ABSTRACT
This chapter outlines how to utilize prognostic features to determine the individual management strategy in patients with differentiated thyroid carcinoma. Thyroid carcinoma comprises a spectrum of malignancies ranging from rarely lethal, slow-growing neoplasms to among the most aggressive cancers to afflict humanity. The mitogen-activated protein kinase pathway is an intracellular signaling cascade that is initiated on the cell surface by binding of a signaling molecule to a transmembrane receptor, leading to phosphorylation of various downstream proteins and ultimately resulting in changes in cellular activity such as growth, proliferation, and apoptosis. Telomerase reverse transcriptase promoter mutations are newly described in thyroid cancers. The RAS oncogenes regulate two signaling pathways in the development of thyroid cancer, the MAP kinase cascade and the phosphoinositide 3-kinases/Akt pathway. Tumor histology is a major determinant of outcome, generally being best with Papillary thyroid carcinoma, intermediate with follicular thyroid carcinoma, and worst with Hurthle cell thyroid carcinoma.
