Int J Thyroidol.  2024 May;17(1):1-20. 10.11106/ijt.2024.17.1.1.

Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Overview and Summary 2024

Affiliations
  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 2Department of Internal Medicine, National Cancer Center, Goyang, Korea
  • 3Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
  • 4Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Hospital, Daejeon, Korea
  • 5Department of Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
  • 6Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
  • 7Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
  • 8Department of Internal Medicine, Asan Medical Center, Seoul, Korea
  • 9Department of Surgery, Asan Medical Center, Seoul, Korea
  • 10Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 11Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
  • 12Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
  • 13Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, Korea
  • 14Department of Pediatrics, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • 15Department of Nuclear Medicine, National Cancer Center, Goyang, Korea
  • 16Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary’s Hospital, Seoul, Korea
  • 17Department of Nuclear Medicine, CHA Bundang Medical Center, Seongnam, Korea
  • 18Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
  • 19Department of Nuclear Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
  • 20Department of Internal Medicine, Severance Hospital, Seoul, Korea
  • 21Department of Pathology, Gangnam Severance Hospital, Seoul, Korea
  • 22Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
  • 23Department of Nucelar Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
  • 24Department of Otolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Korea
  • 25Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong, Korea
  • 26Department of Otolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Korea
  • 27Department of Radiology, Yeouido St. Mary’s Hospital, Seoul, Korea
  • 28Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
  • 29Department of Pathology, Konkuk University Meical Center, Seoul, Korea
  • 30Department of Internal Medicine, Gachon Gil Hospital, Incheon, Korea
  • 31Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
  • 32Department of Radiology, Seoul National University Hospital, Seoul, Korea
  • 33Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 34Department of Surgery, Yongin Severance Hospital, Yongin, Korea
  • 35Department of Internal Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
  • 36Department of Otolaryngology-Head and Neck Surgery, Gangnam Severance Hospital, Seoul, Korea
  • 37Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
  • 38Department of Nuclear Medicine, Chosun University Hospital, Gwangju, Korea
  • 39Department of Pathology, Seoul St. Mary’s Hospital, Seoul, Korea
  • 40Department of Internal Medicine, Incheon St. Mary’s Hospital, Incheon, Korea
  • 41Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
  • 42Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea
  • 43Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 44Department of Surgery, Severance Hospital, Seoul, Korea
  • 45Department of Radiology, Gangneung Asan Hospital, Gangneung, Korea

Abstract

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Keyword

Thyroid cancer; Guideline; Differentiated thyroid cancer; Korean Thyroid Association

