RT Book, Section A1 Noureldine, Salem I. A1 Tufano, Ralph P. A2 Morita, Shane Y. A2 Balch, Charles M. A2 Klimberg, V. Suzanne A2 Pawlik, Timothy M. A2 Posner, Mitchell C. A2 Tanabe, Kenneth K. SR Print(0) ID 1145757305 T1 Locally Advanced and Aggressive Thyroid Cancer T2 Textbook of Complex General Surgical Oncology YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071793315 LK accesssurgery.mhmedical.com/content.aspx?aid=1145757305 RD 2024/10/13 AB Thyroid cancer is considered to be the most common endocrine malignancy, with estimated new cases exceeding 60,000 in 2013.1 Although most patients who present with thyroid cancer have well-differentiated intrathyroidal tumors that carry an excellent prognosis, these tumors have a distinct tendency for multifocal involvement and regional lymph node metastasis. The adverse prognostic factors in thyroid cancer have been well-established and include patient age, tumor histology, primary tumor size, extrathyroidal extension, and distant metastasis.2 The greatest negative impact on prognosis, from a surgical standpoint, is extrathyroidal extension.3 Up to 15% of patients with differentiated thyroid cancer (DTC) exhibit aggressive behavior, hallmarked by extrathyroidal extension, treatment resistance, and increased mortality.3,4