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clinical guideline thyroid cancer

Bryan R Haugen
Thyroid nodules are very common, and thyroid cancer is currently the fifth leading cancer diagnosis in women. The American Thyroid Association has led the development and revision of guidelines for the management of patients with thyroid nodules and differentiated thyroid cancer (DTC). The most current revision was published in the January 2016 issue of the journal Thyroid. The current guidelines have 101 recommendations, with 8 figures and 17 tables that are hopefully helpful to those treating patients with thyroid nodules and cancer...
October 14, 2016: Cancer
Claudio Gambardella, Ernesto Tartaglia, Anna Nunziata, Graziella Izzo, Giuseppe Siciliano, Fabio Cavallo, Claudio Mauriello, Salvatore Napolitano, Guglielmo Thomas, Domenico Testa, Gianluca Rossetti, Alessandro Sanguinetti, Nicola Avenia, Giovanni Conzo
BACKGROUND: Lymph nodal involvement is very common in differentiated thyroid cancer, and in addition, cervical lymph node micrometastases are observed in up to 80 % of papillary thyroid cancers. During the last decades, the role of routine central lymph node dissection (RCLD) in the treatment of papillary thyroid cancer (PTC) has been an object of research, and it is now still controversial. Nevertheless, many scientific societies and referral authors have definitely stated that even if in expert hands, RCLD is not associated to higher morbidity; it should be indicated only in selected cases...
2016: World Journal of Surgical Oncology
Frieda Silva, Ralph J Martin, Jannette Figueroa, Fernando Rincón, Diego Román
OBJECTIVE: Evaluate the variability of stimulated serum thyroglobulin (Tg) levels in post-thyroidectomy patients with well-differentiated thyroid cancer (WDTC) and determine the frequency of undetectable Tg in patients with evidence of functional thyroid tissue after a 131-I whole-body scan (WBS). METHODS: A retrospective record review of patients with WDTC referred to our clinic from 1990 to 2010. Demographic data, histology, staging, imaging studies, stimulated Tg values, and the presence if applicable of Tg antibodies (TgAb) were documented...
September 2016: Puerto Rico Health Sciences Journal
Bashar Matti, Ruben Cohen-Hallaleh
The last few years have witnessed numerous publications addressing the management of thyroid nodules and differentiated thyroid cancers. The purpose of this review is to provide a simplified summary of the newly released guidelines by the American Thyroid Association. A systematic approach has been recommended to evaluate a thyroid nodule through clinical assessment, measurement of serum Thyroid Stimulating Hormone, neck ultrasonography and Fine Needle Aspiration where appropriate. This is followed by cytology analysis using the Bethesda scoring system to detect malignancy...
September 9, 2016: New Zealand Medical Journal
Linda M Youngwirth, Mohamed A Adam, Randall P Scheri, Sanziana A Roman, Julie A Sosa
BACKGROUND: Patients with thyroid cancer who have extrathyroidal extension (ETE) are considered to have more advanced tumors. However, data on the impact of ETE on patient outcomes remain limited. The purpose of this study was to evaluate the association between ETE and survival in patients with thyroid cancer. METHODS: The National Cancer Database (1998-2012) was queried for all adult patients with differentiated thyroid cancer and medullary thyroid cancer. Patients were divided into three groups: no ETE (T1 and T2 tumors), minimal ETE (T3 tumors <4 cm), and extensive ETE (T4 tumors <4 cm)...
October 5, 2016: Thyroid: Official Journal of the American Thyroid Association
Patrick Hanley, Katherine Lord, Andrew J Bauer
Importance: Normal thyroid gland function is critical for early neurocognitive development, as well as for growth and development throughout childhood and adolescence. Thyroid disorders are common, and attention to physical examination findings, combined with selected laboratory and radiologic tools, aids in the early diagnosis and treatment. Objective: To provide a practical review of the presentation, evaluation, and treatment of thyroid disorders commonly encountered in a primary care practice...
October 1, 2016: JAMA Pediatrics
Ana E Espinosa De Ycaza, Kathleen M Lowe, Diana S Dean, M Regina Castro, Vahab Fatourechi, Mabel Ryder, John C Morris, Marius N Stan
BACKGROUND: Fine-needle aspiration (FNA) of thyroid nodules is commonly performed, and despite the use of ultrasound (US) guidance, the rate of non-diagnostic FNAs is still significant. The risk of malignancy of thyroid nodules with a non-diagnostic FNA is not clearly defined. However, most studies exclude the majority of patients without a repeat biopsy or surgery, thus increasing the likelihood of selection bias. The aims of this study were to determine the malignancy risk in nodules with an initial non-diagnostic FNA, and to identify the factors associated with malignancy...
