Int J Thyroidol.  2024 May;17(1):182-187. 10.11106/ijt.2024.17.1.182.

Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part III. Management of Advanced Differentiated Thyroid Cancers - Chapter 5. Treatment of Metastatic Lesions in Advanced Differentiated Thyroid Carcinoma 2024

• Jung KY
• Seo Y
• Kang HC
• Kim SW
• Na DG
• Park YJ
• Song YS
• Shin DY
• Lee SW
• Lee EK
• Lim DJ
• Chung YJ
• Kim WG
• Korean Thyroid Association Guideline Committee on the Managements of Thyroid Nodule and Cancer

• KMID: 2556514
• DOI: http://doi.org/10.11106/ijt.2024.17.1.182

Abstract

Only a small percentage of patients (2-5%) with differentiated thyroid cancer (DTC) exhibit distant metastasis at the initial diagnosis or during the disease course. The most common metastatic sites of DTC are the lungs, followed by the bones. Radioactive iodine (RAI) therapy is considered the primary treatment for RAI-avid distant metastatic DTC. Depending on the characteristics of metastatic lesions, local treatment such as surgical resection, radiofrequency ablation, and external beam radiation therapy may be considered for some patients with metastatic DTC. Slowly growing and asymptomatic metastases can be monitored with follow-up while receiving thyroid-stimulating hormone (TSH) suppression therapy. In patients with a limited number of lung metastases and good performance status, surgical removal of the metastatic lesions may be considered. Systemic therapy should be considered for patients with progressive RAI refractory DTC. In this clinical guideline, we aim to outline the treatment principles for patients with lung, bone, and brain metastases of DTC.

Keyword

Distant metastasis; Advanced differentiated thyroid carcinoma; Lung metastasis; Bone metastasis; Brain metastasis; Radioactive iodine; Local therapy; Korean Thyroid Association; Guideline

Reference

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