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A brief review of when it is appropriate to initiate systemic therapy in patients with differentiated thyroid cancer as opposed to continuing active surveillance.

Treatment approachesSequencing strategiesDifferentiated thyroid cancerActive surveillanceInitiating systemic therapyThyroid cancerDtc cancerRadioiodine refractory dtcRr dtcRai refractoryRadioactive iodine refractoryRiftos studyRiftos trialInitiating treatmentInitiating therapyPatient surveillance