Reference

References

1. Chen DW, Lang BHH, McLeod DSA, Newbold K, Haymart MR. 2023; Thyroid cancer. Lancet. 401(10387):1531–44. DOI: 10.1016/S0140-6736(23)00020-X. PMID: 37023783.
Article
2. Nabhan F, Dedhia PH, Ringel MD. 2021; Thyroid cancer, recent advances in diagnosis and therapy. Int J Cancer. 149(5):984–92. DOI: 10.1002/ijc.33690. PMID: 34013533.
Article
3. Kitahara CM, Schneider AB. 2022; Epidemiology of thyroid cancer. Cancer Epidemiol Biomarkers Prev. 31(7):1284–97. DOI: 10.1158/1055-9965.EPI-21-1440. PMID: 35775227. PMCID: PMC9473679.
Article
4. Kim WB, Kim TY, Kwon HS, Moon WJ, Lee JB, Choi YS, et al. 2007; Management guidelines for patients with thyroid nodules and thyroid cancer. J Korean Endocr Soc. 22(3):157–87. DOI: 10.3803/jkes.2007.22.3.157.
Article
5. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2016; 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 26(1):1–133. DOI: 10.1089/thy.2015.0020. PMID: 26462967. PMCID: PMC4739132.
Article
6. Yi KH, Park YJ, Koong SS, Kim JH, Na DG, Ryu JS, et al. 2010; Revised Korean Thyroid Association management guidelines for patients with thyroid nodules and thyroid cancer. J Korean Thyroid Assoc. 3(2):65–96.
Article
7. Yi KH. 2016; The revised 2016 Korean Thyroid Association guidelines for thyroid nodules and cancers: differences from the 2015 American Thyroid Association guidelines. Endocrinol Metab (Seoul). 31(3):373–8. DOI: 10.3803/EnM.2016.31.3.373. PMID: 27704738. PMCID: PMC5053047.
Article
8. Yi KH, Lee EK, Kang HC, Koh Y, Kim SW, Kim IJ, et al. 2016; 2016 revised Korean Thyroid Association management guidelines for patients with thyroid nodules and thyroid cancer. Int J Thyroidol. 9(2):59–126. DOI: 10.11106/ijt.2016.9.2.59.
Article
9. Park YJ, Lee EK, Song YS, Kang SH, Koo BS, Kim SW, et al. 2023; 2023 Korean Thyroid Association management guidelines for patients with thyroid nodules. Int J Thyroidol. 16(1):1–31. DOI: 10.11106/ijt.2023.16.1.1.
Article
10. Ali SZ, Baloch ZW, Cochand-Priollet B, Schmitt FC, Vielh P, VanderLaan PA. 2023; The 2023 Bethesda system for reporting thyroid cytopathology. J Am Soc Cytopathol. 12(5):319–25. DOI: 10.1016/j.jasc.2023.05.005. PMID: 37438235.
Article
11. Ali SZ, Baloch ZW, Cochand-Priollet B, Schmitt FC, Vielh P, VanderLaan PA. 2023; The 2023 Bethesda system for reporting thyroid cytopathology. Thyroid. 33(9):1039–44. DOI: 10.1089/thy.2023.0141. PMID: 37427847.
Article
12. Ha EJ, Chung SR, Na DG, Ahn HS, Chung J, Lee JY, et al. 2021; 2021 Korean Thyroid Imaging Reporting and Data System and imaging-based management of thyroid nodules: Korean Society of Thyroid Radiology consensus statement and recommendations. Korean J Radiol. 22(12):2094–123. DOI: 10.3348/kjr.2021.0713. PMID: 34719893. PMCID: PMC8628155.
Article
13. Jung CK, Baek JH, Na DG, Oh YL, Yi KH, Kang HC. 2020; 2019 practice guidelines for thyroid core needle biopsy: a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association. J Pathol Transl Med. 54(1):64–86. DOI: 10.4132/jptm.2019.12.04. PMID: 31964112. PMCID: PMC6986975.
Article
14. Park JO, Kim JH, Joo YH, Kim SY, Kim GJ, Kim HB, et al. 2023; Guideline for the surgical management of locally invasive differentiated thyroid cancer from the Korean Society of Head and Neck Surgery. Clin Exp Otorhinolaryngol. 16(1):1–19. DOI: 10.21053/ceo.2022.01732. PMID: 36634669. PMCID: PMC9985989.
Article
15. Aschebrook-Kilfoy B, Ward MH, Sabra MM, Devesa SS. 2011; Thyroid cancer incidence patterns in the United States by histologic type, 1992-2006. Thyroid. 21(2):125–34. DOI: 10.1089/thy.2010.0021. PMID: 21186939. PMCID: PMC3025182.
Article
16. Mazzaferri EL, Jhiang SM. 1994; Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 97(5):418–28. DOI: 10.1016/0002-9343(94)90321-2. PMID: 7977430.
Article
17. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. 1998; A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995 [see commetns]. Cancer. 83(12):2638–48. DOI: 10.1002/(SICI)1097-0142(19981215)83:12<2638::AID-CNCR31>3.0.CO;2-1.
Article
18. Mazzaferri EL. 1999; An overview of the management of papillary and follicular thyroid carcinoma. Thyroid. 9(5):421–7. DOI: 10.1089/thy.1999.9.421. PMID: 10365671.
