Initial Therapy

In addition to the factors mentioned above, timely and appropriate treatment has an important bearing on prognosis. In this section, treatment will be considered only for differentiated tumors of follicular epithelium, PTC, FTC, and HTC. Therapy of MTC is quite different and is the subject of unique guidelines and is discussed in full in Chapter 21 [108,109]. Likewise, therapy of ATC is discussed in Chapter 30 by Drs Haq and Harmer, and in Chapter 31 by Professor Tennvall and colleagues. Current guidelines on the treatment of DTC from the United States [110] and Europe [111] advise total or near-total thyroidectomy followed by 131I ablation of the thyroid remnant for most patients. Although the treatment of children has been more controversial, many now recommend that they be treated the same as adults [79]. This is disussed in detail in Chaper 23 by Sarlis and Hung.

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