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Ullmann TM, Gray KD, Moore MD, et al. Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers. Gland Surg. 2018;7(5):473-486doi: 10.21037/gs.2017.09.08.
Ullmann, T. M., Gray, K. D., Moore, M. D., Zarnegar, R., & Fahey, T. J. (2018). Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers. Gland surgery, 7(5), 473-486. https://doi.org/10.21037/gs.2017.09.08
Ullmann, Timothy M, et al. "Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers." Gland surgery vol. 7,5 (2018): 473-486. doi: https://doi.org/10.21037/gs.2017.09.08
Ullmann TM, Gray KD, Moore MD, Zarnegar R, Fahey TJ. Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers. Gland Surg. 2018 Oct;7(5):473-486. doi: 10.21037/gs.2017.09.08. PMID: 30505769; PMCID: PMC6234236.
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Gland Surg. 2018 Oct;7(5):473-486. doi: 10.21037/gs.2017.09.08.

Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers.

Gland surgery

Timothy M Ullmann, Katherine D Gray, Maureen D Moore, Rasa Zarnegar, Thomas J Fahey

Affiliations

  1. Department of Surgery, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.

PMID: 30505769 PMCID: PMC6234236 DOI: 10.21037/gs.2017.09.08

Abstract

Despite the development of novel diagnostic, surgical, and chemotherapeutic approaches to differentiated thyroid cancers (DTCs), the diagnosis and management of these tumors remains controversial. The most recent American Thyroid Association (ATA) guidelines, released in 2015, reflect a recent shift towards less aggressive management for patients with DTCs. However, many clinicians have expressed concern that more conservative management will put patients at risk for disease recurrence and metastasis. In particular, the management of indeterminate nodules on fine needle aspiration (with special attention to genetic and epigenetic markers of malignancy), the extent of surgery for known differentiated cancers, the role of adjuvant radioactive iodine (RAI) therapy, and novel targeted treatments with tyrosine kinase inhibitors (TKIs) represent current areas of uncertainty and opportunities for future research. In this review, we examine the current state of the art in these areas, and address some of the questions that remain.

Keywords: American Thyroid Association guidelines (ATA guidelines); Differentiated thyroid cancer (DTC); indeterminate thyroid nodules; radioactive iodine (RAI); tyrosine kinase inhibitors (TKIs)