Article
19. Mazzaferri EL. 2000; Long-term outcome of patients with differentiated thyroid carcinoma: effect of therapy. Endocr Pract. 6(6):469–76. DOI: 10.4158/EP.6.6.469. PMID: 11155222.
Article
20. Cooper DS, Specker B, Ho M, Sperling M, Ladenson PW, Ross DS, et al. 1998; Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid. 8(9):737–44. DOI: 10.1089/thy.1998.8.737. PMID: 9777742.
Article
21. Hay ID, Bergstralh EJ, Goellner JR, Ebersold JR, Grant CS. 1993; Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery. 114(6):1050–7. discussion 7–8.
22. Shah MD, Hall FT, Eski SJ, Witterick IJ, Walfish PG, Freeman JL. 2003; Clinical course of thyroid carcinoma after neck dissection. Laryngoscope. 113(12):2102–7. DOI: 10.1097/00005537-200312000-00008. PMID: 14660910.
Article
23. Wang TS, Dubner S, Sznyter LA, Heller KS. 2004; Incidence of metastatic well-differentiated thyroid cancer in cervical lymph nodes. Arch Otolaryngol Head Neck Surg. 130(1):110–3. DOI: 10.1001/archotol.130.1.110. PMID: 14732779.
Article
24. Lin JD, Chao TC, Huang MJ, Weng HF, Tzen KY. 1998; Use of radioactive iodine for thyroid remnant ablation in well- differentiated thyroid carcinoma to replace thyroid reoperation. Am J Clin Oncol. 21(1):77–81. DOI: 10.1097/00000421-199802000-00018. PMID: 9499265.
Article
25. Brierley JD, Panzarella T, Tsang RW, Gospodarowicz MK, O'Sullivan B. 1997; A comparison of different staging systems predictability of patient outcome. Thyroid carcinoma as an example. Cancer. 79(12):2414–23. DOI: 10.1002/(SICI)1097-0142(19970615)79:12<2414::AID-CNCR18>3.0.CO;2-U.
Article
26. Hay ID, Thompson GB, Grant CS, Bergstralh EJ, Dvorak CE, Gorman CA, et al. 2002; Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J Surg. 26(8):879–85. DOI: 10.1007/s00268-002-6612-1. PMID: 12016468.
Article
27. Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. 1998; The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg. 228(3):320–30. DOI: 10.1097/00000658-199809000-00005. PMID: 9742915. PMCID: PMC1191485.
Article
28. Loyo M, Tufano RP, Gourin CG. 2013; National trends in thyroid surgery and the effect of volume on short-term outcomes. Laryngoscope. 123(8):2056–63. DOI: 10.1002/lary.23923. PMID: 23737403.
Article
29. Stavrakis AI, Ituarte PH, Ko CY, Yeh MW. 2007; Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery. Surgery. 142(6):887–99. discussionDOI: 10.1016/j.surg.2007.09.003. PMID: 18063073.
Article
30. Links TP, van Tol KM, Jager PL, Plukker JT, Piers DA, Boezen HM, et al. 2005; Life expectancy in differentiated thyroid cancer: a novel approach to survival analysis. Endocr Relat Cancer. 12(2):273–80. DOI: 10.1677/erc.1.00892. PMID: 15947102.
Article
31. Kim S, Wei JP, Braveman JM, Brams DM. 2004; Predicting outcome and directing therapy for papillary thyroid carcinoma. Arch Surg. 139(4):390–4. discussion 3–4. DOI: 10.1001/archsurg.139.4.390. PMID: 15078706.
Article
32. Bogdanovski AK, Sturgeon C, James BC. 2023; Financial toxicity in thyroid cancer survivors. Curr Opin Endocrinol Diabetes Obes. 30(5):238–43. DOI: 10.1097/MED.0000000000000826. PMID: 37470486.
Article
33. Mongelli MN, Giri S, Peipert BJ, Helenowski IB, Yount SE, Sturgeon C. 2020; Financial burden and quality of life among thyroid cancer survivors. Surgery. 167(3):631–7. DOI: 10.1016/j.surg.2019.11.014. PMID: 31862171.
Article
34. Ronga G, Filesi M, Montesano T, Di Nicola AD, Pace C, Travascio L, et al. 2004; Lung metastases from differentiated thyroid carcinoma. A 40 years' experience. Q J Nucl Med Mol Imaging. 48(1):12–9.
35. Schlumberger M, Challeton C, De Vathaire F, Travagli JP, Gardet P, Lumbroso JD, et al. 1996; Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med. 37(4):598–605.
36. Bernier MO, Leenhardt L, Hoang C, Aurengo A, Mary JY, Menegaux F, et al. 2001; Survival and therapeutic modalities in patients with bone metastases of differentiated thyroid carcinomas. J Clin Endocrinol Metab. 86(4):1568–73. DOI: 10.1210/jcem.86.4.7390. PMID: 11297585.
Article
37. Zettinig G, Fueger BJ, Passler C, Kaserer K, Pirich C, Dudczak R, et al. 2002; Long-term follow-up of patients with bone metastases from differentiated thyroid carcinoma -- surgery or conventional therapy? Clin Endocrinol (Oxf). 56(3):377–82. DOI: 10.1046/j.1365-2265.2002.01482.x. PMID: 11940050.
