Long-Term Follow-up in XXXX .

@entity1 @entity137 @entity66 @entity174 @entity2488 @entity5 @entity294 @entity787 @entity1745 @entity3 @entity158 @entity259 @entity4149
UNASSIGNED: After surgery, @entity1 with @entity259 ( @entity259 ) should be assessed regarding the presence of @entity66 , the localization of @entity3 , and the identification of progressive disease. Postoperatively, @entity1 with @entity259 are staged to separate those at low risk from those at high risk of recurrence. The TNM staging system is based on @entity5 size, extra-thyroidal invasion, nodal @entity3 , and distant spread of @entity5 . In addition, the number of lymph-node @entity3 , the number of compartments involved, and the postoperative calcitonin (CTN) and @entity787 ( @entity787 ) levels should be documented. The postoperative normalization of the serum CTN level is associated with a favorable outcome. When @entity1 have basal serum CTN levels less than 150  pg/ml after a thyroidectomy, any persistent or recurrent disease is nearly always confined to lymph nodes in the neck. When the postoperative serum CTN level exceeds 150  pg/ml, @entity1 should be evaluated with imaging procedures, including computed tomography (CT) of the neck and chest, contrast-enhanced magnetic resonance imaging (MRI) and ultrasound (US) of the liver, bone scintigraphy, MRI of the bone, and positron emission tomography (PET)/CT. One can estimate the growth rate of @entity259 @entity3 by quantifying increases in @entity5 size over time from sequential imaging studies analyzed with response evaluation criteria in @entity5 (RECIST), and by determining the @entity5 marker doubling time from sequential measures of serum CTN or @entity787 levels over multiple time points. One of the main challenges remains to find effective adjuvant and palliative options for @entity1 with @entity3 . @entity1 with persistent or recurrent @entity259 localized to the neck following thyroidectomy are candidates for neck operations, depending on the @entity5 extension. Once @entity3 appear, the clinician must decide which @entity1 require therapy. This requires a balance between the (often) slow rate of @entity5 progression, which is associated with a good quality of life, and the limited efficacy and potential @entity137 of local and systemic therapies. Considering that metastatic @entity259 is incurable, the management goals are to provide loco-regional disease control, palliate symptoms of hormonal excess, such as @entity294 , palliate symptomatic @entity3 , like @entity158 or @entity174 , and control @entity3 that threaten life, such as @entity2488 or @entity1745 . This can be achieved with palliative surgery, external beam radiation therapy (EBRT), or systemic therapy with @entity4149 kinase inhibitor (TKI).
