CONSENSUS AND CONTROVERSY ON THE TREATMEN T OF DIFFERENTIATED THYROID-CARCINOMA

Differentiated thyroid carcinomas are the most common endocrine neopla sia. Because of their rather benign evolution, the treatment varies wi dely from minimal to aggressive interventions. Therefore there are con siderable controversies as to the best therapeutic choice. In this art icle we review the literature on the subject and we discuss the advant ages and drawbacks of the different treatments. Furthermore we present a consensus on the subject recently adopted by l'Association des endo crinologues du Quebec. We propose an ipsilateral lobectomy for small p apillary cancers of less than 1.5 cm without metastasis, in patients l ess than 40 year-old. In all the other tumors we recommend a total thy roidectomy followed by a dose of 131I for complete ablation of the thy roid tissue.