October 5, 2016: Thyroid: Official Journal of the American Thyroid Association
Barbara Pereira Pires, Paulo Alonso Garcia Alves, Maria Alice Bordallo, Daniel Alves Bulzico, Flavia Paiva Proença Lobo Lopes, Terence Farias, Fernando Dias, Roberto Araújo Lima, Izabella Costa Santos Gisler, Claudia Medina Coeli, Raquel Vasconcellos Carvalhaes de Oliveira, Rossana Corbo, Mario Vaisman, Fernanda Vaisman
BACKGROUND: The incidence of pediatric differentiated thyroid carcinoma (DTC) has been rising in recent years, and the main risk factors for recurrence are lymph node and distant metastasis at diagnosis. Other clinical features remain unclear, such as the impact of age, sex, and puberty. Furthermore, until now, this population has been treated using the same strategies used to treat adults. In 2015, the American Thyroid Association (ATA) published the first guidelines targeted at this age group...
October 2016: Thyroid: Official Journal of the American Thyroid Association
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
Thyrotoxicosis is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormones. Including its subclinical form, it is considered as one of the most frequent endocrine disorders in the general population. If not detected in a timely fashion, thyrotoxicosis can have serious health consequences. The most common forms of thyrotoxicosis include diffuse toxic goiter (Graves' disease), toxic multinodular goiter (Plummer's disease), and toxic adenoma (Goetsch's disease). The significant progress in the fields of hormonal assessment, imaging procedures and molecular biology made in recent years has brought about great improvement in the identification, differentiation and treatment of many other disorders associated with thyrotoxicosis...
2016: Przegla̧d Lekarski
(no author information available yet)
<strong>Objective </strong>To dynamically observe the early change of thyroglobulin(Tg) levels after (131)I therapy in differentiated thyroid cancer(DTC) patients. <strong>Methods </strong>The study enrolled 22 post-total-thyroidectomy DTC patients and they were stratified as low to intermediate recurrence according to the 2009 American Thyroid Association Guidelines. The clinical data including pre-ablation stimulated Tg (ps-Tg),corresponding thyroid stimulating hormone(TSH),anti-thyroglobulin (TgAb) values,and the afterwards parameters were dynamically measured each week in the first month after (131)I therapy...
June 10, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Carolina Franco Uliaque, Francisco Javier Pardo Berdún, Ricardo Laborda Herrero, Carmen Pérez Lórenz
OBJECTIVE: To evaluate the diagnostic capacity of ultrasonography (US) for differentiating between malignant and benign thyroid nodules and its usefulness in obviating unnecessary invasive procedures. PATIENTS AND METHODS: From January 2012 through December 2014, a total of 321 fine-needle aspiration biopsy (FNAB) procedures were done in 302 patients selected according to the criteria recommended by the American Association of Clinical Endocrinology guidelines and the American Thyroid Association guidelines...
September 2016: Radiología
Eun Hae Estelle Chang, Waseem Lutfi, Joseph Feinglass, Alexandra Eudokia Reiher, Tricia Moo-Young, Mihir Kiran Bhayani
BACKGROUND: Medullary thyroid cancer (MTC) represents the third most common type of thyroid cancer, and the prognosis depends on the stage of the disease at diagnosis and completeness of tumor resection. In 2009, the American Thyroid Association (ATA) published guidelines with evidence-based recommendations for the treatment of MTC. This study aimed to determine national adherence rates of the treatment according to the ATA guidelines specific for MTC. METHODS: Patients diagnosed with MTC from 2004 to 2013 were identified from the National Cancer Database...
July 22, 2016: World Journal of Surgery
Cari M Kitahara, Julie A Sosa
During the past few decades, the incidence of thyroid cancer has increased substantially in many countries, including the USA. The rise in incidence seems to be attributable both to the growing use of diagnostic imaging and fine-needle aspiration biopsy, which has led to enhanced detection and diagnosis of subclinical thyroid cancers, and environmental factors. The latest American Thyroid Association (ATA) practice guidelines for the management of adult patients with thyroid nodules and differentiated thyroid cancer differ substantially from the previous ATA guidelines published in 2009...
November 2016: Nature Reviews. Endocrinology
Elmira Amirazodi, Evan J Propst, Catherine T Chung, Dimitri A Parra, Jonathan D Wasserman
BACKGROUND: Thyroid malignancy is rare in young children, although the incidence increases sharply during adolescence. Nodular thyroid disease and thyroid cancer in children differ substantially from those in adults, because the rates of malignancy among children are roughly 5-fold higher, and local and distant metastases as well as recurrences are more common. Even with the recent introduction of pediatric guidelines, there remains a paucity of pediatric data on which to base clinical decision making...
