Management of Recurrent Well-Differentiated Thyroid Carcinoma in the Neck: A Comprehensive Review †

SIMPLE SUMMARY: Surgery is generally the treatment of choice for locoregional recurrences of well-differentiated thyroid carcinomas, but other therapies can be considered on an individual basis. These patients are expected to have prolonged survival, even with the possibility of long periods of active disease and the need for subsequent treatments. The present review intends to provide considerations regarding these therapeutic possibilities. ABSTRACT: Surgery has been historically the preferred primary treatment for patients with well-differentiated thyroid carcinoma and for selected locoregional recurrences. Adjuvant therapy with radioactive iodine is typically recommended for patients with an intermediate to high risk of recurrence. Despite these treatments, locally advanced disease and locoregional relapses are not infrequent. These patients have a prolonged overall survival that may result in long periods of active disease and the possibility of requiring subsequent treatments. Recently, many new options have emerged as salvage therapies. This review offers a comprehensive discussion and considerations regarding surgery, active surveillance, radioactive iodine therapy, ultrasonography-guided percutaneous ablation, external beam radiotherapy, and systemic therapy for well-differentiated thyroid cancer based on relevant publications and current reference guidelines. We feel that the surgical member of the thyroid cancer management team is empowered by being aware and facile with all management options.