Personalized Treatment Strategies for Thyroid Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 4077

Special Issue Editors


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Guest Editor
1. Department of Clinical Medicine, University of Bergen (UiB), Bergen, Norway
2. Nuclear Medicine/PET-Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
Interests: (para)thyroid imaging; thyroid cancer; multimodal imaging; ultrasound; positron emission tomography

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Guest Editor
1. Department of Clinical Science, University of Bergen (UiB), Bergen, Norway
2. Endocrine Surgery, Department of Surgery, Haukeland University Hospital, Bergen, Norway
Interests: endocrine neck surgery; thyroid cancer; neuromonitoring

Special Issue Information

Dear Colleagues,

“Personalized medicine” has become the guiding principle for thyroid cancer management. Gone are the days when every patient with thyroid cancer would undergo total thyroidectomy followed by radioiodine ablation.

Instead, there has been progress on multiple fronts:

  1. New insights into the epidemiology of thyroid cancer which, for selected patients, can be followed with imaging rather than operation.
  2. Improvements in fine-needle cytology including molecular biology.
  3. New approaches to imaging with [18F]FDG including PET/MRI as well as new tracers such as [18F]FDOPA or [18F]tetrafluoroborate (TFB).
  4. Hemithyroidectomy instead of total thyroidectomy. Alternatively, percutaneous ablation or remote access surgery.
  5. Continuous intraoperative neuromonitoring.
  6. Autofluorescence for intraoperative identification of parathyroid glands.
  7. Refinements in postoperative risk assessment: Which patient needs adjuvant radioiodine treatment? How much TSH suppression should we aim for and for how long?
  8. Finally, several groups have succeeded in conducting large nation-wide prospective randomized trials.

This Special Issue of Cancers encompasses new research articles and timely reviews on major new approaches for individualized, risk-adapted management of thyroid cancer.

Prof. Dr. Martin Biermann
Dr. Katrin Brauckhoff
Guest Editors

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Keywords

  • differentiated thyroid cancer
  • medullary thyroid cancer
  • thyroid surgery
  • thyroidectomy
  • radioiodine treatment

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Published Papers (3 papers)

