EDITORIAL August 01, 2015 August 01, 2015

The evolving field of thyroid cancer: refinement of old and creation of new paradigms

DOI: 10.1590/2359-3997000000099

Since the landmark paper by Mazzaferri and Jhiang () indicating the benefit of adequate surgery and postoperative radioactive iodine treatment in patients with well-differentiated thyroid cancer (DTC), a lot has been learned about prognostic factors associated with disease recurrence and mortality and the risks and benefits of treatment. In addition, over the past 3 decades we have experienced a dramatic improvement in imaging and laboratorial techniques resulting in highly sensitive and specific studies for disease detection, and have observed a significant advance in the understanding of the molecular pathogenesis of thyroid cancer.

This accumulated knowledge has confirmed a few paradigms and has provided important insights that have refined the treatment of thyroid cancer. First, surgery is the mainstay treatment of thyroid cancer and therefore an experienced surgeon and an adequate surgical treatment have the highest impact in cure. Second, the major roles and best responses of radioactive iodine treatment are in reducing recurrence rate in high-risk patients and in treating young patients with micronodular lung metastases and; third, the development of kinase inhibitors has been a major breakthrough in treating metastatic thyroid cancer, not only DTC but also medullary thyroid cancer (MTC).

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