July 14, 2016: Cancer Cytopathology
Yoon Young Cho, Sejong Chun, Soo Youn Lee, Jae Hoon Chung, Hyung Doo Park, Sun Wook Kim
BACKGROUND: Measurement of postoperative serum thyroglobulin (Tg) is important for detecting persistent or recurrent differentiated thyroid cancer. We evaluated the analytic performance of the DxI 800 assay (Beckman Coulter, USA) for serum Tg and anti-thyroglobulin antibodies (TgAbs) in comparison with that of the GAMMA-10 assay (Shinjin Medics Inc., Korea) for serum Tg and RIA-MAT 280 assay (Stratec, Germany) for TgAb. METHODS: We prospectively collected blood samples from 99 patients thyroidectomized for thyroid cancer...
September 2016: Annals of Laboratory Medicine
Kourosh Parham, Nikita Chapurin, Kris Schulz, Jennifer J Shin, Melissa A Pynnonen, David L Witsell, Alan Langman, Anh Nguyen-Huynh, Sheila E Ryan, Andrea Vambutas, Anne Wolfley, Rhonda Roberts, Walter T Lee
OBJECTIVES: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Provide practice-based data related to flexible laryngoscopy vocal fold assessment before and after thyroid surgery based on the American Academy of Otolaryngology-Head and Neck Surgery Foundation's clinical practice guidelines. STUDY DESIGN: Review of retrospective data collection (RDC) database of the CHEER network using ICD-9 and CPT codes related to thyroid conditions...
July 2016: Otolaryngology—Head and Neck Surgery
Markus Dietlein, Wolfgang Eschner, Frank Grünwald, Michael Lassmann, Frederik A Verburg, Markus Luster
The procedure guideline for radioiodine therapy of differentiated thyroid cancer (version 4) was developed in the consensus of a representative expert group. This fulfils the level S1 (first step) within the AWMF classification of Clinical Practice Guidelines (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Germany). This procedure guideline completed the guideline for surgical management of thyroid cancer (level S2) with the aspects from nuclear medicine. Controversies over ablative radioiodine therapy in small papillary thyroid cancers and in minimally invasive follicular cancer without angioinvasion, over empirical standard doses for ablative radioiodine therapy, and over the kind of TSH-stimulation were described and the guideline formulated a corridor of good clinical practice...
June 28, 2016: Nuklearmedizin. Nuclear Medicine
Colette Zwarthoed, Kaouthar Chatti, Julien Guglielmi, Maha Hichri, Cathy Compin, Jacques Darcourt, Georges Vassaux, Danielle Benisvy, Thierry Pourcher, Beatrice Cambien
BACKGROUND: MicroSPECT/CT imaging was used to quantitatively evaluate how iodide uptake in the mouse thyroid is influenced by i) route of iodine administration; ii) injection of recombinant human TSH (rhTSH); and iii) low iodide diet in euthyroid and T3-treated mice. METHODS: 99mTcO4- and 123I thyroid uptake in euthyroid and T3-treated animals fed either a normal-iodine diet (NID) or a low-iodide diet (LID), treated or not with rhTSH, and radiotracer administered intravenously, subcutaneously, intraperitoneally or by gavage, were assessed using microSPECT/CT imaging...
June 27, 2016: Thyroid: Official Journal of the American Thyroid Association
Inmaculada Prior-Sánchez, Ana Barrera Martín, Estefanía Moreno Ortega, Juan A Vallejo Casas, María Á Gálvez Moreno
OBJECTIVE: The management of patients with differentiated thyroid cancer (DTC) has changed in recent years, and monitoring depends on the risk of persistent/recurrent disease. The objective was to assess the prognostic value of a single stimulated thyroglobulin (Tg) measured at the time of the first radioiodine therapy (Stim-Tg1), and the utility of a second stimulated Tg measurement performed 6-12 months later (Stim-Tg2). We also examined the role of neck ultrasound (US) in the early diagnosis of recurrence...
June 21, 2016: Clinical Endocrinology
Joachim Feldkamp, Dagmar Führer, Markus Luster, Thomas J Musholt, Christine Spitzweg, Matthias Schott
BACKGROUND: Thyroid nodules are a common finding in Germany. Most are benign; thyroid cancer is very rare. The challenge for the physician is to diagnose malignant tumors early. Fine needle aspiration is an important tool for this purpose. METHODS: This review is based on pertinent articles (1980-2014) retrieved by a selective search in PubMed and on the current recommendations of guidelines issued by the specialty societies in Germany and abroad. RESULTS: Clinical, ultrasonographic, and scintigraphic criteria are used to identify high-risk nodules, which are then further studied by fine needle aspiration...
May 20, 2016: Deutsches Ärzteblatt International
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