Article
38. Chiu AC, Delpassand ES, Sherman SI. 1997; Prognosis and treatment of brain metastases in thyroid carcinoma. J Clin Endocrinol Metab. 82(11):3637–42. DOI: 10.1210/jcem.82.11.4386. PMID: 9360519.
Article
39. Lin JD, Chao TC, Chou SC, Hsueh C. 2004; Papillary thyroid carcinomas with lung metastases. Thyroid. 14(12):1091–6. DOI: 10.1089/thy.2004.14.1091. PMID: 15650364.
Article
40. Shoup M, Stojadinovic A, Nissan A, Ghossein RA, Freedman S, Brennan MF, et al. 2003; Prognostic indicators of outcomes in patients with distant metastases from differentiated thyroid carcinoma. J Am Coll Surg. 197(2):191–7. DOI: 10.1016/S1072-7515(03)00332-6. PMID: 12892796.
Article
41. Pittas AG, Adler M, Fazzari M, Tickoo S, Rosai J, Larson SM, et al. 2000; Bone metastases from thyroid carcinoma: clinical characteristics and prognostic variables in one hundred forty-six patients. Thyroid. 10(3):261–8. DOI: 10.1089/thy.2000.10.261. PMID: 10779141.
Article
42. Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gorman CA, Hay ID. 1995; Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab. 80(7):2041–5. DOI: 10.1210/jcem.80.7.7608252. PMID: 7608252.
Article
43. Eustatia-Rutten CF, Romijn JA, Guijt MJ, Vielvoye GJ, van den Berg R, Corssmit EP, et al. 2003; Outcome of palliative embolization of bone metastases in differentiated thyroid carcinoma. J Clin Endocrinol Metab. 88(7):3184–9. DOI: 10.1210/jc.2003-030231. PMID: 12843163.
Article
44. Foote RL, Brown PD, Garces YI, McIver B, Kasperbauer JL. 2003; Is there a role for radiation therapy in the management of Hurthle cell carcinoma? Int J Radiat Oncol Biol Phys. 56(4):1067–72. DOI: 10.1016/S0360-3016(03)00199-8. PMID: 12829143.
45. Pak H, Gourgiotis L, Chang WI, Guthrie LC, Skarulis MC, Reynolds JC, et al. 2003; Role of metastasectomy in the management of thyroid carcinoma: the NIH experience. J Surg Oncol. 82(1):10–8. DOI: 10.1002/jso.10189. PMID: 12501164.
Article
46. Vitale G, Fonderico F, Martignetti A, Caraglia M, Ciccarelli A, Nuzzo V, et al. 2001; Pamidronate improves the quality of life and induces clinical remission of bone metastases in patients with thyroid cancer. Br J Cancer. 84(12):1586–90. DOI: 10.1054/bjoc.2001.1832. PMID: 11401309. PMCID: PMC2363684.
Article
47. Kitamura Y, Shimizu K, Nagahama M, Sugino K, Ozaki O, Mimura T, et al. 1999; Immediate causes of death in thyroid carcinoma: clinicopathological analysis of 161 fatal cases. J Clin Endocrinol Metab. 84(11):4043–9. DOI: 10.1210/jcem.84.11.6115. PMID: 10566647.
Article
48. Lee YA, Jung HW, Kim HY, Choi H, Kim HY, Hah JH, et al. 2015; Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients: a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years. J Clin Endocrinol Metab. 100(4):1619–29. DOI: 10.1210/jc.2014-3647. PMID: 25632969.
Article
49. Redlich A, Luster M, Lorenz K, Lessel L, Rohrer TR, Schmid KW, et al. 2022; Age, American Thyroid Association risk group, and response to therapy are prognostic factors in children with differentiated thyroid cancer. J Clin Endocrinol Metab. 107(1):e165–e77. DOI: 10.1210/clinem/dgab622. PMID: 34415989.
Article
50. Rangel-Pozzo A, Sisdelli L, Cordioli MIV, Vaisman F, Caria P, Mai S, et al. 2020; Genetic landscape of papillary thyroid carcinoma and nuclear architecture: an overview comparing pediatric and adult populations. Cancers (Basel). 12(11):3146. DOI: 10.3390/cancers12113146. PMID: 33120984. PMCID: PMC7693829.
Article
51. van de Berg DJ, Kuijpers AMJ, Engelsman AF, Drukker CA, van Santen HM, Terwisscha van Scheltinga S, et al. 2022; Long-term oncological outcomes of papillary thyroid cancer and follicular thyroid cancer in children: a nationwide population- based study. Front Endocrinol (Lausanne). 13:899506. DOI: 10.3389/fendo.2022.899506. PMID: 35600573. PMCID: PMC9114695.
Article
52. Lee YA, Im SW, Jung KC, Chung EJ, Shin CH, Kim JI, et al. 2020; Predominant DICER1 pathogenic variants in pediatric follicular thyroid carcinomas. Thyroid. 30(8):1120–31. DOI: 10.1089/thy.2019.0233. PMID: 32228164.
Article
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