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Thyroid Cancer

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Surgical Oncology

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Abstract

The incidence of thyroid cancer is increasing in the United States, and patients present frequently with newly diagnosed thyroid nodules. An understanding of the differences between the histological types of thyroid cancers in their presentation, diagnostic workup, surgical management, adjuvant therapy, surveillance, and management for recurrent disease is therefore important. This chapter explores these differences and provides current recommendations for multimodality treatment to optimize the care of thyroid cancer patients.

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Abbreviations

AJCC:

American Joint Committee on Cancer

ATA:

American Thyroid Association

AUS/FLUS:

Atypia of undetermined significance/follicular lesion of undetermined significance

CEA:

Carcinoembryonic antigen

CNS:

Central nervous system

CT:

Computed tomography

DTC:

Differentiated thyroid cancer

EBRT:

External beam radiation therapy

FDG-PET:

Fluoro-deoxy-glucose positron emission tomography

FMTC:

Familial medullary thyroid cancer

FN:

Follicular neoplasms

FNA:

Fine-needle aspiration

FTC:

Follicular thyroid cancer

HCC:

Hürthle cell carcinoma

HCN:

Hürthle cell neoplasms

MEN:

Multiple endocrine neoplasia

MRI:

Magnetic resonance imaging

MTC:

Medullary thyroid carcinoma

NCI:

National Cancer Institute

PET:

Positron emission tomography

PHPT:

Primary hyperparathyroidism

PTC:

Papillary thyroid carcinoma

PTH:

Parathyroid hormone

RAI:

Radioactive iodine

RET:

Rearranged during transfection

rhTSH:

Recombinant human TSH

SEER:

Surveillance, epidemiology, and end results

Tg:

Thyroglobulin

TSH:

Thyroid-stimulating hormone

WBS:

Whole-body RAI scans

References

  1. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.

    Article  PubMed  Google Scholar 

  2. Aschebrook-Kilfoy B, Ward MH, Sabra MM, Devesa SS. Thyroid cancer incidence patterns in the United States by histologic type, 1992–2006. Thyroid. 2011;21(2):125–34.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mazeh H, Chen H. Advances in surgical therapy for thyroid cancer. Nat Rev Endocrinol. 2011;7(10):581–8.

    Article  PubMed  Google Scholar 

  4. Melck AL, Carty SE. Evaluation of a new thyroid nodule. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 39–48.

    Google Scholar 

  5. Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab. 2006;91(11):4295–301.

    Article  PubMed  CAS  Google Scholar 

  6. Haymart MR, Repplinger DJ, Leverson GE, et al. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab. 2008;93(3):809–14.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Jabiev AA, Ikeda MH, Reis IM, Solorzano CC, Lew JI. Surgeon-performed ultrasound can predict differentiated thyroid cancer in patients with solitary thyroid nodules. Ann Surg Oncol. 2009;16(11):3140–5.

    Article  PubMed  Google Scholar 

  8. Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol Clin North Am. 2010;43(2):229–38, vii.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Layfield LJ, Cibas ES, Baloch Z. Thyroid fine needle aspiration cytology: a review of the National Cancer Institute state of the science symposium. Cytopathology. 2010;21(2):75–85.

    Article  PubMed  CAS  Google Scholar 

  10. Seningen JL, Nassar A, Henry MR. Correlation of thyroid nodule fine-needle aspiration cytology with corresponding histology at Mayo Clinic, 2001–2007: an institutional experience of 1,945 cases. Diagn Cytopathol. 2012;40 Suppl 1:E27–32.

    Article  PubMed  Google Scholar 

  11. Pinchot SN, Al-Wagih H, Schaefer S, Sippel R, Chen H. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 2009;144(7):649–55.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chen H, Nicol TL, Udelsman R. Follicular lesions of the thyroid. Does frozen section evaluation alter operative management? Ann Surg. 1995;222(1):101–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  13. Haymart MR, Greenblatt DY, Elson DF, Chen H. The role of intraoperative frozen section if suspicious for papillary thyroid cancer. Thyroid. 2008;18(4):419–23.

    Article  PubMed  Google Scholar 

  14. Randolph G, Duh QY, Heller KS, et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension ATA Surgical Affairs Committee’s Taskforce on Thyroid Cancer Nodal Surgery. Thyroid. 2012;11:1144–52.

    Article  Google Scholar 

  15. Elaraj DM, Sturgeon C. Papillary thyroid carcinoma. In: Morita SY, Dackiw APB, Zeiger MA, editors. Endocrine surgery. New York: McGraw-Hill; 2010. p. 47–64.

    Google Scholar 

  16. Elaraj DM, Sturgeon C. Management of papillary thyroid cancer. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 49–61.

    Google Scholar 

  17. Grebe SK, Hay ID. Thyroid cancer nodal metastases: biologic significance and therapeutic considerations. Surg Oncol Clin N Am. 1996;5(1):43–63.

    PubMed  CAS  Google Scholar 

  18. Kouvaraki MA, Shapiro SE, Fornage BD, et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134(6):946–54, discussion 54–5.

