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KMID : 1202020100030020123
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Journal of Korean Thyroid Association
2010 Volume.3 No. 2 p.123 ~ p.133
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Management of Differentiated Thyroid Cancer with Distant Metastasis
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Lee Jeong-Hun
Soh Euy-Young
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Abstract
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Differentiated carcinoma of thyroid tumors accounts for 90% of thyroid cancer in Korea, of which the 10 yrs-survival rate is 80∼95% and prognosis is good. However, if distant metastasis (DM) occurs, 5 yr survival rate of differentiated thyroid carcinoma (DTC) is reduced to less than 60%. Therefore, the author in the study reviewed the journals about DTC with DM and investigated diagnostic methods, treatments and prognostic factors. DM was diagnosed not only through biopsy but also through the level of thyroglobuin and a variety of radiologic examination, as such as 131I whole body scan (RAI WBS), FDG-PET/CT etc. After initial treatment, thyroglobulin (Tg) and RAI WBS are important, but the level of Tg may not be equivalent to the finding of RAI WBS. In these cases, a variety of diagnostic tests are needed to confirm the metastasis. For the treatment of DTC with DM, there are several treatments, such as surgery, radioactive iodine therapy, external radiation therapy, chemotherapy and tyrosine kinase inhibitors etc. However, for the selection of appropriate management, the treatment should be individualized according to the patient’s general condition, the side effects and the characteristics of metastatic lesions.
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KEYWORD
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Well differentiated thyroid cancer, Distant metastasis, Thyroglobulin, Radioactive iodine, FDG-PET/CT, Tyrosine kinase inhibitor, External radiotherapy, Chemotherapy
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