Follicular Thyroid Cancer

As is the case with papillary thyroid cancer, the effort applied to the search for recurrent follicular thyroid cancer is determined by the likelihood of tumor recurrence and death from disease. Patients with follicular cancer have a higher incidence of cancer-related death than patients with papillary thyroid cancer (1) . A recent review of survival statistics for these two malignancies cited 16 studies showing improved survival in papillary thyroid cancer compared to follicular thyroid cancer, 5 studies showing no difference in survival, and 1 study showing improved survival in patients with follicular thyroid cancer (2). Recently, patients with minimally invasive follicular thyroid cancer have been scrutinized with respect to outcome and found to be at relatively low risk for recurrence and cancer-related death (3 − 6) . As is discussed below (see Chapter 32), many of the same determinants of prognosis in papillary thyroid cancer are applicable to patients with follicular thyroid cancer. The presence or absence of poor prognostic indicators is used to tailor the frequency and intensity of surveillance for tumor recurrence. This chapter reviews the rationale used to determine appropriate follow-up for patients with follicular thyroid cancer and provides a current overview of the tools available to assist in this objective. These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.