Int J Thyroidol.  2024 May;17(1):147-152. 10.11106/ijt.2024.17.1.147.

Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part III. Management of Advanced Differentiated Thyroid Cancers - Chapter 1-2. Locally Recurred/Persistent Thyroid Cancer Management Strategies 2024

• Won HR
• Lee MK
• Kang HC
• Koo BS
• Kwon H
• Kim SW
• Kim WW
• Kim JH
• Park YJ
• Park JO
• Song YS
• Woo SH
• Ryu CH
• Lee EK
• Lee JH
• Lee JY
• Lee CR
• Lim DJ
• Lim JY
• Chung YJ
• Back K
• Na DG
• Korean Thyroid Association Guideline Committee on the Managements of Thyroid Nodule and Cancer

• KMID: 2556511
• DOI: http://doi.org/10.11106/ijt.2024.17.1.147

Abstract

These guidelines aim to establish the standard practice for diagnosing and treating patients with differentiated thyroid cancer (DTC). Based on the Korean Thyroid Association (KTA) Guidelines on DTC management, the “Treatment of Advanced DTC” section was revised in 2024 and has been provided through this chapter. Especially, this chapter covers surgical and nonsurgical treatments for the local (previous surgery site) or regional (cervical lymph node metastasis) recurrences. After drafting the guidelines, it was finalized by collecting opinions from KTA members and related societies. Surgical resection is the preferred treatment for local or regional recurrence of advanced DTC. If surgical resection is not possible, nonsurgical resection treatment under ultrasonography guidance may be considered as an alternative treatment for local or regional recurrence of DTC. Furthermore, if residual lesions are suspected even after surgical resection or respiratory-digestive organ invasion, additional radioactive iodine and external radiation treatments are considered.

Keyword

Differentiated thyroid cancer; Guidelines; Korean Thyroid Association; Recurrence; Lymph node metastasis; Treatment

Reference

References

1. 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.

2. 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.

3. 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.

4. Clayman GL, Agarwal G, Edeiken BS, Waguespack SG, Roberts DB, Sherman SI. 2011; Long-term outcome of comprehensive central compartment dissection in patients with recurrent/persistent papillary thyroid carcinoma. Thyroid. 21(12):1309–16. DOI: 10.1089/thy.2011.0170. PMID: 22136266. PMCID: PMC3968954.

5. 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.

6. Chinn SB, Zafereo ME, Waguespack SG, Edeiken BS, Roberts DB, Clayman GL. 2017; Long-term outcomes of lateral neck dissection in patients with recurrent or persistent well- differentiated thyroid cancer. Thyroid. 27(10):1291–9. DOI: 10.1089/thy.2017.0203. PMID: 28806882.

7. 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.

8. 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.

9. Ge JH, Zhao RL, Hu JL, Zhou WA. 2004; Surgical treatment of advanced thyroid carcinoma with aero-digestive invasion. Zhonghua Er Bi Yan Hou Ke Za Zhi. 39(4):237–40.

10. Avenia N, Ragusa M, Monacelli M, Calzolari F, Daddi N, Di Carlo L, et al. 2004; Locally advanced thyroid cancer: therapeutic options. Chir Ital. 56(4):501–8.

11. Van Nostrand D. 2009; The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid. 19(12):1381–91. DOI: 10.1089/thy.2009.1611. PMID: 20001720.

12. Haymart MR, Muenz DG, Stewart AK, Griggs JJ, Banerjee M. 2013; Disease severity and radioactive iodine use for thyroid cancer. J Clin Endocrinol Metab. 98(2):678–86. DOI: 10.1210/jc.2012-3160. PMID: 23322816. PMCID: PMC3565122.

13. McCaffrey JC. 2000; Evaluation and treatment of aerodigestive tract invasion by well-differentiated thyroid carcinoma. Cancer Control. 7(3):246–52. DOI: 10.1177/107327480000700304. PMID: 10832111.

14. Musholt TJ, Musholt PB, Behrend M, Raab R, Scheumann GF, Klempnauer J. 1999; Invasive differentiated thyroid carcinoma: tracheal resection and reconstruction procedures in the hands of the endocrine surgeon. Surgery. 126(6):1078–87. discussion 87–8. DOI: 10.1067/msy.2099.102267. PMID: 10598191.

15. Czaja JM, McCaffrey TV. 1997; The surgical management of laryngotracheal invasion by well-differentiated papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 123(5):484–90. DOI: 10.1001/archotol.1997.01900050030003. PMID: 9158394.

16. Shindo ML, Caruana SM, Kandil E, McCaffrey JC, Orloff LA, Porterfield JR, et al. 2014; Management of invasive well-differentiated thyroid cancer: an American Head and Neck Society consensus statement. AHNS consensus statement. Head Neck. 36(10):1379–90. DOI: 10.1002/hed.23619. PMID: 24470171.

17. Cabanillas ME, McFadden DG, Durante C. 2016; Thyroid cancer. Lancet. 388(10061):2783–95. DOI: 10.1016/S0140-6736(16)30172-6. PMID: 27240885.

18. Medas F, Tuveri M, Canu GL, Erdas E, Calo PG. 2019; Complications after reoperative thyroid surgery: retrospective evaluation of 152 consecutive cases. Updates Surg. 71(4):705–10. DOI: 10.1007/s13304-019-00647-y. PMID: 30937820.

