“Additionally, molecular testing of indeterminate thyroid nodule fine needle aspirates has become much more common over the last decade,” he added, “and the new guidelines outline some general scenarios when molecular testing may be considered.”
Explore this issue:June 2016
The updated guidelines also include potential areas of interest for future research, including:
- Optimizing molecular markers for diagnosis, prognosis, and therapeutic targets;
- Active surveillance of disseminated tumor cell (DTC)-positive primary tumors;
- Improved risk stratification;
- Improved understanding of the risks and benefits of DTC treatments and optimal implementation/utilization;
- Issues with measurement of Tg and anti-Tg antibodies;
- Management of metastatic cervical adenopathy detected on ultrasound;
- Novel therapies for systemic radioactive iodine (RAI)-refractory disease; and
- Survivorship care.
According to Dr. Zafereo, these recommendations on future research topics are an important step in closing any research gaps. “It’s important as a specialty that we contribute to and stay up to date on the latest evidence in the field of head and neck endocrine surgery,” he said. “This way, we can best educate and care for our patients with thyroid neoplasms, and best communicate and collaborate with our medical endocrinology colleagues.”
“We used to recommend a standard set of treatments,” says Dr. Tufano. “Now, given updated recommendations and the fact that we don’t know the particular behavior of a particular tumor, we should be more thoughtful and complete in our own clinical practices. We want all physicians to sit down and talk about personal care for patients, and how we as physicians can help patients as much as possible without hurting them. These guidelines will prove quite useful in allowing us more flexibility in terms of what care is chosen and how that care is rendered.”
Amy E. Hamaker is a freelance medical writer based in California.