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

References

  1. Cancer. 2005 Sep 1;104(5):943-51 - PubMed
  2. Arch Otolaryngol Head Neck Surg. 2010 Nov;136(11):1055-61 - PubMed
  3. Int J Endocrinol. 2016;2016:2586512 - PubMed
  4. Curr Treat Options Oncol. 2016 Jun;17(6):30 - PubMed
  5. Eur J Endocrinol. 2001 Nov;145(5):599-604 - PubMed
  6. J Surg Res. 2013 Jun 1;182(1):85-93 - PubMed
  7. Mol Cancer Ther. 2016 Aug;15(8):1952-63 - PubMed
  8. Clin Endocrinol (Oxf). 2011 Jul;75(1):112-9 - PubMed
  9. Mod Pathol. 2011 Apr;24 Suppl 2:S34-43 - PubMed
  10. Cancer. 2014 Dec 1;120(23):3627-34 - PubMed
  11. J Oncol Pharm Pract. 2018 Jan;24(1):28-32 - PubMed
  12. Target Oncol. 2016 Feb;11(1):115-22 - PubMed
  13. J Clin Endocrinol Metab. 2015 Apr;100(4):1529-36 - PubMed
  14. Thyroid. 2017 Aug;27(8):1053-1057 - PubMed
  15. Surgery. 2000 Dec;128(6):984-93 - PubMed
  16. Cancer Biomark. 2017;18(1):87-94 - PubMed
  17. Biologics. 2014 Dec 04;8:281-91 - PubMed
  18. Hell J Nucl Med. 2017 Jan-Apr;20(1):3-10 - PubMed
  19. N Engl J Med. 1947 Aug 14;237(7):221 - PubMed
  20. Otolaryngol Head Neck Surg. 2017 Mar;156(3):472-479 - PubMed
  21. Onco Targets Ther. 2016 Oct 20;9:6467-6477 - PubMed
  22. Cancer. 2004 Mar 15;100(6):1123-9 - PubMed
  23. Endocr Pathol. 2002 Spring;13(1):3-16 - PubMed
  24. Cancer. 2017 Feb 1;123(3):372-381 - PubMed
  25. Ann Surg. 2015 Sep;262(3):519-25; discussion 524-5 - PubMed
  26. World J Surg. 2014 Jan;38(1):68-79 - PubMed
  27. N Engl J Med. 2015 Feb 12;372(7):621-30 - PubMed
  28. N Engl J Med. 2012 May 3;366(18):1674-85 - PubMed
  29. Ann Surg Oncol. 2015 Jan;22(1):125-31 - PubMed
  30. Cancer Treat Rev. 2015 Dec;41(10):925-34 - PubMed
  31. Cancer. 2013 Apr 15;119(8):1495-502 - PubMed
  32. J Clin Invest. 2011 Dec;121(12):4700-11 - PubMed
  33. N Engl J Med. 2012 Aug 23;367(8):705-15 - PubMed
  34. Cancer Cytopathol. 2017 Apr;125(4):245-256 - PubMed
  35. J Clin Endocrinol Metab. 2002 Aug;87(8):3947-52 - PubMed
  36. J Surg Oncol. 2017 Dec;116(7):877-883 - PubMed
  37. Clin Cancer Res. 2014 May 15;20(10):2516-22 - PubMed
  38. Ann Surg. 2007 Sep;246(3):375-81; discussion 381-4 - PubMed
  39. World J Surg Oncol. 2016 Sep 06;14(1):241 - PubMed
  40. Clin Cancer Res. 1998 Feb;4(2):287-94 - PubMed
  41. Cancer Cytopathol. 2017 Jun;125(S6):477-485 - PubMed
  42. Front Endocrinol (Lausanne). 2012 Apr 11;3:54 - PubMed
  43. J Clin Endocrinol Metab. 2003 May;88(5):2318-26 - PubMed
  44. J Clin Endocrinol Metab. 2001 Apr;86(4):1447-63 - PubMed
  45. Clin Cancer Res. 2012 Apr 1;18(7):2032-8 - PubMed
  46. Cancer Cytopathol. 2014 Jul;122(7):512-20 - PubMed
  47. Clin Endocrinol (Oxf). 1997 Dec;47(6):713-20 - PubMed
  48. J Thyroid Res. 2012;2012:618985 - PubMed
  49. J Nucl Med. 2012 Oct;53(10):1633-51 - PubMed
  50. Thyroid. 2012 Jul;22(7):683-9 - PubMed
  51. PLoS One. 2008 Apr 02;3(4):e1885 - PubMed
  52. Cancer. 2012 Jul 1;118(13):3260-7 - PubMed
  53. Endocr Relat Cancer. 2017 Mar;24(3):127-136 - PubMed
  54. World J Surg. 1992 Jul-Aug;16(4):711-6; discussion 716-7 - PubMed
  55. Am J Surg. 2011 Jun;201(6):770-5 - PubMed
  56. Hematol Oncol Clin North Am. 2017 Aug;31(4):589-612 - PubMed
  57. Diagn Cytopathol. 2008 Jun;36(6):425-37 - PubMed
  58. N Engl J Med. 2013 Feb 14;368(7):623-32 - PubMed
  59. Cancer. 2016 Jan 15;122(2):198-206 - PubMed
  60. AJR Am J Roentgenol. 2009 Sep;193(3):871-8 - PubMed
  61. Semin Surg Oncol. 1999 Jan-Feb;16(1):34-41 - PubMed
  62. Am J Pathol. 2003 Apr;162(4):1053-60 - PubMed
