Current Guidelines for Postoperative Treatment and Follow-Up of Well-Differentiated Thyroid Cancer

2016 ◽  
Vol 25 (1) ◽  
pp. 41-59 ◽  
Author(s):  
Jenny Y. Yoo ◽  
Michael T. Stang
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Postoperative Treatment ◽  
Well Differentiated ◽  
Current Guidelines

Confronting the practice of surgery on differentiated thyroid cancer with current guidelines in Germany

2005 ◽  
Vol 44 (05) ◽  
pp. 185-191 ◽  
Author(s):  
H. Wieler ◽  
S. Birtel ◽  
E. Ostwald-Lenz ◽  
K. P. Kaiser ◽  
H. P. Becker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Survival Rates ◽  
Perioperative Morbidity ◽  
Referral Hospitals ◽  
Principles Of Treatment ◽  
Current Guidelines ◽  
Papillary Microcarcinomas ◽  
Retrospective Multicenter Study

Summary:Aim: For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected?. Is there a difference concerning the surgical radicalism and the outcome?. Does the perioperative morbidity increase with the higher radicalism of the procedure?. Patients, methods: Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following radioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. Results: 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas <1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas <1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Conclusion: Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the socalled papillary microcarcinomas (old term) has to be respected within the current guidelines.

scholarly journals Management of differentiated thyroid cancer diagnosed during pregnancy

1999 ◽  
pp. 404-406 ◽  
Author(s):  
L Vini ◽  
S Hyer ◽  
B Pratt ◽  
C Harmer
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Differentiated Thyroid Cancer ◽  
Subtotal Thyroidectomy ◽  
Second Trimester ◽  
Original Cohort ◽  
Well Differentiated ◽  
Disease Free ◽  
In Pregnancy

OBJECTIVE: To assess the outcome of thyroid cancer diagnosed during pregnancy. DESIGN: Retrospective analysis of patients diagnosed between 1949 and 1997 with thyroid cancer presenting during pregnancy. RESULTS: Nine women with a median age of 28 years were identified. A thyroid nodule was discovered by the clinician during routine antenatal examination in four cases, the remainder had noted a lump in the neck. In all patients, the nodule was reported to almost double in size during the pregnancy. One patient underwent subtotal thyroidectomy during the second trimester; eight were operated on within 3 to 10 months from delivery. Total thyroidectomy was performed in five and subtotal thyroidectomy in four. All tumours were well differentiated and ranged in size from 1 to 6 cm. OUTCOME: The median follow-up was 14 years (5-31 years). One patient relapsed locally requiring further surgery. One patient developed bone metastases dying 7 years after presentation; her planned treatment had been delayed because of an intervening pregnancy. Eight of the original cohort of patients are currently disease free. CONCLUSIONS: Differentiated thyroid cancer presenting in pregnancy generally has an excellent prognosis. When the disease is discovered early in pregnancy, surgery should be considered in the second trimester but radioiodine scans and treatment can be safely delayed until after delivery. In all cases, treatment should not be delayed for more than a year.

Iodine uptake in the chest in the follow-up of well-differentiated thyroid cancer

2011 ◽  
Vol 30 (1) ◽  
pp. 24-28
Author(s):  
M.P. García Alonso ◽  
M.A. Balsa Bretón ◽  
C. Paniagua Correa ◽  
L. Castillejos Rodríguez ◽  
F.J. Penín González ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Iodine Uptake ◽  
Well Differentiated

scholarly journals Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2323
Author(s):  
Hyunju Park ◽  
Jun Park ◽  
So Young Park ◽  
Tae Hyuk Kim ◽  
Sun Wook Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Cause Of Death ◽  
Differentiated Thyroid Cancer ◽  
Causes Of Death ◽  
Clinical Course ◽  
Common Causes ◽  
Regional Disease ◽  
Well Differentiated

Because of the low mortality rate of well-differentiated thyroid cancer (WDTC), investigation of the clinical course leading to death is limited. We analyzed the cause of death and clinical course from diagnosis to death in patients who died of WDTC. A total of 592 WDTC patients died between 1996 and 2018. After exclusion, 79 patients were enrolled and divided into four groups based on their clinical course; that is, inoperable at the time of diagnosis (inoperable), distant metastasis (DM) detected at the time of diagnosis (initial-DM), DM detected during follow-up (late-DM), and loco-regional disease (L-R). Lung (55.6%) in papillary thyroid carcinoma (PTC) and bone (46.7%) in follicular thyroid carcinoma (FTC) were the most common metastasis locations. The most common causes of death were respiratory failure (32.3%) and airway obstruction (30.6%) in PTC, and complications due to immobilization arising from bone metastasis (35.3%) in FTC. Brain metastasis was found in 13.3% of patients and had the worst prognosis. The overall survival (OS) differed significantly (p = 0.001) according to clinical course; the inoperable had the shortest survival, followed by the initial-DM, L-R, and late-DM. However, OS did not differ significantly between PTC and FTC patients with initial-DM (p = 0.83). Other causes of death were far more common than death resulting from WDTC. In patients dying of WDTC, the major cause of death varied by metastatic site. OS differed according to clinical course, but not histologic type. Timing and DM sites differed between PTC and FTC.

Primary versus tertiary care follow-up of low risk well differentiated thyroid cancer

2017 ◽  
Author(s):  
Syed Imran ◽  
Mal Rajaraman ◽  
Karen Chu ◽  
Stan VanUum ◽  
Stephanie Kaiser
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Tertiary Care ◽  
Low Risk ◽  
Well Differentiated

scholarly journals Dosimetry during adjuvant 131I therapy in patients with differentiated thyroid cancer-clinical implications

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Piotr Szumowski ◽  
Saeid Abdelrazek ◽  
Dorota Iwanicka ◽  
Małgorzata Mojsak ◽  
Monika Sykała ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Absorbed Dose ◽  
Clinical Implications ◽  
Therapeutic Activity ◽  
Uniform Value ◽  
Therapeutic Activities ◽  
Current Guidelines

AbstractThe activity of radioiodine (131I) used in adjuvant therapy for thyroid cancer ranges between 30 mCi (1.1 GBq) and 150 mCi (5.5 GBq). Dosimetry based on Marinelli's formula, taking into consideration the absorbed dose in the postoperative tumour bed (D) should systematise the determination of 131I activity. Retrospective analysis of 57 patients with differentiated thyroid cancer (DTC) after thyreidectomy and adjuvant 131I therapy with the fixed activity of 3.7 GBq. In order to calculate D from Marinelli's formula, the authors took into account, among other things, repeated dosimetry measurements (after 6, 24, and 72 h) made during scintigraphy and after administration of the therapeutic activity or radioiodine. In 75% of the patients, the values of D were > 300 Gy (i.e. above the value recommended by current guidelines). In just 16% of the patients, the obtained values fell between 250 and 300 Gy, whereas in 9% of the patients, the value of D was < 250 Gy. The therapy was successful for all the patients (stimulated Tg < 1 ng/ml and 131I uptake < 0.1% in the thyroid bed in follow-up examination). Dosimetry during adjuvant 131I therapy makes it possible to diversify the therapeutic activities of 131I in order to obtain a uniform value of D.

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