[Consensus and controversy on the treatment of differentiated thyroid cancers]

Differentiated thyroid carcinomas are the most common endocrine neoplasia. Because of their rather benign evolution, the treatment varies widely from minimal to aggressive interventions. Therefore there are considerable controversies as to the best therapeutic choice. In this article we review the literature on the subject and we discuss the advantages and drawbacks of the different treatments. Furthermore we present a consensus on the subject recently adopted by l'Association des endocrinologues du Québec. We propose an ipsilateral lobectomy for small papillary cancers of less than 1.5 cm without metastasis, in patients less than 40 year-old. In all the other tumors we recommend a total thyroidectomy followed by a dose of 131I for complete ablation of the thyroid tissue.