions for any individual patient
  • Over the last decade, additional models have been developed that provide predictive information with regard to other clinically relevant outcomes, such as:
    • The risk of having persistent disease after initial therapy
    • The risk of structural or biochemical disease recurrence
    • The likelihood of going into remission following initial therapy in adult patients with thyroid cancer
  • Furthermore, rather than using information that is only available at one particular point in time, these new models emphasize the importance of dynamic risk assessment:
    • Where the initial risk assessment is modified over time as new data become available
  • These dynamic risk assessments allow us to:
    • Integrate response to therapy assessments with the underlying individual tumor biology:
      • To provide real-time risk assessments at any point in the course of the patient’s disease
  • Thus, the modern view of risk stratification begins with:
    • The identification of a suspicious nodule (peri-diagnostic period) and continues through the phases of:
      • Diagnosis
      • Treatment
      • Adjuvant therapy
      • Follow-up

#Arrangoiz #ThyroidSurgeon #CancerSurgeon #HeadandNeckSurgeon #SurgicalOncologist #Teacher #Miami #MountSinaiMedicalCenter

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