Reflections on Thyroid Cancer Discussions for Martinique III: Blown off course, but sails re-set

By March 18, 2020 Featured, Sidebar, Thyroid Cancer

As many of you may know, a unique four-society collaborative group was founded in 2018 to discuss the perspectives of the various specialists involved in treating patients with thyroid cancer. The societies engaging in this collaboration are the European Thyroid Association (ETA), the European Association for Nuclear Medicine (EANM), the Society of Nuclear and Molecular Imaging (SNMMI) and the American Thyroid Association (ATA), with moderator Laszlo Hegedüs at the helm. The inception of this group was in the setting of international debates that were vigorously aired following the publication of the 2015 ATA guidelines for the treatment of thyroid cancer. The mission of the intersocietal working group is

To provide a forum to discuss our differences in an open, honest, data-driven, and respectful manner. Discussion will focus on areas of agreement, and those disagreements which result in meaningful differences in clinical management. The group will propose potential solutions and strategies to address those differences”.

The group has held productive meetings in 2018 and 2019, with one resultant publication (1) and one manuscript in press (2). These meetings, fondly named Martinique I and Martinique II (see photograph), were held in a setting that could not possibly have been more conducive to collegiality and open discussion: namely the beautiful island of Martinique. The atmosphere of friendly cooperation has been supported and amplified by the gracious hosts of these meetings, Dr Patrick Bourguet and Dr Ciprian Draganescu. The 2020 meeting of this group (Martinique III) was to take place in mid-March with the following important areas slated for discussion:

 Topic 1: Should peri-operative risk stratification be used to guide management in the absence of complete, accurate, and detailed risk factor descriptions?

 Topic 2: Should diagnostic radioactive iodine imaging be routinely recommended as part of initial staging for all ATA intermediate risk patients?

 Topic 3: How should response to radioactive iodine therapy in structural disease be defined?

 Due to a perfect storm of occurrences, of the magnitude and gravity of those events that we are all now experiencing, it was necessary to cancel this meeting. Furthermore, the cancellation occurred at a time that some participants were en route, but others had already arrived at the meeting location. Despite the anxiety and fraught nature of this situation, the group has quickly re-mobilized and is working together to distill presentations already prepared into a summary manuscript. Furthermore, the group has been inspired to work together on some additional projects, and Martinique IV is being discussed.

The seascape of the sailor and the seafarer has a rich and evocative language. The splendor, turmoil, and challenges of the ocean provide many analogies with the passion and fervor of scientific inquiry directed at optimizing patient care. The Martinique group has debated, agreed, and disagreed, and despite the ebb and flow, has been able to make progress in their deliberations. With our compasses out, sails trimmed, and hoping for fair winds and a guiding star, the ETA, EANM, SNMMI, and ATA members eagerly anticipate Martinique IV.

Sincerely,

Jacqueline Jonklaas, MD

Secretary/COO, American Thyroid Association

 

  1. Controversies, Consensus, and Collaboration in the Use of 131I Therapy in Differentiated Thyroid Cancer: A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid. 2019 Apr;29(4):461-470. doi: 10.1089/thy.2018.0597. Tuttle RM, Ahuja S, Avram AM, Bernet VJ, Bourguet P, Daniels GH, Dillehay G, Draganescu C, Flux G, Führer D, Giovanella L, Greenspan B, Luster M, Muylle K, Smit JWA, Van Nostrand D, Verburg FA, Hegedüs L.

 

  1. Brief progress report from the Intersocietal Working Group on Differentiated Thyroid Cancer. Frederik A. Verburg, Sukhjeet Ahuja, Anca M. Avram, Manuel Bardiès, Victor Bernet, Patrick Bourguet, Dagmar Führer-Sakel, Ciprian Draganescu, Gilbert H. Daniels, Bennett Greenspan, Seza Gulec, Jacqueline Jonklaas, Markus Luster, Wim Oyen, Johannes Smit, R. Michael Tuttle, Douglas Van Nostrand, Slimane Zerdoud, Laszlo Hegedüs (20). In press, Eur J Nucl Med Mol Imaging, 2020