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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

Published on: June 9, 2023

597

Guideline Adherence and Practice Patterns in the Management of Medullary Thyroid Cancer

Nicholas A Frisco1, Alexander H Gunn1, Frances Wang2

  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina.

The Journal of Surgical Research
|October 3, 2022
PubMed
Abstract

Insights

Adherence to 2015 American Thyroid Association guidelines for medullary thyroid cancer (MTC) management improved post-2015. Guideline-concordant care is linked to better survival outcomes for localized and regional MTC patients.

Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Oncology

Background:

  • Nationwide practice patterns for medullary thyroid cancer (MTC) management and their impact on survival in relation to the 2015 American Thyroid Association (ATA) guidelines are not well understood.
  • Evaluating treatment trends and outcomes is crucial for optimizing patient care.

Purpose of the Study:

  • To assess nationwide practice patterns for medullary thyroid cancer (MTC) management.
  • To evaluate adherence to the 2015 American Thyroid Association (ATA) guidelines.
  • To determine the impact of guideline-concordant care on survival outcomes.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) Program database (2000-2018) to identify 3332 MTC patients.
  • Analyzed treatment patterns across three time periods: 2000-2009, 2010-2015, and 2016-2018.
  • Assessed guideline concordance, treatment utilization, disease-specific survival (DSS), and overall survival (OS).

Main Results:

  • Guideline-concordant surgery rates for locoregional MTC increased from 63.0% (2000-2009) to 76.0% (2016-2018).
  • Guideline-concordant care was associated with improved overall survival (OS) in localized disease and both disease-specific survival (DSS) and OS in regional disease.
  • For distant MTC, median OS was 31 months and median DSS was 55 months, with a rise in chemotherapy use from 21.6% to 39.2%.

Conclusions:

  • The rate of guideline-concordant surgery for locoregional MTC has increased since the 2015 ATA guideline publication.
  • Guideline-concordant care is associated with prolonged OS and DSS.
  • While chemotherapy use has increased for distant MTC, prognosis remains variable.
Keywords:
Lymph node excisionMedullaryPractice guidelines as topicRetrospective studiesSEER programThyroid cancerThyroidectomy

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