Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
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Clinical Thyroidology for the Public Volume 13 Issue 12 (PDF file, 7.12MB)
TABLE OF CONTENTS – Web Format
THYROID SURGERY
Racial disparities in thyroid surgery
Thyroid surgery is a commonly used treatment for many noncancerous thyroid conditions. There is already evidence that there are gender, socioeconomic and racial disparities when looking at patients who had thyroid surgery for thyroid cancer or parathyroid disease, with non-white patients having worse outcomes than white patients. In this study, the authors sought to understand whether racial inequalities exist in outcomes after surgery for benign thyroid conditions.
Maduka RC et al 2020 Racial disparities in surgical outcomes for benign thyroid disease. Am J Surg. Epub 2020 Jul 6. PMID: 32669203.
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THYROID AND PREGNANCY .
Radioactive iodine therapy for the most common types of thyroid cancer does not decrease pregnancy chances in women
Radioactive iodine therapy can potentially affect a woman’s fertility, or ability to become pregnant, long-term. The current study reviewed original research studies to assess the potential effect of radioactive iodine therapy for thyroid cancer on fertility among young women.
Piek MW et al 2020 The effect of radioactive iodine therapy on ovarian function and fertility in female thyroid cancer patients: A systematic review and meta-analysis. Thyroid. Epub 2020 Nov 2. PMID: 33012254.
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THYROID CANCER
Declining frequency and variability of radioactive iodine therapy for thyroid cancer suggests increasing adoption of evidence-based guidelines
Standard treatment for the most common types of thyroid cancer includes surgery to remove the thyroid followed in some instances by radioactive iodine therapy. Recent ATA guidelines have recommended progressively a more selective use of radioactive iodine therapy, based on growing research evidence that many patients with thyroid cancer are at very low risk for complications and recurrence of the cancer. The aim of this study was to analyze trends in radioactive iodine therapy use in the United States after the introduction of the new thyroid cancer treatment guidelines.
Jacobs D et al 2020 Changes in population-level and institutional- level prescribing habits of radioiodine therapy for papillary thyroid cancer. Thyroid. Epub 2020 Sep 22. PMID: 32811347.
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THYROID NODULES
Initial ATA risk and subsequent growth helps identify missed cancers in initially benign thyroid nodules
In 2015 the ATA published an ultrasound risk stratification system to identify concerning ultrasound features of thyroid nodules, which should be followed by a thyroid biopsy when present. These guidelines recommend repeating a biopsy in a benign nodule only when it grows or develops suspicious ultrasound characteristics. In this study, the authors evaluate the accuracy of the ATA guidelines in monitoring benign thyroid nodules for growth and indications to repeat a biopsy.
Maino F et al 2020 Validation of American Thyroid Association ultrasound risk-adapted approach for repeating cytology in benign thyroid nodules. Thyroid. Epub 2020 Jul 27. PMID: 32718278.
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THYROID CANCER
Routine preoperative chest CT does not identify distant metastases in papillary thyroid microcarcinoma
It is increasingly recognized that patients with papillary microcarcinomas can be monitored with periodic ultrasound exams. However, it is known that a very tiny number of patients with these microcarcinomas can have spread outside of the thyroid. This study was done to see if there was any evidence that routine chest CT scans could identify patients with papillary microcarcinomas who develop spread of the cancer to the lungs.
Kawano S et al. 2020 Routine chest computed tomography at presentation does not identify distant metastasis in cT1aN0 papillary thyroid carcinoma. Thyroid. Epub 2020 May 27. PMID: 32368954.
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HYPOTHYROIDISM
Levothyroxine does not affect heart function after a heart attack in patients who have mild hypothyroidism
Prior studies suggest that patients with subclinical hypothyroidism are at higher risk for heart disease and they are more likely to die after a heart attack compared to someone without thyroid disease. However, we do not know whether treatment with thyroid hormone would decrease this risk. This study was designed to find out whether levothyroxine treatment would improve left ventricular function after having a heart attack in patients with subclinical hypothyroidism.
Jabbar A et al 2020 Effect of levothyroxine on left ventricular ejection fraction in patients with subclinical hypothyroidism and acute myocardial infarction: a randomized clinical trial. JAMA 324:249–258. PMID: 32692386.
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