Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Cooper, David S.; Doherty, Gerard M.; Haugen, Bryan R.; Kloos, Richard T.; Lee, Stephanie L.; Mandel, Susan J.; Mazzaferri, Ernest L.; McIver, Bryan; Sherman, Steven I.; Tuttle, R. Michael

doi:10.1089/thy.2006.16.109

Cited by 1,921 publications

(1,043 citation statements)

References 279 publications

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“…This study included patients referred for surgery and had a high percentage of malignant thyroid nodules (37%). Most studies show an incidence of malignancy of 2%-5% in nodules selected for biopsy, with a much lower incidence in unselected nodules (Cooper et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Impact of nodular size on the predictive values of gray-scale, color-Doppler ultrasound, and sonoelastography for assessment of thyroid nodules

Hong

Luo

et al. 2012

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To define the roles of gray-scale, color-Doppler ultrasound, and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant. Methods: A total of 243 consecutive subjects (214 women, 29 men) with 329 thyroid nodules were examined by gray-scale, color-Doppler ultrasound, and sonoelastography in this prospective study. All patients underwent surgery and the final diagnosis was obtained from histopathological examination. Results: Three hundred and twenty-nine nodules (208 benign, 121 malignant) were divided into small (SNs, 5-10 mm, n=137) and large (LNs, >10 mm, n=192) nodules. Microcalcifications were more frequent in malignant LNs than in malignant SNs, but showed no significant difference between benign LNs and SNs. Poorly-circumscribed margins were not significantly different between malignant SNs and LNs, but were less frequent in benign LNs than in benign SNs. Among all nodules, marked intranodular vascularity was more frequent in LNs than in SNs. By comparison, shape ratio of anteroposterior to transverse dimensions (A/T) ≥1 was less frequent in LNs than in SNs. Otherwise, among all nodules, marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs. Conclusions:The predictive values of microcalcifications, nodular margins, A/T ratio, and marked intranodular vascularity depend on nodule size, but the predictive values of echogenicity and elastography do not.

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Section: Discussionmentioning

confidence: 99%

Impact of nodular size on the predictive values of gray-scale, color-Doppler ultrasound, and sonoelastography for assessment of thyroid nodules

Hong

Luo

et al. 2012

J. Zhejiang Univ. Sci. B

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“…If PTM is found after total or near-total thyroidectomy for multinodular goiter or Graves' disease both guidelines state that no further treatment is indicated when the PTM is unifocal, well-diff erentiated, without lymph node metastases or extrathyroidal invasion [ 63 , 64 ] . Recently, the revised guideline of the American thyroid association suggests that lobectomy alone is a suffi cient treatment for small ( < 1 cm), low-risk, unifocal, intrathyroidal papillary carcinomas in the absence of head and neck irradiation or cervical lymph nodes metastases [ 65 ] . Obviously this recommendation would not be applicable for patients with Graves' hyperthyroidism, as lobectomy is no suffi cient treatment for relapsing Graves' disease.…”

Section: Extent Of Surgerymentioning

confidence: 99%

Thyroid Cancer in Patients with Hyperthyroidism

2012

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“…The 10-year recurrence rate is 20% to 30% in high-risk patients, and approximately 5% will progress to radioiodine refractory disease. The 10-year survival rate is less than 15% (6, 7). Doxorubicin is the only U.S. Food and Drug Administration–approved therapy but is generally considered of low efficacy and high toxicity (8, 9).…”

Section: Introductionmentioning

confidence: 99%

Phase II Efficacy and Pharmacogenomic Study of Selumetinib (AZD6244; ARRY-142886) in Iodine-131 Refractory Papillary Thyroid Carcinoma with or without Follicular Elements

Hayes

Lucas

Tanvetyanon

et al. 2012

Clinical Cancer Research

141

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Purpose A multicenter, open-label, phase II trial was conducted to evaluate the efficacy, safety, and tolerability of selumetinib in iodine-refractory papillary thyroid cancer (IRPTC). Experimental Design Patients with advanced IRPTC with or without follicular elements and documented disease progression within the preceding 12 months were eligible to receive selumetinib at a dose of 100 mg twice daily. The primary endpoint was objective response rate using Response Evaluation Criteria in Solid Tumors. Secondary endpoints were safety, overall survival, and progression-free survival (PFS). Tumor genotype including mutations in BRAF, NRAS, and HRAS was assessed. Results Best responses in 32 evaluable patients out of 39 enrolled were 1 partial response (3%), 21 stable disease (54%), and 11 progressive disease (28%). Disease stability maintenance occurred for 16 weeks in 49%, 24 weeks in 36%. Median PFS was 32 weeks. BRAF V600E mutants (12 of 26 evaluated, 46%) had a longer median PFS compared with patients with BRAF wild-type (WT) tumors (33 versus 11 weeks, respectively, HR = 0.6, not significant, P = 0.3). The most common adverse events and grades 3 to 4 toxicities included rash, fatigue, diarrhea, and peripheral edema. Two pulmonary deaths occurred in the study and were judged unlikely to be related to the study drug. Conclusions Selumetinib was well tolerated but the study was negative with regard to the primary outcome. Secondary analyses suggest that future studies of selumetinib and other mitogen-activated protein (MAP)/extracellular signal-regulated kinase (ERK; MEK) inhibitors in IRPTC should consider BRAF V600E mutation status in the trial design based on differential trends in outcome.

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Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Cited by 1,921 publications

References 279 publications

Impact of nodular size on the predictive values of gray-scale, color-Doppler ultrasound, and sonoelastography for assessment of thyroid nodules

Impact of nodular size on the predictive values of gray-scale, color-Doppler ultrasound, and sonoelastography for assessment of thyroid nodules

Thyroid Cancer in Patients with Hyperthyroidism

Phase II Efficacy and Pharmacogenomic Study of Selumetinib (AZD6244; ARRY-142886) in Iodine-131 Refractory Papillary Thyroid Carcinoma with or without Follicular Elements

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