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 18 Issue 6
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Clinical Thyroidology for the Public Volume 18 Issue 6 (PDF file, 2.64 MB)
TABLE OF CONTENTS – Web Format
THYROID CANCER
Does surgery without radioactive iodine therapy affect outcomes in low-risk thyroid cancer?
Historically, thyroid cancer surgery was a total thyroidectomy followed by radioactive iodine therapy to destroy all remaining thyroid cancer cells. More recently, a less aggressive approach is recommended, especially with small thyroid cancers with low-risk features. Indeed, the American Thyroid Association now recommends against using radioactive iodine therapy in low-risk patients. This study was done to examine the long-term results of omitting radioactive iodine therapy in treating patients with low-risk thyroid cancer.
Leboulleux S et al. Thyroidectomy without radioiodine in patients with low-risk thyroid cancer: 5 years of follow-up of the prospective randomised ESTIMABL2 trial. Lancet Diabetes Endocrinol,. 2025;13(1):38-46; doi: 10.1016/ S2213-8587(24)00276-6.
THYROID CANCER
Does radioactive iodine therapy change outcomes in low-to-intermediate risk papillary thyroid cancers?
Papillary thyroid cancer has an excellent prognosis. Since the vast majority of patients with papillary thyroid cancer do not die of their cancer, it can be difficult to evaluate the effect of treatment on overall survival. This study was performed to evaluate whether the use of radioactive iodine therapy can improve survival in patients with low-to-intermediate risk papillary thyroid cancer that have spread of the cancer to lymph nodes in the neck at the time of surgery.
Palacardo F, et al. The impact of radioactive iodine on diseasespecific survival in low-to-intermediate risk N1b papillary thyroid carcinoma. Ann Surg Oncol. Epub 2024 Nov 6; doi: 10.1245/s10434-024-16388-1. PMID: 39505729.
THYROID CANCER
How do additional high-risk features change patient survival for large thyroid cancers?
Thyroid cancer is common and usually has an excellent prognosis. The ATA guidelines recommend total thyroidectomy rather than a lobectomy for thyroid cancers larger than 4 cm due to worse reported patient outcomes. The goal of this study is to evaluate if 4 cm is the best cut off for risk stratification in thyroid cancer.
Ginzberg SP, et al. Revisiting the relationship between tumor size and risk in well-differentiated thyroid cancer. Thyroid 2024;34(8):953-1063; doi: 10.1089/thy.2023.0327. PMID: 38877803.
THYROID CANCER (MEDULLARY)
Can lobectomy be enough surgery for treatment of medullary thyroid cancer?
Complete surgical removal of cancer is the best option for cure of medullary thyroid cancer (MTC). Total thyroidectomy with central neck dissection is the currently recommended initial surgery for MTC. This study aimed to investigate whether total thyroidectomy and lobectomy would result in different outcomes related to cancer-related death or recurrence in early-stage MTC that is smaller than 2 cm in size and limited to thyroid gland.
Jishu JA, et al. Limited thyroidectomy achieves equivalent survival to total thyroidectomy for early localized medullary thyroid cancer. Cancers (Basel) 2024;16(23):4062; doi: 10.3390/cancers16234062. PMID: 39682246.
GRAVES’ DISEASE
Can Graves’ disease be treated with just medication?
Graves’ disease is the most common cause of an overactive thyroid gland. The initial treatment of Graves’ disease is usually anti-thyroid drugs to control the hyperthyroidism and return the thyroid levels to normal. Unfortunately, half of the patients will become hyperthyroid again their anti-thyroid drugs are stopped. The goal of this study is to identify patient characteristics that will make them more likely to become hyperthyroid again after the anti-thyroid drugs are stopped.
El Kawkgi O, et al. A predictive model for Graves’ disease recurrence after antithyroid drug therapy: a retrospective multicenter cohort study. Endocr Pract. Epub 2024 Dec 16; doi:10.1016/j.eprac.2024.12.011. PMID: 39694327.
GRAVES’ DISEASE
Does the addition of low-dose methotrexate to antithyroid drugs improve remission rates in Graves’ disease?
Graves’ disease is the most common type of hyperthyroidism and is an autoimmune disease. Methotrexate is a drug that decreases the immune response and is an effective treatment for other autoimmune diseases, such as rheumatoid arthritis. This study examined the effect of adding low dose methotrexate to antithyroid drugs on the remission rates in patients with Graves’ disease.
Xie P, et al. Effects of low-dose methotrexate with methimazole in patients with Graves’ disease: results of a randomized clinical trial. J Clin Endocrinol Metab 2025;110(2):489-497; doi: 10.1210/clinem/dgae472. PMID: 38994582.
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