Advances in the medical management of differentiated thyroid carcinoma and their impact on the surgical approach.

The introduction of recombinant human TSH and neck ultrasonography has refined the management of differentiated thyroid cancer, leading to the publication of new guidelines by the American Thyroid Association (ATA) and a consensus report by the European Thyroid Association (ETA) in 2006. In this paper, we give an overview of the current medical management of differentiated thyroid cancer (pre-surgical, post-surgical), of how the advances have been integrated into the recent 2006 ATA guidelines and ETA consensus and finally, of the impact on the surgical management (first surgery, treatment of cervical lymph nodes) of differentiated thyroid cancer.