Active Surveillance of Low-Risk Thyroid Cancer

Zanocco, Kyle; Hershman, Jerome M.; Leung, Angela M.

doi:10.1001/jama.2019.5350

Cited by 31 publications

(17 citation statements)

References 9 publications

(23 reference statements)

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“…Transition from active surveillance to surgery should be considered when a thyroid nodule size increases in the greatest dimension by at least > 3mm from initial measurement, in cases where a new suspicious metastatic LN disease shows cytological evidence for thyroid cancer, and when tumor volume increases by 50 % in three-dimensional measurements [32,34]. The identification of tracheal invasion can be challenging, as ultrasound as standalone imaging may not provide a complete evaluation of tumors located at the dorsal side of the thyroid.…”

Section: Current Standard Of Care For Dtcmentioning

confidence: 99%

Updates on the Management of Thyroid Cancer

2020

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The diagnostic modalities, stratification tools, and treatment options for patients with thyroid cancer have rapidly evolved since the development of the American Thyroid Association (ATA) guidelines in 2015. This review compiles newer concepts in diagnosis, stratification tools and treatment options for patients with differentiated thyroid cancer (DTC), medullary thyroid carcinoma (MTC) and anaplastic thyroid cancer (ATC). Newer developments apply precision medicine in thyroid cancer patients to avoid over-treatment in low risk disease and under-treatment in high risk disease. Among novel patient-tailored therapies are selective RET inhibitors that have shown efficacy in the treatment of MTC with limited systemic toxicity compared with non-specific tyrosine kinase inhibitors. The combination of BRAF and MEK inhibitors have revolutionized management of BRAF V600E mutant ATC. Several immunotherapeutic agents are being actively investigated in the treatment of all forms of thyroid cancer. In this review, we describe the recent advances in the diagnosis and management of DTC, MTC, and ATC, with an emphasis on novel treatment modalities.

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Section: Current Standard Of Care For Dtcmentioning

confidence: 99%

Updates on the Management of Thyroid Cancer

2020

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“…Until now, most of the long-term follow-up data of AS were based on PTMCs that were cytologically diagnosed. Researchers also suggested that it was reasonable to apply these selection criteria to sonographically suspicious cases, without a biopsy 37 . Without a cytological confirmation of PTMC, patients with suspicious nodules would be undergoing an ultrasound image analysis at follow-up.…”

Section: Some Concerns About Asmentioning

confidence: 99%

Active surveillance as a management strategy for papillary thyroid microcarcinoma

et al. 2020

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“…Surgery is the first-line treatment for bilateral PTMC. However, its drawbacks include invasiveness, cosmetic problems and life-long thyroid hormone replacement, which affect the quality of life (10). Moreover, the incidence of transient vocal fold paralysis and transient hypocalcemia after surgery were 5.5 and 4.3%, respectively (11).…”

Section: Introductionmentioning

confidence: 99%

The Efficacy and Safety of Radiofrequency Ablation for Bilateral Papillary Thyroid Microcarcinoma

et al. 2021

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ObjectiveTo investigate the long-term clinical results of radiofrequency ablation (RFA) for bilateral papillary thyroid microcarcinoma (PTMC).Materials and MethodsFrom October 2014 to February 2018, 47 patients (37 females, 10 males, mean age 43.39 ± 9.26 years) with 100 bilateral PTMC (mean volume 75.22 ± 73.87 mm3) treated by RFA were included in this retrospective study. Bilateral PTMC was defined as at least one tumor located in the contralateral lobe. Patients were followed up at 1, 3, 6, 12 months and every 6–12 months thereafter. Volume, volume reduction ratio (VRR) and local tumor recurrence were evaluated during the follow-up period.ResultsAfter a mean follow-up period of 47.77 ± 11.54 months, the mean volume of bilateral PTMC decreased from 75.22 ± 73.87 mm3 to 0.09 ± 0.44 mm3. The mean VRR was 99.94 ± 0.28% and the complete disappearance rate was 92.00%. During the follow-up, one patient (2.13%) developed lymph node metastasis and two patients (4.26%) had recurrent PTMC. All the recurrent lesions underwent additional RFA and two of them disappeared completely. No life-threatening or delayed complications occurred.ConclusionsWith sufficient preoperative evaluation, RFA might be a promising alternative for bilateral PTMC patients who were unsuitable for surgery or refused surgery.

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Active Surveillance of Low-Risk Thyroid Cancer

Cited by 31 publications

References 9 publications

Updates on the Management of Thyroid Cancer

Updates on the Management of Thyroid Cancer

Active surveillance as a management strategy for papillary thyroid microcarcinoma

The Efficacy and Safety of Radiofrequency Ablation for Bilateral Papillary Thyroid Microcarcinoma

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