Abstract
The goals of clinical practice guidelines are to improve patient care by providing consensus on stage-specific therapies, reduce the use of unnecessary or harmful interventions, and to maximize the chance of treatment benefit at accepted societal costs. The American Thyroid Association (ATA) has published three prior versions of differentiated thyroid cancer (DTC) recommendation guidelines, and is set to release a fourth iteration in the upcoming year. The volume of research that has been performed in the field of thyroid cancer over the past decade has been immense. Therefore, in order to continue to maintain clinical excellence and state-of-the-art practice patterns, guidelines must be frequently updated and controversies perpetually reexamined. In this chapter, we discuss some relevant controversies and we examine some of the more significant updates in the treatment of well-differentiated thyroid cancer, as described by the ATA.
Editors’ Note: This chapter and the chapter “Well-differentiated Thyroid Cancer” by Dr. Yip are excellent companion pieces. We suggest reading them together to appreciate the many nuances of therapy for thyroid nodules and thyroid cancer.
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References
Howlander N, et al. SEER cancer statistics review, 1975–2011. National Cancer Institute. 2013. http://seer.cancer.gov/csr/1975_2011. Posted to the SEER web site, April 2014.
Irani S, et al. Evaluating clinical practice guidelines developed for the management of thyroid nodules and thyroid cancers and assessing the reliability and validity of the AGREE instrument. J Eval Clin Pract. 2011;17(4):729–36.
Carling T, et al. American Thyroid Association design and feasibility of a prospective randomized controlled trial of prophylactic central lymph node dissection for papillary thyroid carcinoma. Thyroid. 2012;22(3):237–44.
U.S. Preventive Services Task Force Grade Definitions. USPTF. http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm. Accessed 1 May 2014.
Davis L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295:2164–67
Singer P, et al. Treatment guidelines for patients with thyroid nodules and well-differentiated thyroid cancer. Arch Intern Med. 1996;156:2165–72.
Cooper DS, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16(2):109–42.
Cooper D, et al. Revised American Thyroid Association Management Guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.
Grant CS. Papillary thyroid cancer: strategies for optimal individualized surgical management. Clin Ther. 2014;36:1117–26.
Boelaert K, et al. 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.
NCCN Clinical Practice Guidelines in Oncology: Thyroid Carcinoma. Version 2. 2013. http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed 1 May 2014.
Gharib H, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyrois Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010;16(1):1–43.
Perros P, et al. Guidelines for the management of thyroid cancer. 2nd ed. British Thyroid Association, Royal College of Physicians; 2007.
Conzo G, et al. The current status of lymph node dissection in the treatment of papillary thyroid cancer. A literature review. Clin Ter. 2013;164(4):343–6.
Kouvaraki MA, et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134(6):946–54.
O’Connell K, et al. The utility of routine preoperative cervical ultrasonography in patients undergoing thyroidectomy for differentiated thyroid cancer. Surgery. 2013;154(4):697–701.
Stulak JM, et al. Value of preoperative ultrasonography in the surgical management of initial and reoperative papillary thyroid cancer. Arch Surg. 2006;141(5):489–94.
Marshall CL, et al. Routine pre-operative ultrasonography for papillary thyroid cancer: effects on cervical recurrence. Surgery. 2009;146(6):1063–72.
Chaikhoutdinov I, et al. Incidental thyroid nodules: incidence, evaluation, and outcome. Otolaryngol Head Neck Surg. 2014;150: 939–42.
Liebeskind A, et al. Rates of malignancy in incidentally discovered thyroid nodules evaluated with sonography and fine-needle aspiration. J Ultrasound Med. 2005;24:629–34.
Sung JY, et al. Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. Eur Radiol. 2012;22(7):1564–72.
Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132(5):658–65.
Ahmadieh H, Azar ST. Controversies in the management and followup of differentiated thyroid cancer: beyond the guidelines. J Thyroid Res. 2012; Epub ahead of print.
Yip L, et al. Optimizing surgical treatment of papillary thyroid carcinoma associated with BRAF mutation. Surgery. 2009;146(6): 1215–23.
Alexander EK, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8): 705–15.
Alexander EK, et al. Multicenter clinical experience with the Afirma gene expression classifier. J Clin Endocrinol Metab. 2014;99(1):119–25.
