Current management of thyroid cancer--a change of therapeutic strategy over the last 20 years.

A radical change of epidemiological structure of thyroid cancer incidence in Poland has been reported for few years. The total incidence of thyroid cancer is successively increasing, mostly in form of well differentiated thyroid cancer, especially papillary cancer. The diagnostic and therapeutic approach to thyroid cancer have also changed. Ultrasound guided fine needle aspiration has become the first choice procedure in diagnostics of thyroid cancer. Careful assessment of prognostic factors is no longer helpful in choice of selective surgical procedure in thyroid cancer as elective total thyroidectomy is widely recommended. In well differentiated thyroid cancer a complementary treatment with radioiodine is mandatory in most cases. Own experience in treatment of thyroid cancer presented in the paper is based on over 520 consecutive patients with thyroid cancer treated in a single department specialised in endocrine surgery during last 20 years. Successive changes in epidemiological structure of thyroid cancer incidence as well as the evolution of diagnostic and therapeutic algorithm in thyroid cancer are presented in details. Radical surgical treatment of thyroid cancer is still a fundamental part of a complex treatment of thyroid cancer.