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Therapeutic options in the management of low-grade papillary thyroid carcinomas

Krešimir Gršić ; KBC Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska


Puni tekst: engleski pdf 188 Kb

str. 36-36

preuzimanja: 58

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Sažetak

The papillary thyroid carcinoma (PTC) represents the predominant form of differentiated thyroid malignancy,
accounting for nearly 85 – 90% of all thyroid cancers and demonstrating disease-specific survival rates above
90% at 20 years of age. Within this spectrum, T1 low-grade tumors – defined as intrathyroidal lesions ≤2 cm
in diameter, without extrathyroidal extension, aggressive histological variants, or distant metastases – exhibit
particularly indolent biological behavior. In this context, treatment strategies have shifted from routine radical
approaches toward individualized, risk-adapted management. While the total thyroidectomy remains an
established option, lobectomy has emerged as a safe and oncologically adequate alternative for carefully
selected patients, with the added benefit of reducing surgical morbidity and long-term dependence on thyroid
hormone replacement. Increasing evidence also supports an active surveillance for intrathyroidal
microcarcinomas, provided that high-resolution ultrasonography and strict follow-up protocols are available,
reserving surgery for disease progression or patient preference. These evolving paradigms reflect an effort to
minimize overtreatment and its associated risks, including recurrent laryngeal nerve injury and
hypoparathyroidism, without compromising disease-specific survival. A multidisciplinary, patient-centered
approach –integrating tumor biology, molecular markers such as BRAF V600E, and patient comorbidities –
remains essential to optimize outcomes. Current trends emphasize tailoring therapy to the biological and
clinical heterogeneity of T1 low-grade PTC, thereby aligning oncological safety with the preservation of life
quality.

Ključne riječi

T1 low-grade Papillary thyroid carcinoma; lobectomy; total thyroidectomy; active surveillance

Hrčak ID:

336302

URI

https://hrcak.srce.hr/336302

Datum izdavanja:

10.11.2025.

Posjeta: 130 *