  63. Thyroid. 2012 Oct;22(10):996-1001 - PubMed
  64. Clin Nucl Med. 2014 Aug;39(8):675-9 - PubMed
  65. Clin Lab. 2012;58(9-10):919-26 - PubMed
  66. Cancer Res. 1998 Dec 1;58(23):5523-8 - PubMed
  67. Head Neck. 2014 Feb;36(2):191-202 - PubMed
  68. Cancer Cytopathol. 2016 Oct;124(10):711-721 - PubMed
  69. Onco Targets Ther. 2015 Sep 03;8:2435-42 - PubMed
  70. J Clin Endocrinol Metab. 2015 Jul;100(7):2743-50 - PubMed
  71. Nat Rev Endocrinol. 2014 Oct;10(10):616-23 - PubMed
  72. Adv Clin Exp Med. 2017 Jan-Feb;26(1):177-182 - PubMed
  73. Thyroid. 2016 Jan;26(1):1-133 - PubMed
  74. J Clin Endocrinol Metab. 2013 Jun;98(6):2502-12 - PubMed
  75. Surgery. 1988 Dec;104(6):954-62 - PubMed
  76. J Natl Compr Canc Netw. 2007 Jul;5(6):631-40 - PubMed
  77. J Laryngol Otol. 2016 May;130(S2):S150-S160 - PubMed
  78. Science. 2000 Aug 25;289(5483):1357-60 - PubMed
  79. Indian J Otolaryngol Head Neck Surg. 2012 Dec;64(4):305-11 - PubMed
  80. J Am Med Assoc. 1946 Dec 7;132(14):838-47 - PubMed
  81. J Clin Endocrinol Metab. 1985 Feb;60(2):376-80 - PubMed
  82. Thyroid. 2015 Sep;25(9):1008-12 - PubMed
  83. JAMA Otolaryngol Head Neck Surg. 2014 Apr;140(4):317-22 - PubMed
  84. Surgery. 2017 Jan;161(1):127-133 - PubMed
  85. Oncol Lett. 2017 Jun;13(6):4252-4266 - PubMed
  86. J Clin Pathol. 2017 Jun;70(6):500-507 - PubMed
  87. Eur J Endocrinol. 2015 Oct;173(4):525-40 - PubMed
  88. Oncotarget. 2016 Mar 29;7(13):16716-30 - PubMed
  89. Cancer Cytopathol. 2013 Apr;121(4):197-205 - PubMed
  90. Recent Pat Anticancer Drug Discov. 2015;10(3):259-69 - PubMed
  91. Thyroid. 2017 Apr;27(4):481-483 - PubMed
  92. World J Surg. 2008 Jul;32(7):1552-8 - PubMed
  93. Thyroid. 2012 Nov;22(11):1144-52 - PubMed
  94. BMC Med. 2015 Aug 07;13:184 - PubMed
  95. Drug Des Devel Ther. 2015 Jul 03;9:3459-70 - PubMed
  96. Lung Cancer. 2017 Aug;110:7-13 - PubMed
  97. Ann Surg Oncol. 2012 Jun;19(6):1874-80 - PubMed
  98. Tumori. 1990 Oct 31;76(5):480-3 - PubMed
  99. Int J Clin Exp Med. 2012;5(4):310-5 - PubMed
  100. J Clin Endocrinol Metab. 1996 Sep;81(9):3360-5 - PubMed
  101. Eur J Surg Oncol. 2018 Mar;44(3):348-356 - PubMed
  102. Endocr J. 2012;59(5):417-24 - PubMed
  103. J Clin Endocrinol Metab. 2003 Sep;88(9):4440-5 - PubMed
  104. Cancer Cytopathol. 2016 Jan;124(1):14-27 - PubMed
  105. PLoS Curr. 2013 Feb 11;5:null - PubMed
  106. J Clin Endocrinol Metab. 2014 Jun;99(6):2086-94 - PubMed
  107. Oncotarget. 2015 Oct 13;6(31):31792-804 - PubMed
  108. Cancer. 1993 Dec 1;72(11):3287-95 - PubMed
  109. Eur Thyroid J. 2013 Sep;2(3):147-59 - PubMed
  110. Head Neck. 2011 May;33(5):645-9 - PubMed
  111. N Engl J Med. 2012 May 3;366(18):1663-73 - PubMed
  112. Nucl Med Commun. 2012 Mar;33(3):275-82 - PubMed
  113. Minerva Endocrinol. 2017 Mar;42(1):64-76 - PubMed
  114. J Clin Endocrinol Metab. 2013 May;98(5):E914-22 - PubMed
  115. Am J Surg. 2012 Apr;203(4):461-6 - PubMed
  116. Int J Mol Sci. 2017 Apr 06;18(4): - PubMed
  117. Eur J Endocrinol. 2002 Dec;147(6):741-5 - PubMed
  118. Thyroid. 2015 Nov;25(11):1217-23 - PubMed
  119. Thyroid. 2014 Sep;24(9):1369-74 - PubMed
  120. Oncotarget. 2017 Jan 3;8(1):583-595 - PubMed
  121. Cell. 2009 Feb 20;136(4):642-55 - PubMed
  122. Nucl Med Commun. 2014 Aug;35(8):808-17 - PubMed
  123. Ann Surg Oncol. 2005 Jan;12(1):81-9 - PubMed
  124. Ann Surg. 2014 Oct;260(4):601-5; discussion 605-7 - PubMed
  125. Endocr Relat Cancer. 2016 May;23(5):367-76 - PubMed
  126. Thyroid. 2017 Jan;27(1):39-48 - PubMed

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