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
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Clinical Thyroidology for the Public Volume 16 Issue 2 (PDF file, 2.77 MB)
TABLE OF CONTENTS – Web Format
Overtreatment and under treatment of hypothyroidism with thyroid hormone is associated with increased death from heart disease
The goal of treating hypothyroidism is achieving a TSH in the normal range. Not keeping the levels in the normal range can increase risk for heart issues and increase the risk of death from heart disease. This study looks into the association of overtreatment and undertreatment of hypothyroidism and the risk of death due to heart disease.
Evron JM et al 2022 Association of thyroid hormone treatment intensity with cardiovascular mortality among US veterans. JAMA Netw Open 5(5):e2211863. PMID: 35552725.
Is there a risk of heart disease in thyroid cancer patients?
It remains controversial whether patients with thyroid cancer have an increased risk of heart disease as compared to the general population. The goal of this study was to determine the risk of death due to heart disease in a population of adult patients with thyroid cancer compared to a population of patients without thyroid cancer.
Qiang JK et al 2022 Risk of adverse cardiovascular outcomes in differentiated thyroid cancer survivors: A systematic review and meta-analysis. Thyroid. Epub 2022 Oct 20. PMID: 36074932.
Has the diagnostic accuracy of thyroid nodule biopsy improved?
Biopsy of thyroid nodules, which became available in the late 1970s, is an accurate and safe test available to identify cancerous or suspicious thyroid nodules and the results of this test has been used to guide treatment. Several improvements in thyroid biopsy have been developed over the years. The goal of this study was to evaluate whether the diagnostic performance of thyroid biopsy has improved over the past four decades since its introduction.
Hsiao V et al 2022 Diagnostic accuracy of fine-needle biopsy in the detection of thyroid malignancy: A systematic review and meta-analysis. JAMA Surg. Epub 2022 Oct 12. PMID: 36223097.
How effective is radiofrequency ablation as a treatment for benign thyroid nodules?
Radiofrequency ablation (RFA) has been shown to be safe and effective in treating single benign thyroid nodules. RFA uses heat energy to irreversibly destroy thyroid cells and shrink the target tissue. This study was done evaluate the effectiveness and safety of RFA for benign nodules.
Kandil E et al 2022 Efficacy and safety of radiofrequency ablation of thyroid nodules: A multi-institutional prospective cohort study. Ann Surg. Epub 2022 Jul 15. PMID: 35837903.
What should you expect after radioactive iodine therapy for Graves’ disease?
Radioactive iodine therapy has been used for treatment of Graves’ disease since the 1940s. The current approach is to give a dose of radioactive iodine to completely destroy the thyroid gland, so most patients develop hypothyroidism within the first year of treatment. The main goal of this study was to find out how often and when the thyroid hormone abnormalities developed after radioactive iodine therapy and to compare the effects of different management strategies.
Perros P et al 2022 Post radioiodine Graves’ management: The PRAGMA study. Clin Endocrinol (Oxf ). Epub 2022 Mar 11. PMID: 35274331.
Trends in lobectomy for pediatric thyroid cancer
While only 1.8% of all thyroid cancers occur in the pediatric population, it is still one of the most common endocrine cancers in the young. In 2015, ATA recommendations urged treating pediatric thyroid cancer with a total thyroidectomy. In contrast, recommendations for treating thyroid cancer in adults stated lobectomy was a suitable procedure. In the current study, the authors evaluate the impact of the ATA guidelines on the treatment of thyroid cancer in children.
Stein E et al 2022 The 2015 American Thyroid Association guidelines and trends in hemithyroidectomy utilization for pediatric thyroid cancer. Head Neck 44:1833–1841.