19. Kim JH, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, et al. 2018; 2017 thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology. Korean J Radiol. 19(4):632–55. DOI: 10.3348/kjr.2018.19.4.632. PMID: 29962870. PMCID: PMC6005940.

20. Mauri G, Hegedus L, Bandula S, Cazzato RL, Czarniecka A, Dudeck O, et al. 2021; European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the use of minimally invasive treatments in malignant thyroid lesions. Eur Thyroid J. 10(3):185–97. DOI: 10.1159/000516469. PMID: 34178704. PMCID: PMC8215982.

21. Orloff LA, Noel JE, Stack BC Jr, Russell MD, Angelos P, Baek JH, et al. 2022; Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: an international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck. 44(3):633–60. DOI: 10.1002/hed.26960. PMID: 34939714.

22. Kim SY, Kim SM, Chang H, Kim BW, Lim CY, Lee YS, et al. 2017; Long-term outcomes of ethanol injection therapy for locally recurrent papillary thyroid cancer. Eur Arch Otorhinolaryngol. 274(9):3497–501. DOI: 10.1007/s00405-017-4660-2. PMID: 28664330.

23. Zhang X, Ni T, Zhang W. 2022; Ultrasonography-guided thermal ablation for cervical lymph node metastasis of recurrent papillary thyroid carcinoma: is it superior to surgical resection? Front Endocrinol (Lausanne). 13:907195. DOI: 10.3389/fendo.2022.907195. PMID: 35832431. PMCID: PMC9272822.

24. Dupuy DE, Monchik JM, Decrea C, Pisharodi L. 2001; Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery. 130(6):971–7. DOI: 10.1067/msy.2001.118708. PMID: 11742325.

25. Park KW, Shin JH, Han BK, Ko EY, Chung JH. 2011; Inoperable symptomatic recurrent thyroid cancers: preliminary result of radiofrequency ablation. Ann Surg Oncol. 18(9):2564–8. DOI: 10.1245/s10434-011-1619-1. PMID: 21347777.

26. Baek JH, Kim YS, Sung JY, Choi H, Lee JH. 2011; Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol. 197(2):W331–6. DOI: 10.2214/AJR.10.5345. PMID: 21785061.

27. Lee SJ, Jung SL, Kim BS, Ahn KJ, Choi HS, Lim DJ, et al. 2014; Radiofrequency ablation to treat loco-regional recurrence of well-differentiated thyroid carcinoma. Korean J Radiol. 15(6):817–26. DOI: 10.3348/kjr.2014.15.6.817. PMID: 25469095. PMCID: PMC4248639.

28. Wang L, Ge M, Xu D, Chen L, Qian C, Shi K, et al. 2014; Ultrasonography-guided percutaneous radiofrequency ablation for cervical lymph node metastasis from thyroid carcinoma. J Cancer Res Ther. 10 Suppl:C144–9. DOI: 10.4103/0973-1482.145844. PMID: 25450273.

29. Kim JH, Yoo WS, Park YJ, Park DJ, Yun TJ, Choi SH, et al. 2015; Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology. 276(3):909–18. DOI: 10.1148/radiol.15140079. PMID: 25848897.

30. Lim HK, Baek JH, Lee JH, Kim WB, Kim TY, Shong YK, et al. 2015; Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer. Eur Radiol. 25(1):163–70. DOI: 10.1007/s00330-014-3405-5. PMID: 25199815.

31. Choi Y, Jung SL, Bae JS, Lee SH, Jung CK, Jang J, et al. 2019; Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study. Int J Hyperthermia. 36(1):359–67. DOI: 10.1080/02656736.2019.1571248. PMID: 30836037.

32. Tang W, Sun W, Niu X, Wang X, Wang X, Zhang M, et al. 2022; Evaluating the safety and efficacy of microwave ablation in treatment of cervical metastatic lymph nodes of papillary thyroid carcinoma compared to repeat surgery. Int J Hyperthermia. 39(1):813–21. DOI: 10.1080/02656736.2022.2086713. PMID: 35719117.

33. Urken ML, Milas M, Randolph GW, Tufano R, Bergman D, Bernet V, et al. 2015; Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide for the Thyroid Cancer Care Collaborative. Head Neck. 37(4):605–14. DOI: 10.1002/hed.23615. PMID: 24436291.

34. Ding Z, Chen J, Chen Z, Zeng X, Zheng P, Wang X, et al. 2022; Efficacy and safety of thermal ablation for treating lymph node metastasis from papillary thyroid carcinoma: a systematic review and meta-analysis. Front Oncol. 12:738299. DOI: 10.3389/fonc.2022.738299. PMID: 35433407. PMCID: PMC9010561.

35. Suh CH, Baek JH, Choi YJ, Lee JH. 2016; Efficacy and safety of radiofrequency and ethanol ablation for treating locally recurrent thyroid cancer: a systematic review and meta-analysis. Thyroid. 26(3):420–8. DOI: 10.1089/thy.2015.0545. PMID: 26782174.

36. Chung SR, Baek JH, Choi YJ, Lee JH. 2019; Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol. 29(9):4897–903. DOI: 10.1007/s00330-019-06063-5. PMID: 30805701.

37. Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH. 2017; Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia. 33(8):920–30. DOI: 10.1080/02656736.2017.1337936. PMID: 28565997.

38. Kim C, Lee JH, Choi YJ, Kim WB, Sung TY, Baek JH. 2017; Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol. 27(8):3128–37. DOI: 10.1007/s00330-016-4690-y. PMID: 27975148.