McIver B, et al. An independent study of a gene expression classifier (Afirma™) in the evaluation of cytologically indeterminate thyroid nodules. J Clin Endocrinol Metab. 2014; Epub ahead of print.
Tuttle RM, et al. Clinical features associated with an increased risk of thyroid malignancy in patients with folicular neoplasm by fine-needle aspiration. Thyroid. 1998;8(5):377–83.
Tamez-Pérez HE, et al. Nondiagnostic thyroid fine needle aspiration cytology: outcome in surgical treatment. Rev Invest Clin. 2007;59(3):180–3.
Bilimoria KY, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007;246(3):375–81; discussion 381–74.
Pelizzo MR, et al. High prevalence of occult papillary thyroid carcinoma in a surgical series for benign thyroid disease. Tumori. 1990;76(3):255–7.
Yu XM, et al. Current treatment of papillary thyroid microcarcinoma. Adv Surg. 2012;46:191–203.
Ito Y, et al. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid. 2014;24(1):27–34.
Wang TS, et al. Papillary thyroid microcarcinoma: an over-treated malignancy? World J Surg. 2014; Epub ahead of print.
Carty SE, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19(11):1153–8.
Stack BC, et al. American thyroid association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid. 2012;22(5):501–8.
Davidson HC, et al. Papillary thyroid cancer: controversies in the management of neck metastasis. Laryngoscope. 2008;118(12): 2161–5.
Mazzaferri EL, et al. The pros and cons of prophylactic central compartment lymph node dissection for papillary thyroid carcinoma. Thyroid. 2009;19(7):683–9.
Lee CR, et al. Lobectomy and prophylactic central neck dissection for papillary thyroid microcarcinoma: do involved lymph nodes mandate completion thyroidectomy? World J Surg. 2014;38(4): 872–7.
Oltmann SC, et al. Radioactive iodine remnant uptake after completion thyroidectomy: not such a complete cancer operation. Ann Surg Oncol. 2014;21(4):1379–83.
Luster M, et al. Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging. 2008;35(10): 1941–59.
Zaman MU, et al. Controversies about radioactive iodine-131 remnant ablation in low risk thyroid cancers: are we near a consensus? Asian Pac J Cancer Prev. 2013;14(11):6209–13.
Hugo J, et al. recombinant human thyroid stimulating hormone-assisted radioactive iodine remnant ablation in thyroid cancer patients at intermediate to high risk of recurrence. Thyroid. 2012;22(10):1007–15.
Tu J, et al. Recombinant human thyrotropin-aided versus thyroid hormone withdrawal-aided radioiodine treatment for differentiated thyroid cancer after total thyroidectomy: a meta-analysis. Radiother Oncol. 2014;110(1):25–30.
Tuttle RM, et al. Recombinant human TSH-assisted radioactive iodine remnant ablation achieves short-term clinical recurrence rates similar to those of traditional thyroid hormone withdrawal. J Nucl Med. 2008;49(5):764–70.
Castagna MG, et al. Limited value of repeat recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin testing in differentiated thyroid carcinoma patients with previous negative rhTSH-stimulated thyroglobulin and undetectable basal serum thyroglobulin levels. J Clin Endocrinol Metab. 2008;93(1):76–81.
Kloos RT, Mazzaferri EL. A single recombinant human thyrotropin-stimulated serum thyroglobulin measurement predicts differentiated thyroid carcinoma metastases three to five years later. J Clin Endocrinol Metab. 2005;90(9):5047–57.
Tuttle RM, et al. Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid. 2010;20(12):1341–9.
Boi F, et al. The diagnostic value for differentiated thyroid carcinoma metastases of thyroglobulin (Tg) measurement in washout fluid from fine-needle aspiration biopsy of neck lymph nodes is maintained in the presence of circulating anti-Tg antibodies. J Clin Endocrinol Metab. 2006;91(4):1364–9.
Snozek CL, et al. Serum thyroglobulin, high-resolution ultrasound, and lymph node thyroglobulin in diagnosis of differentiated thyroid carcinoma nodal metastases. J Clin Endocrinol Metab. 2007;92(11):4278–81.
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Glenn, J., Wang, T. (2015). Update of the Treatment Guidelines for Well-Differentiated Thyroid Cancer. In: Pasieka, J., Lee, J. (eds) Surgical Endocrinopathies. Springer, Cham. https://doi.org/10.1007/978-3-319-13662-2_17
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