Treatment of Patients with Advanced Thyroid Cancer

Nowadays, thyroid nodules are very frequent as a consequence of the increasing use of diagnostic tools and other not well-known factors as well as the diagnostic evaluation with fine needle aspiration cytology indicated in most thyroid nodules; only 5% of all thyroid nodules are diagnosed as malignant. Only 1% of all epithelial malignancies are thyroid cancer and they represent 95% of all endocrine malignancies. Thus, thyroid cancer is the most frequent endocrine malignancy with 62,980 new cases is expected in 2014 in the United States with an associated rise in mortality [1-3]. Thyroid cancers are divided into four major histological types: papillary (PTC) (85% of cases), follicular (FTC) (11% of cases), medullary (MTC) (3% of cases), and anaplastic thyroid carcinoma (1% of cases). PTC, FTC and MTC thyroid cancers are considered as differentiated thyroid cancer (DTC), which also includes poorly differentiated carcinomas. DTC have a favorable prognosis, however, recurrence or metastasis is observed in 10-15% of patients following the standard treatment of surgery and radioiodine. MTC is a malignancy of the parafollicular C cells of the thyroid.