American Head and Neck Society Endocrine Surgery Section and International Thyroid Oncology Group consensus statement

David C Shonka1, Alan Ho2, Ashish V Chintakuntlawar3

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA.

Head & Neck
|March 11, 2022
PubMed
Abstract

Insights

This evidence-based statement defines advanced thyroid cancer and its targeted systemic treatments. It provides consensus statements on molecular evaluation and therapies for better patient outcomes.

Area of Science:

  • Oncology
  • Molecular Biology
  • Evidence-Based Medicine

Background:

  • The molecular landscape of advanced thyroid cancer is driving the development of novel systemic treatments.
  • A multidisciplinary, evidence-based approach is crucial for defining advanced thyroid cancer and its management.

Purpose of the Study:

  • To establish a consensus definition for advanced thyroid cancer.
  • To provide evidence-based statements on the molecular evaluation and targeted systemic treatment of advanced thyroid cancer.

Main Methods:

  • An expert panel was convened to review the literature on advanced thyroid cancer.
  • Best practice statements were developed using a modified Delphi method to ensure consensus.

Main Results:

  • A review of thyroid cancer oncogenesis at the molecular level is presented.
  • Characteristics of advanced thyroid cancer are defined.
  • Twenty consensus statements cover multidisciplinary management, molecular testing, and targeted systemic therapies.

Conclusions:

  • A consensus definition and management guidelines for advanced thyroid cancer are needed due to expanding targeted therapies.
  • Molecular testing and targeted systemic treatments are essential components of managing advanced thyroid cancer.

Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Goiter01:27

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...