Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

Abstract

Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).

Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada

“…Multiple guidelines suggest the use of molecular testing as an adjunct to clinical, radiological and cytological findings to refine the risk of malignancy [ 1 , 9 , 11 , 62 ]. According to The National Comprehensive Cancer Network (NCCN) Guidelines, if molecular testing indicates a risk of malignancy equivalent to the risk that is seen in benign thyroid nodule FNA (about 5% or less), clinical follow-up of the thyroid nodules can be considered [ 63 ]. To achieve this goal, a test with high sensitivity and NPV should be used.…”

Thyroid cancer in women of reproductive age: Key issues for the clinical team

“…The overall survival rate for thyroid cancer depends on histopathological classification. 40 Differentiated thyroid cancer usually has an excellent prognosis with 10-year survival rates exceeding 95%. 40 This percentage diminished as the carcinoma spread to lymph nodes or tissue in the neck, 76% for metastatic papillary thyroid cancer, 64% for metastatic follicular thyroid cancer, and about 28% in stage IV MTC.…”

PET-CT en el carcinoma anaplásico de tiroides y otros subtipos histológicos agresivos

“…Los carcinomas diferenciados de tiroides pueden concentrar yodo, expresar receptores de TSH, y producir Tg mientas que los carcinomas pobremente diferenciados o indiferenciados no pueden. Por tanto, la imagen de 131 I no puede ser utilizada y el tratamiento con radioyodo no es efectivo en los pacientes con carcinoma anaplásico [11].…”

“…ORL, 2022, 13, 2, 125-135 significativas (p<0.001) en supervivencia global entre los pacientes con un SUVmax tumoral alto y bajo [15]. En cuanto a la realización de PET-CT 18 F-FDG durante el seguimiento, según la guía NCCN, en estadio IVC se recomienda valorar la realización de esta técnica, 3-6 meses tras tratamiento inicial [11].…”

“…Según la NCCN, la mayoría de los CCH no son ávidos por el yodo, particularmente la enfermedad de alto riesgo que es negativa en la imagen con 123 I o 131 I. Si la Tiroglobulina es alta y/o la patología es de alto riesgo, está indicado el PET-CT con 18 F-FDG (11). Por otro lado, en el seguimiento, si la imagen con radioyodo es negativa y la Tg estimulada es > 2-5ng/ml, se debe considerar imagen adicional (ecografía cervical, CT cervical con contraste, CT de tórax, PET-CT) [11].…”