    Article  PubMed  Google Scholar 

  19. Pinchot SN, Sippel RS, Chen H. Multi-targeted approach in the treatment of thyroid cancer. Ther Clin Risk Manag. 2008;4(5):935–47.

    PubMed  CAS  PubMed Central  Google Scholar 

  20. Patel SS, Goldfarb M. Well-differentiated thyroid carcinoma: the role of post-operative radioactive iodine administration. J Surg Oncol. 2013;107(6):665–72.

    Article  PubMed  CAS  Google Scholar 

  21. Kim HJ, Kim NK, Choi JH, et al. Radioactive iodine ablation does not prevent recurrences in patients with papillary thyroid microcarcinoma. Clin Endocrinol (Oxf). 2013;78(4):614–20.

    Article  Google Scholar 

  22. Jonklaas J, Sarlis NJ, Litofsky D, et al. Outcomes of patients with differentiated thyroid carcinoma following initial therapy. Thyroid. 2006;16(12):1229–42.

    Article  PubMed  Google Scholar 

  23. Podnos YD, Smith DD, Wagman LD, Ellenhorn JD. Survival in patients with papillary thyroid cancer is not affected by the use of radioactive isotope. J Surg Oncol. 2007;96(1):3–7.

    Article  PubMed  Google Scholar 

  24. Poehls JL, Sippel RS. Thyroid evaluation – laboratory testing. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 3–13.

    Google Scholar 

  25. Mazzaferri EL. Long-term outcome of patients with differentiated thyroid carcinoma: effect of therapy. Endocr Pract. 2000;6(6):469–76.

    Article  PubMed  CAS  Google Scholar 

  26. McGriff NJ, Csako G, Gourgiotis L, Lori CG, Pucino F, Sarlis NJ. Effects of thyroid hormone suppression therapy on adverse clinical outcomes in thyroid cancer. Ann Med. 2002;34(7–8):554–64.

    Article  PubMed  CAS  Google Scholar 

  27. Jeh SK, Jung SL, Kim BS, Lee YS. Evaluating the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor. Korean J Radiol. 2007;8(3):192–7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kushchayeva Y, Duh QY, Kebebew E, D’Avanzo A, Clark OH. Comparison of clinical characteristics at diagnosis and during follow-up in 118 patients with Hurthle cell or follicular thyroid cancer. Am J Surg. 2008;195(4):457–62.

    Article  PubMed  Google Scholar 

  29. McHenry CR, Wilhelm SM. Management of follicular and Hürthle cell cancer. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 79–88.

    Google Scholar 

  30. Yip L, Carty SE. Follicular thyroid carcinoma and oncocytic (Hürthle cell) carcinoma. In: Morita SY, Dackiw APB, Zeiger MA, editors. Endocrine surgery. New York: McGraw-Hill; 2010. p. 65–88.

    Google Scholar 

  31. Chen H, Nicol TL, Zeiger MA, et al. Hürthle cell neoplasms of the thyroid: are there factors predictive of malignancy? Ann Surg. 1998;227(4):542–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  32. Zhang YW, Greenblatt DY, Repplinger D, et al. Older age and larger tumor size predict malignancy in hürthle cell neoplasms of the thyroid. Ann Surg Oncol. 2008;15(10):2842–6.

    Article  PubMed  Google Scholar 

  33. Zettinig G, Fueger BJ, Passler C, et al. Long-term follow-up of patients with bone metastases from differentiated thyroid carcinoma – surgery or conventional therapy? Clin Endocrinol (Oxf). 2002;56(3):377–82.

    Article  Google Scholar 

  34. McWilliams RR, Giannini C, Hay ID, Atkinson JL, Stafford SL, Buckner JC. Management of brain metastases from thyroid carcinoma: a study of 16 pathologically confirmed cases over 25 years. Cancer. 2003;98(2):356–62.

    Article  PubMed  Google Scholar 

  35. Pinchot SN, Sippel RS. Management of medullary thyroid cancer. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 63–78.

    Google Scholar 

  36. Chen H, Sippel RS, O’Dorisio MS, et al. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas. 2010;39(6):775–83.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kloos RT, Eng C, Evans DB, et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009;19(6):565–612.

    Article  PubMed  Google Scholar 

  38. Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88(5):1139–48.

    Article  PubMed  CAS  Google Scholar 

  39. Machens A, Schneyer U, Holzhausen HJ, Dralle H. Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab. 2005;90(4):2029–34.

    Article  PubMed  CAS  Google Scholar 

  40. Sippel RS, Kunnimalaiyaan M, Chen H. Current management of medullary thyroid cancer. Oncologist. 2008;13(5):539–47.

    Article  PubMed  Google Scholar 

  41. Truong M, Cook MR, Pinchot SN, Kunnimalaiyaan M, Chen H. Resveratrol induces Notch2-mediated apoptosis and suppression of neuroendocrine markers in medullary thyroid cancer. Ann Surg Oncol. 2011;18(5):1506–11.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Callender GG, Hu MI, Evans DB, Perrier ND. Medullary thyroid carcinoma. In: Morita SY, Dackiw APB, Zeiger MA, editors. Endocrine surgery. New York: McGraw-Hill; 2010. p. 89–109.

