Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
Volume 16 Issue 12
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Clinical Thyroidology for the Public Volume 16 Issue 12 (PDF file, 2.79MB)
TABLE OF CONTENTS – Web Format
AMERICAN THYROID ASSOCIATION CENTENNIAL
Clinical Thyroidology for the Public – A Historical Celebration!
Fears experienced by women and men diagnosed with low-risk papillary thyroid cancer
Many patients experience emotions such as shock, fear, and anxiety when they get diagnosed with thyroid cancer. In studies involving cancer patients, gender has been found to be important in influencing the level of distress that patients experience. This study aimed to examine the association between gender and age with fears related to thyroid cancer progression or potential surgical treatment.
Sawka AM et al for the Canadian Thyroid Cancer Active Surveillance Study Group (Greater Toronto Area) 2023 Gender differences in fears related to low-risk papillary thyroid cancer and its treatment. JAMA Otolaryngol Head Neck Surg. Epub 2023 Sep 1. PMID: 37410454.
Molecular profiling of thyroid nodules: the road towards personalized treatment
Thyroid nodule biopsy can help to determine whether a nodule is benign or a cancer in 70-80% of cases. The remaining 20-30% of thyroid nodules are called indeterminate and scored as Bethesda 3 or 4, where the cancer risk ranges from 13-34%. The aim of this study was to evaluate the molecular profile of indeterminate thyroid nodules by using comprehensive molecular marker testing.
Chiosea S et al. 2023 Molecular profiling of 50,734 Bethesda III-VI thyroid nodules by ThyroSeq v3: Implications for personalized management. J Clin Endocrinol Metab. Epub 2023 Apr 18. PMID: 37071871.
Obtaining molecular markers on thyroid biopsies prior to surgery may affect initial surgery and intensity of postoperative follow-up
Molecular marker testing is recommended for Bethesda 3 and 4 thyroid nodules and has led to increased accuracy for diagnosing thyroid cancers. Since the risk for cancer in Bethesda 5 and 6 nodules is greater than 50%, molecular marker testing is usually not done as most often patients are recommended to proceed to surgery. This study was performed to see if molecular marker testing for Bethesda 5 and 6 nodules could aid in prediction of the aggressiveness of the thyroid cancer and even help to determine the planned management.
Schumm MA et al 2023 Prognostic value of preoperative molecular testing and implications for initial surgical management in thyroid nodules harboring suspected (Bethesda V) or known (Bethesda VI) papillary thyroid cancer. JAMA Otolaryngol Head Neck Surg 149:735–742. PMID: 37382944.
The importance of evaluating the lateral neck in patients with papillary thyroid microcarcinomas
Most papillary thyroid microcarcinomas are considered low risk as they are very slow growing. However, a subgroup of papillary thyroid microcarcinomas are higher risk and can spread outside the neck. The aim of this study was to evaluate the association between the spread of cancer to the lymph nodes in the neck in patients with papillary thyroid microcarcinomas and future risk of cancer recurrence.
Ruan J et al 2023 Lateral lymph node metastasis in papillary thyroid microcarcinoma: A study of 5241 follow-up patients. Endocrine. Epub 2023 Aug 7. PMID: 37596455.
Is more radioactive iodine the answer for increased thyroglobulin levels alone?
Our current American Thyroid Association 2015 guidelines categorize patient’s thyroid cancer in terms of how likely it is to recur in a neck lymph node in the next ten years. Thyroglobulin levels that are rising or remain elevated and no evidence of cancer is noted on imaging are termed “biochemically incomplete or indeterminate response to therapy.” The goal of this study is to better understand if additional doses of radioactive iodine therapy is beneficial when the thyroid cancer is not responding to therapy in the “biochemically indeterminate or incomplete” category.
Gambale C et al 2023 Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients. Eur Thyroid J. Epub 2023 Sep 1. PMID: 37768697.
THYROID EYE DISEASE
Medical therapy for thyroid eye disease
Graves’ disease can be associated with inflammation of the muscles that control eye movements, known as thyroid eye disease (TED). In recent years, agents that modify the immune system have been studied as alternative treatments to steroids and surgery. The aim of this study was to report real world experience with these new medical therapies in the treatment of TED at a single medical center in the US.
Toro-Tobon et al. 2023 Medical therapy in patients with moderate to severe, steroid-resistant, thyroid eye disease.