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12 pages, 4096 KiB  
Article
Continuous Intraoperative Nerve Monitoring of a Non-Recurrent Laryngeal Nerve: Real-Life Data of a High-Volume Thyroid Surgery Center
by Ann-Kathrin Lederer, Julia I. Staubitz-Vernazza, Rabea Margies, Florian Wild and Thomas J. Musholt
Cancers 2024, 16(5), 1007; https://doi.org/10.3390/cancers16051007 - 29 Feb 2024
Viewed by 1025
Abstract
Thyroid surgery is associated with a risk of injury to the recurrent laryngeal nerve, especially in the presence of anatomical variants such as a non-recurrent laryngeal nerve (NRLN). Injury to the nerve leads to transient or permanent vocal cord palsy (VCP). A novel [...] Read more.
Thyroid surgery is associated with a risk of injury to the recurrent laryngeal nerve, especially in the presence of anatomical variants such as a non-recurrent laryngeal nerve (NRLN). Injury to the nerve leads to transient or permanent vocal cord palsy (VCP). A novel method to prevent VCP is continuous intraoperative nerve monitoring (cIONM), but less is known about the applicability of this method in patients with NRLN. The aim of this study was to evaluate our own data regarding feasibility and detailed characteristics of cIONM in NRLN patients. We performed a monocentric retrospective cohort analysis including clinical data and intraoperative nerve monitoring data (measured by Inomed Medizintechnik GmbH, Emmendingen, ‘C2’ and ‘C2 Xplore’ device) of all thyroid surgery patients, showing NRLN between 2014 and 2022. Of 1406 patients who underwent thyroid surgery with cIONM between 2014 and 2022, 12 patients (0.9%) showed NRLN intraoperatively. Notably, cIONM was feasible in eight patients (67%). In all cases the onset latency of the right vagus nerve was shorter (<3.0 ms) than usually expected, suggesting that a short latency might be suitable to distinguish NRLN. None of the patients had a post-operative VCP. Overall, cIONM appears to be feasible and safe in NRLN patients and provides helpful information to prevent VCP. Full article
(This article belongs to the Special Issue Personalized Treatment Strategies for Thyroid Carcinoma)
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15 pages, 2255 KiB  
Article
A 16-Year Single-Center Series of Trachea Resections for Locally Advanced Thyroid Carcinoma
by Julia I. Staubitz-Vernazza, Sina Schwind, Oana Lozan and Thomas J. Musholt
Cancers 2024, 16(1), 163; https://doi.org/10.3390/cancers16010163 - 28 Dec 2023
Viewed by 925
Abstract
(1) Background: Infiltration of the aerodigestive tract in advanced thyroid carcinoma determines the prognosis and quality of life. Different stages of tracheal tumor invasion require customization of the surgical concept. (2) Methods: In the period from January 2007 to January 2023, patients who [...] Read more.
(1) Background: Infiltration of the aerodigestive tract in advanced thyroid carcinoma determines the prognosis and quality of life. Different stages of tracheal tumor invasion require customization of the surgical concept. (2) Methods: In the period from January 2007 to January 2023, patients who underwent surgery for advanced thyroid carcinomas with trachea resections were included in a retrospective observational study. The surgical resection concepts and operation-associated complications were documented. The overall survival and post-resection survival were analyzed. (3) Results: From 2007 to 2023, at the single-center UMC Mainz, 33 patients (15 female and 18 male) underwent neck surgery with trachea resections for locally advanced thyroid carcinomas. Of these, 14 were treated with non-transmural (trachea shaving) and 19 transmural trachea resections (9 “window” resections, 6 near-circular resections, 3 sleeve resections and 1 total laryngectomy with extramucosal esophageal resection). The two-year postoperative survival rate was 82.0 percent. The two-year recurrence-free survival rate was 75.0 percent (mean follow-up period: 29.2 months). (4) Conclusions: Tracheal resections for locally advanced tumor infiltration are feasible as an element of highly individualized treatment concepts. Full article
(This article belongs to the Special Issue Personalized Treatment Strategies for Thyroid Carcinoma)
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13 pages, 2236 KiB  
Systematic Review
Latest Progress in Risk-Adapted Surgery for Medullary Thyroid Cancer
by Andreas Machens, Kerstin Lorenz, Tim Brandenburg, Dagmar Führer, Frank Weber and Henning Dralle
Cancers 2024, 16(5), 917; https://doi.org/10.3390/cancers16050917 - 24 Feb 2024
Cited by 2 | Viewed by 1438
Abstract
(1) Background: The wider adoption of a preoperative ultrasound and calcitonin screening complemented by an intraoperative frozen section has increased the number of patients with occult sporadic medullary thyroid cancer (MTC). These advances offer new opportunities to reduce the extent of the initial [...] Read more.
(1) Background: The wider adoption of a preoperative ultrasound and calcitonin screening complemented by an intraoperative frozen section has increased the number of patients with occult sporadic medullary thyroid cancer (MTC). These advances offer new opportunities to reduce the extent of the initial operations, minimizing operative morbidity and the risk of postoperative thyroxin supplementation without compromising the cure. (2) Methods: This systematic review of the international literature published in the English language provides a comprehensive update on the latest progress made in the risk-adapted surgery for sporadic and hereditary MTC guided by an intraoperative frozen section. (3) Results: The current evidence confirms the viability of a hemithyroidectomy for desmoplasia-negative sporadic MTC. To add an extra safety margin, the hemithyroidectomy may be complemented by a diagnostic ipsilateral central node dissection. Despite the limited extent of the surgery, all the patients with desmoplasia-negative sporadic tumors achieved a biochemical cure with excellent clinical outcomes. A hemithyroidectomy decreases the need for postoperative thyroxine substitution, but a total thyroidectomy may be required for bilateral nodular thyroid disease. Hereditary MTC is a different issue. Because each residual thyroid C cell carries its own risk of malignant progression, a total thyroidectomy remains mandatory for hereditary MTC. (4) Conclusion: In experienced hands, a hemithyroidectomy, which minimizes morbidity without compromising the cure, is an adequate therapy for desmoplasia-negative sporadic MTC. Full article
(This article belongs to the Special Issue Personalized Treatment Strategies for Thyroid Carcinoma)
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