Practical Management of Well Differentiated Thyroid Carcinoma in Korea

Abstract

Abstract. Objectives: The optimal extent of surgery and postoperative management of patients with well differentiated thyroid carcinoma (WDTC) vary among countries and institutions. We assessed the practical management of WDTC in Korea by questionnaire and compared these results with those obtained in similar surveys of members of the Japanese Society of Thyroid Surgery (JSTS) and the International Association of Endocrine Surgeons (IAES). Materials and Methods: Questionnaires were sent by mail or e-mail to 266 members of the Korean Association of Endocrine Surgeons (KAES). Ninety members (33.8%) completed the questionnaire; their responses were compared with those of the JSTS and IAES surveys. Results: Total thyroidectomy was more prevalent in the KAES and IAES than in the JSTS, irrespective of tumor size in the low-risk group. Patients with papillary microcarcinoma were more likely to undergo aggressive central compartment node dissection in the KAES than in the IAES or JSTS. Thyroid stimulating hormone suppression therapy was administered to a higher proportion of patients and for longer times in the KAES and IAES than in the JSTS. Postoperative radioactive iodine treatment was more prevalent in the KAES than in the JSTS. There were no differences between the KAES and the JSTS in the treatment of patients with locally advanced thyroid carcinoma. External irradiation and radioactive iodine treatment for recurrent papillary thyroid carcinoma were favored more by the KAES than the IAES and JSTS. Conclusions: The actual practices of members of the KAES were almost similar to those of the IAES, but differed from those in Japan in some aspects. In general, however, members of the KAES favored more aggressive treatment of WDTC than did physicians in other countries.

Changing trends in the management of well-differentiated thyroid carcinoma in Korea

“…Korean respondents in 2009 favored more aggressive treatments of patients with locally advanced thyroid carcinoma than respondents from other countries [1]. Many respondents in 2014 also favored aggressive treatment modalities, such as surgical resection.…”

“…Methods that can deliver a high dose of radiation to a certain area, such as stereotactic radiation therapy or tomotherapy, may be more beneficial [1]. Limited and selective neck node dissection was more favored than modified radical neck dissection for patients with recurrent PTC, with the preference for RAI treatment and external irradiation lower in 2014 than in 2009.…”

“…A questionnaire used for previous surveys was sent by e-mail to 885 members of KATES [1][2][3]. The questionnaire consisted of descriptions of five patients with WDTC and several questions related to each.…”

“…These cases included patients with (1) papillary thyroid carcinoma (PTC) smaller than 2 cm (T1), (2) low-risk PTC larger than 2 cm (T2), (3) high risk, poorly differentiated thyroid carcinoma, (4) high risk, locally advanced well-differentiated thyroid carcinoma, and (5) recurrent PTC. The full text of the questionnaire has been published [1].…”

“…Korean Association of Thyroid-Endocrine Surgeons (KATES) [1]. Comparison of the findings with those of surveys administered to members of the Japanese Society of Thyroid Surgery (JSTS) and the International Association of Endocrine Surgeons (IAES) indicated that members of KATES favored more aggressive treatment of WDTC than did physicians from these other countries [1][2][3].…”