Papillary carcinoma of the thyroid gland: treatment based on risk group definition

This article outlines the current controversy regarding the extent of treatment of papillary carcinoma of the thyroid. It emphasizes that following general principles in surgical oncology, surgeons doing endocrine cancer management should scale the extensiveness of their operative procedure to the risk of the cancer. The majority of patients with papillary carcinoma fall into a low-risk group with a 1% or less risk of death over a period of many years. It is illogical to treat these patients in the same fashion as patients who have a 50% risk of death in a shorter period of time. The various components of the risk assignment systems are outlined and emphasized to give surgeons the confidence to use risk category in their selection of surgical and adjuvant treatment of papillary carcinoma of the thyroid.