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
Volume 18 Issue 3
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Clinical Thyroidology for the Public Volume 18 Issue 3 (PDF file, 2.02 MB)
TABLE OF CONTENTS – Web Format
THYROID CANCER
Is there a link between diabetes and weight loss drugs and thyroid cancer?
GLP1 receptor agonists (GLP1-RAs) are popular medications that are used to treat diabetes and obesity. In animal studies with GLP1-RAs, an increase in C-cell tumors was seen, which are associated with medullary thyroid cancer, which is a rare form of thyroid cancer. However, it’s unclear if this risk applies to humans. This large, international study was done to clarify whether GLP1-RAs increase the risk of thyroid cancer and whether higher doses overtime make the risk bigger.
Baxter SM, et al. Glucagon-like peptide 1 receptor agonists and risk of thyroid cancer: an international multisite cohort study. Thyroid 2024; in press.
THYROID CANCER
What is the risk for recurrence of Medullary thyroid carcinoma?
In the setting of medullary thyroid carcinoma (MTC), calcitonin serves as a cancer marker, since the cancer cells continue to secrete calcitonin. There is controversy regarding the best cutoff calcitonin level to identify cancer that has spread outside of the neck as opposed to cancer limited to the thyroid and local lymph nodes. This study was done to determine the which factors are associated with MTC response after surgery, cancer recurrence and effective treatment without the cancer progressing.
Abou Azar S et al. Medullary thyroid cancer: single institute experience over 3 decades and risk factors for recurrence. J Clin Endocrinol Metab 2024;109(11):2729-2734; doi: 10.1210/clinem/dgae279. PMID: 38651609.
THYROID CANCER
Is lobectomy an option for patients with Medullary thyroid cancer?
Once Medullary thyroid cancer (MTC) is diagnosed, a total thyroidectomy is generally recommended for patients. However, thyroid lobectomy has become increasingly advocated for other types of thyroid cancer if there is no evidence of spread of the cancer to the opposite lobe. It is unclear whether this approach would be appropriate for treatment of MTC. This study investigated frequency of finding small foci of MTC in the lobe opposite to the lobe containing the primary cancer that was not identified on ultrasound before surgery.
Mao YV et al. Extent of surgery for medullary thyroid cancer and prevalence of occult contralateral foci. JAMA Otolaryngol Head Neck Surg 2024;150(9):838; doi: 10.1001/ jamaoto.2023.4376. PMID: 38270925
HYPERTHYROIDISM .
Hyperthyroidism treatment and risk for heart problems
Heart racing/palpitations are common symptoms of hyperthyroidism. Indeed, hyperthyroidism has been associated with increased risk of atrial fibrillation, heart attacks and death. This study sought to determine if treatment choice impacts major adverse cardiac events (MACE) and death rates (all-cause mortality). These investigators examined long term MACE and all-cause mortality in newly diagnosed hyperthyroid subjects in Taiwan based on treatment choice.
Peng CC-H, et al. MACE and hyperthyroidism treated with medication, radioactive iodine, or thyroidectomy. JAMA Netw Open 2024;7:e240904. PMID: 38436957. doi: 10.1001/ jamanetworkopen.2024.0904.
THYROID NODULES
Long-term data show that RFA remains effective and is low risk
Radiofrequency ablation (RFA) is a relatively new and nonsurgical option that has gained popularity for the management of benign thyroid nodules. RFA uses radiowave-based heat delivered by a needle to destroy abnormal tissue or lymph nodes containing cancer. This study focuses on the long-term results of RFA use in benign thyroid nodules, including response, regrowth rates, delay in surgery, and complications.
Park SI et al. Radiofrequency ablation for treatment of benign thyroid nodules: 10-year experience. Thyroid 2024;34(8):990- 998; doi: 10.1089/thy.2024.0082. PMID: 39041607.
THYROID SURGERY
Does treatment with iodine before thyroid surgery for Graves’ disease make this surgery safer?
Thyroid surgery is a very effective treatment for Graves’ disease, especially with patients with very large thyroid glands. In preparing patients for surgery for Graves’ disease, iodine in the form of Lugol’s solution/LS or saturated solution of potassium iodide/SSKI is often used for several days before surgery. This study compares the outcomes of thyroid surgery in people diagnosed with Graves’ disease with or without pre-surgery iodine treatment.
Schiavone D et al. Role of Lugol solution before total thyroidectomy for Graves’ disease: randomized clinical trial. Br J Surg 2024;111(8):znae196; doi: 10.1093/bjs/znae196. PMID: 39129619.
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