Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

TLDR

Differentiated thyroid carcinomas have an excellent prognosis and are mainly treated with surgery, sometimes followed by radioactive iodine ablation or thyroxine therapy, while medullary carcinoma is also primarily managed surgically, and anaplastic carcinoma is almost uniformly lethal.

Abstract

Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).