    Google Scholar 

  43. Burke JF, Sippel RS, Chen H. Evolution of pediatric thyroid surgery at a tertiary medical center. J Surg Res. 2012;177(2):268–74.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Boi F, Maurelli I, Pinna G, et al. Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab. 2007;92(6):2115–8.

    Article  PubMed  CAS  Google Scholar 

  45. Chen H, Roberts JR, Ball DW, et al. Effective long-term palliation of symptomatic, incurable metastatic medullary thyroid cancer by operative resection. Ann Surg. 1998;227(6):887–95.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  46. Brierley J, Sherman E. The role of external beam radiation and targeted therapy in thyroid cancer. Semin Radiat Oncol. 2012;22(3):254–62.

    Article  PubMed  Google Scholar 

  47. Brierley J, Tsang R, Simpson WJ, Gospodarowicz M, Sutcliffe S, Panzarella T. Medullary thyroid cancer: analyses of survival and prognostic factors and the role of radiation therapy in local control. Thyroid. 1996;6(4):305–10.

    Article  PubMed  CAS  Google Scholar 

  48. Campbell MJ, Seib CD, Gosnell J. Vandetanib and the management of advanced medullary thyroid cancer. Curr Opin Oncol. 2013;25(1):39–43.

    Article  PubMed  CAS  Google Scholar 

  49. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995 [see comments]. Cancer. 1998;83(12):2638–48.

    Article  PubMed  CAS  Google Scholar 

  50. Ruan DT, Clark OH. Anaplastic thyroid carcinoma, metastases to the thyroid gland, and thyroid lymphoma. In: Morita SY, Dackiw APB, Zeiger MA, editors. Endocrine surgery. New York: McGraw-Hill; 2010. p. 110–24.

    Google Scholar 

  51. Nishiyama RH. Overview of surgical pathology of the thyroid gland. World J Surg. 2000;24(8):898–906.

    Article  PubMed  CAS  Google Scholar 

  52. Smallridge RC, Ain KB, Asa SL, et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2012;22(11):1104–39.

    Article  PubMed  Google Scholar 

  53. Neff RL, Farrar WB, Kloos RT, Burman KD. Anaplastic thyroid cancer. Endocrinol Metab Clin North Am. 2008;37(2):525–38, xi.

    Article  PubMed  Google Scholar 

  54. Kim TY, Kim KW, Jung TS, et al. Prognostic factors for Korean patients with anaplastic thyroid carcinoma. Head Neck. 2007;29(8):765–72.

    Article  PubMed  Google Scholar 

  55. Pierie JP, Muzikansky A, Gaz RD, Faquin WC, Ott MJ. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma. Ann Surg Oncol. 2002;9(1):57–64.

    Article  PubMed  Google Scholar 

  56. McIver B, Hay ID, Giuffrida DF, et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery. 2001;130(6):1028–34.

    Article  PubMed  CAS  Google Scholar 

  57. Passler C, Scheuba C, Prager G, et al. Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis. Langenbecks Arch Surg. 1999;384(3):284–93.

    Article  PubMed  CAS  Google Scholar 

  58. Guerrero MA, Kebebew E. Management of aggressive variants and anaplastic thyroid cancers. In: Sippel RS, Chen H, editors. The handbook of endocrine surgery. Singapore: World Scientific Publishing; 2012. p. 89–100.

    Google Scholar 

  59. Levendag PC, De Porre PM, van Putten WL. Anaplastic carcinoma of the thyroid gland treated by radiation therapy. Int J Radiat Oncol Biol Phys. 1993;26(1):125–8.

    Article  PubMed  CAS  Google Scholar 

  60. Compton C, Byrd D, Garcia-Aguilar J. Thyroid. In: Compton C, Byrd D, Garcia-Aguilar J, Kurtzman S, Olawaiye A, Washington M, editors. AJCC cancer staging atlas. 2nd ed. New York: Springer Science + Business Media; 2012. p. 113–20.

    Chapter  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, 53792, WI, USA

    Jocelyn F. Burke M.D. & Herbert Chen M.D.

Authors
  1. Jocelyn F. Burke M.D.
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  2. Herbert Chen M.D.
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Correspondence to Herbert Chen M.D. .

Editor information

Editors and Affiliations

  1. Department of Surgery, LSU Health Sciences Center-Shreveport, Shreveport, Louisiana, USA

    Quyen D. Chu

  2. Department of Surgery, Jersey Shore University Medical Center, Neptune, New Jersey, USA

    John F. Gibbs

  3. John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, Louisiana, USA

    Gazi B. Zibari

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Burke, J.F., Chen, H. (2015). Thyroid Cancer. In: Chu, Q., Gibbs, J., Zibari, G. (eds) Surgical Oncology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1423-4_23

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  • DOI: https://doi.org/10.1007/978-1-4939-1423-4_23

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