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Alonso-Gordoa T, Jimenez-Fonseca P, Martinez-Trufero J, Navarro M, Porras I, Rubió-Casadevall J, Arregui Valles M, Basté N, Hernando J, Iglesias Docampo L. SEOM-GETNE-TTCC Clinical guideline thyroid cancer (2023). Clin Transl Oncol 2024:10.1007/s12094-024-03736-6. [PMID: 39325263 DOI: 10.1007/s12094-024-03736-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2024] [Indexed: 09/27/2024]
Abstract
Thyroid cancer (TC) represents 3% of global cancer incidence. Recent changes have optimized treatment decisions based on risk assessment, molecular profiling, and imaging assessment, leading the development of targeted agents that have modified the natural history of this disease. This increasing complexity on treatment options requires careful assessment at the different stages of the disease to provide the most suitable approach from diagnosis to long-term follow-up. This guideline aims to offer a comprehensive and practical overview on the current status and last updates of TC management.
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Affiliation(s)
- Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | | | - Miguel Navarro
- Medical Oncology Department, Complejo Asistencial Universitario de Salamanca. IBSAL, Salamanca, Spain
| | - Ignacio Porras
- Medical Oncology Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Jordi Rubió-Casadevall
- Medical Oncology Department, Catalan Institute of Oncology of Girona, Hospital Josep Trueta. ONCOGIRPRO Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Marta Arregui Valles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Neus Basté
- Medical Oncology Department, Hospital Clinic Barcelona, IDIBAPS, Barcelona, Spain
| | - Jorge Hernando
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Hospital Universitario Vall D'Hebron, VHIO, Barcelona, Spain
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Trivedi S, Salahuddin T, Mithi MT, Rathod P, Bandi A, Pandya SJ, Sharma M, Patel S, Warikoo V, Puj K, Salunkhe A, Patel K, Pandya S. Medullary Thyroid Carcinoma: A Single Institute Experience. Indian J Otolaryngol Head Neck Surg 2023; 75:2884-2889. [PMID: 37974849 PMCID: PMC10645935 DOI: 10.1007/s12070-023-03867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 11/19/2023] Open
Abstract
Medullary thyroid carcinoma is a rare tumour that is anatomically located in the thyroid gland but is functionally a neuroendocrine tumour. It is usually a disease of older age group but manifests in a young patient in familial form. It is derived from parafollicular c cells and has a predilection for lymph node metastasis. It is associated with slow growth in thyroid gland with early nodal metastasis. Serum calcitonin is useful as a preoperative marker of disease burden and prognosis. In the preoperative period serum levels of calcitonin can guide regarding the need for compartment wise lymph node dissection and the possibility of distant metastasis. It is used as a tool of surveillance in the postoperative period. The levels of serum CEA and calcitonin and their doubling time is a useful guide in the detection of early recurrence or distant metastasis. Imaging modality useful for diagnosis is USG in a majority of patients. Thus, the initial diagnosis and preoperative assessment of medullary thyroid carcinoma is similar to other forms of thyroid cancer but further management of disease differs significantly form other forms of differentiated thyroid carcinoma or even anaplastic carcinoma. Prognosis however differs according to age, gender, presence or absence of lymph node metastasis at presentation, metastatic disease at presentation and levels of biochemical markers.
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Affiliation(s)
- Sonal Trivedi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - T. Salahuddin
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohamed Taher Mithi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Arpit Bandi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank J. Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohit Sharma
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shailesh Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vikas Warikoo
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ketul Puj
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Abhijeet Salunkhe
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Keval Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shivam Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years? Cancers (Basel) 2022; 14:cancers14153643. [PMID: 35892901 PMCID: PMC9332800 DOI: 10.3390/cancers14153643] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
Medullary thyroid carcinoma (MTC) is a neoplasm originating from parafollicular C cells. MTC is a rare disease, but its prognosis is less favorable than that of well-differentiated thyroid cancers. To improve the prognosis of patients with MTC, early diagnosis and prompt therapeutic management are crucial. In the following paper, recent advances in laboratory and imaging diagnostics and also pharmacological and surgical therapies of MTC are discussed. Currently, a thriving direction of development for laboratory diagnostics is immunohistochemistry. The primary imaging modality in the diagnosis of MTC is the ultrasound, but opportunities for development are seen primarily in nuclear medicine techniques. Surgical management is the primary method of treating MTCs. There are numerous publications concerning the stratification of particular lymph node compartments for removal. With the introduction of more effective methods of intraoperative parathyroid identification, the complication rate of surgical treatment may be reduced. The currently used pharmacotherapy is characterized by high toxicity. Moreover, the main limitation of current pharmacotherapy is the development of drug resistance. Currently, there is ongoing research on the use of tyrosine kinase inhibitors (TKIs), highly specific RET inhibitors, radiotherapy and immunotherapy. These new therapies may improve the prognosis of patients with MTCs.
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Papachristos AJ, Glover AR, Sidhu SB. ASO Author Reflections: Medullary Thyroid Cancer-Establishing Treatment Paradigms in a Rapidly Evolving Therapeutic Landscape. Ann Surg Oncol 2021; 29:72-73. [PMID: 34739638 DOI: 10.1245/s10434-021-10989-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Alexander J Papachristos
- Royal North Shore Hospital, Endocrine Surgical Unit, Northern Sydney Local Health District, St. Leonards, NSW, Australia. .,Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia. .,Faculty of Medicine and Health, Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - Anthony R Glover
- Royal North Shore Hospital, Endocrine Surgical Unit, Northern Sydney Local Health District, St. Leonards, NSW, Australia.,Faculty of Medicine and Health, Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine, Garvan Institute of Medical Research, Endocrine Cancer Program, The Kinghorn Cancer Centre and St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Stan B Sidhu
- Royal North Shore Hospital, Endocrine Surgical Unit, Northern Sydney Local Health District, St. Leonards, NSW, Australia.,Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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