Management of Recurrent Well-Differentiated Thyroid Carcinoma in the Neck : A Comprehensive Review †

ORCID
0000-0001-9720-5034
Affiliation
Cancer Institute of São Paulo State, Department of Head and Neck Surgery, University of São Paulo Medical School, Sao Paulo 01246-903, Brazil
Cavalheiro, Beatriz G.;
ORCID
0000-0002-6444-6592
Affiliation
Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
Shah, Jatin P.;
ORCID
0000-0001-5373-9181
Affiliation
Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, MA 02115, USA
Randolph, Gregory W.;
Affiliation
Department of Otolaryngology and Head and Neck Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA
Medina, Jesus E.;
Affiliation
Multidisciplinary Thyroid and Parathyroid Center, Head and Neck Endocrine Surgery, Sarasota Memorial Health Care System, Sarasota, FL 34239, USA
Tufano, Ralph P.;
ORCID
0000-0001-7918-9739
Affiliation
Department of Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX 77030, USA
Zafereo, Mark;
ORCID
0000-0003-1161-5628
Affiliation
Department of Surgery, Gustave Roussy, 94800 Villejuif, France
Hartl, Dana M.;
Affiliation
Department of Otolaryngology Head and Neck Surgery, NHS Lothian, University of Edinburgh, Edinburgh EH8 9YL, UK
Nixon, Iain J.;
GND
1078441464
Affiliation
Department of Otorhinolaryngology-Head and Neck Surgery, Jena University Hospital, 07747 Jena, Germany
Guntinas-Lichius, Orlando;
ORCID
0000-0003-1341-829X
Affiliation
Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
Vander Poorten, Vincent;
ORCID
0000-0001-7019-9746
Affiliation
ENT and Head and Neck Department, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, 33011 Oviedo, Spain
López, Fernando;
Affiliation
Assuta Medical Center, Ben-Gurion University of the Negev, Tel Aviv 8436322, Israel
Khafif, Avi Hefetz;
Affiliation
Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Mount Sinai Hospital, Icahn School of Medicine, New York, NY 10029, USA
Owen, Randall P.;
Affiliation
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
Shaha, Ashok;
ORCID
0000-0003-3063-0890
Affiliation
ENT and Head and Neck Department, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, 33011 Oviedo, Spain
Rodrigo, Juan P.;
ORCID
0000-0001-7956-6709
Affiliation
School of Medicine, University of Udine, 33100 Udine, Italy
Rinaldo, Alessandra;
ORCID
0000-0002-0451-2404
Affiliation
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland
Mäkitie, Antti A.;
Affiliation
Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ 85724, USA
Silver, Carl E.;
ORCID
0000-0002-5563-8840
Affiliation
Department of Surgery, School of Medicine, University of Antioquia, Medellín 0500100, Colombia
Sanabria, Alvaro;
ORCID
0000-0002-0481-156X
Affiliation
Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, Sao Paulo 01509-001, Brazil
Kowalski, Luiz P.;
ORCID
0000-0002-8247-8002
Affiliation
Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy
Ferlito, Alfio

Simple Summary: Surgery is generally the treatment of choice for locoregional recurrences of well-differentiated thyroid carcinomas, but other therapies can be considered on an individual basis. These patients are expected to have prolonged survival, even with the possibility of long periods of active disease and the need for subsequent treatments. The present review intends to provide considerations regarding these therapeutic possibilities.

Abstract: Surgery has been historically the preferred primary treatment for patients with well-differentiated thyroid carcinoma and for selected locoregional recurrences. Adjuvant therapy with radioactive iodine is typically recommended for patients with an intermediate to high risk of recurrence. Despite these treatments, locally advanced disease and locoregional relapses are not infrequent. These patients have a prolonged overall survival that may result in long periods of active disease and the possibility of requiring subsequent treatments. Recently, many new options have emerged as salvage therapies. This review offers a comprehensive discussion and considerations regarding surgery, active surveillance, radioactive iodine therapy, ultrasonography-guided percutaneous ablation, external beam radiotherapy, and systemic therapy for well-differentiated thyroid cancer based on relevant publications and current reference guidelines. We feel that the surgical member of the thyroid cancer management team is empowered by being aware and facile with all management options.

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