AI Article Synopsis

  • - Japan has a distinct history with radioactive iodine (RAI) therapy and surgery for thyroid cancer, primarily focusing on less than total thyroidectomy for papillary thyroid carcinoma (PTC) due to regulatory and financial limitations.
  • - Following updated clinical guidelines in 2010, a risk-adapted approach has been adopted, allowing high-risk PTC patients to receive total thyroidectomy, RAI therapy, and thyrotropin suppression therapy for better outcomes.
  • - The 2018 guidelines and advancements in RAI therapy aim to enhance patient management, with future goals including increased clinical research and approval for outpatient high-dose RAI treatment.

Article Abstract

We have a unique history of using radioactive iodine (RAI) therapy and surgical treatment for thyroid cancer in Japan. Less than total thyroidectomy without RAI therapy was the most common management of papillary thyroid carcinoma (PTC) in the past. Limited availability of dedicated facilities for the RAI administration due to the strict regulations and insufficient coverage of the expenses were the major reasons that impacted on the management decisions. Following the publication of the Japanese clinical practice guidelines for thyroid tumors in 2010, the risk-adapted approach has become a standard where the high-risk and selected intermediate-risk PTC patients undergo total thyroidectomy followed by RAI therapy and thyrotropin suppression therapy. We are on the shoulders of pioneers who made every effort to bring the interventions closer to an ideal environment for patients. Armed with the revised clinical practice guidelines 2018 and devised inpatient/outpatient RAI therapy, Japanese physicians are ready to proceed to more rational management that would improve patients' outcomes. Directions for the future include further advancement of relevant clinical research to fill the gaps between current evidence and recommendations in the guidelines, and obtaining approval for high-dose RAI therapy on an outpatient basis to improve its effectiveness in both adjuvant and treatment settings.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667117PMC
http://dx.doi.org/10.21037/gs-20-378DOI Listing

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