New trends in management of low risk differentiated thyroid cancer

  Low Risk Follicular cell Derived Thyroid Cancer

Vahab Fatourechi MD, FRCPC, FACP

 Professor of Medicine

 Mayo Clinic College of Medicine

Tehran November 2018

What are the New Trends in Management of  FCDTC

• Less is more : Avoid over diagnosis and over treatment
• Micro –PTC  that may not be clinically relevant  is  present in 5% of population
•  Concept of active surveillance
• More lobectomies  alone for low risk PTC, and follicular cancer  with no vascular invasion
• Concept of NIFT-P
• Less RAI use

New Trends in Management of  DTC

• Follicular cancer with capsular but not vascular invasion is low risk  and lobectomy is adequate

• Encapsulated follicular variant of thyroid cancer is not  cancer – and should be

re-classified as  non invasive follicular neoplasm with papillary features (NIFT-P)

Not much changes for high risk cancers except TKIs for therapy