Reconsidering the Treatment of Multifocal Papillary Thyroid Carcinoma

 

• In sporadic papillary thyroid cancer (PTC):
  • Multifocal tumors are common, particularly in familial PTC syndromes (such as those driven by PTEN mutations).
• Initially thought to be genetically distinct tumors:
  • It is now recognized that a mixture of individual clones and intrathyroidal metastases can be present in sporadic multifocal PTC.
• Historically:
  • The presence of multifocal disease has been interpretedas conveying an increased risk for disease recurrence.
  • And has been used to determine the extent of surgery and the use of adjuvant radioiodine administration for individual patients.
• Current National Comprehensive Cancer Network (NCCN) guidelines list macronodular multifocal PTC (one tumor focus >1 cm) as a clinicopathologic factor that can supportthe use of radioiodine (RAI).
• American ThyroidAssociation (ATA) guidelines state that the presence of multifocal micronodular PTC:
  • Is a low-risk feature and should not prompt the use of RAI:
    • However, they do not comment on macronodular multifocal disease.
• The current study sought to clarify theassociation of multifocal PTC with disease-specificrecurrence and long‐term outcomes using a novel propensity score–matching analysis (6).

 

https://www.liebertpub.com/doi/pdf/10.1089/ct.2019%3B31.204-206

 

Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon / endocrine surgeon / surgical oncologist and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

• He is an expert in the management thyroid cancer

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

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