Thyroid cancer, recent advances in diagnosis and therapy

Abstract

Over the past several decades, the approach to the diagnosis and management of patients with follicular cell-derived thyroid cancer has evolved based on improved classification of patients better matching clinical outcomes, as well as advances in imaging, laboratory, molecular technologies and knowledge. While thyroid surgery, radioactive iodine therapy and TSH suppression remain the mainstays of treatment, this expansion of knowledge has enabled de-escalation of therapy for individuals diagnosed with low-risk well-differentiated thyroid cancer; better definition of treatment choices for patients with more aggressive disease; and improved ability to optimize treatments for patients with persistent and/or progressive disease. Most recently, the advancement of knowledge regarding the molecular aspects of thyroid cancer has improved thyroid cancer diagnosis and has enabled individualized therapeutic options for selected patients with the most aggressive forms of the disease.Guidelines from multiple societies across the world reflect these changes, which focus on taking a more individualized approach to clinical management. In this review, we discuss the current more personalized approach to patients with follicular cell-derived thyroid cancer and point toward areas of future research still needed in the field.

Factors in the occurrence and restoration of hypoparathyroidism after total thyroidectomy for thyroid cancer patients with intraoperative parathyroid autotransplantation

“…Thyroid cancer (THCA) is one of the most prevalent endocrine neoplasms, and its incidence has been constantly increasing over recent years (1). Total thyroidectomy has been regarded as the main modality of treatment for THCA, but it carries the potential for several complications (2). Postoperative hypoparathyroidism (POH) is the most common and important complication and is associated with decreased serum parathyroid hormone (PTH) levels, hypocalcemia and hyperphosphatemia (3).…”

Anti-PD-1 Immunotherapy Combined With Stereotactic Body Radiation Therapy and GM-CSF as Salvage Therapy in a PD-L1-Positive Patient With Refractory Metastatic Thyroid Hürthle Cell Carcinoma: A Case Report and Literature Review

“…Surgical resection is the standard treatment for most patients who suffer from thyroid cancers, while radioactive iodine therapy and TSH suppression treatment are required for those with high-risk factors ( 7 ). The therapies targeting MAPK pathway, PI3K/Akt-mTOR pathways, or VEGF, and immunotherapies such as CTLA-4 inhibitor and PD-1/PD-L1 inhibitor, have altered the therapeutic strategies for the aggressive types of thyroid cancer ( 16 ). However, due to the rarity of HCC, its pathological features and behavior are not yet clear, and there is currently no consensus regarding the optimal treatment modality.…”

Thyroid Cancer Diagnostics Related to Occupational and Environmental Risk Factors: An Integrated Risk Assessment Approach

“…The identification of oncometabolites is an important contribution to the establishment of current TC diagnosis and management protocols [ 40 , 41 ]. Metabolomics is a powerful tool that can identify cancer biomarkers and drivers of tumorigenesis and open up future opportunities to improve diagnosis, monitoring, and treatment [ 42 ].…”