Tiroit ve Paratiroit Tümörleri
Özet
Klinik uygulama kılavuzlarının amacı, hekimlere belirli hastalıklar ve durumlar için mevcut en iyi kanıtları sunarak en yüksek bakım standartlarını sağlamada rehberlik etmektir. Tiroid ve paratiroid kanseri olan hastaların birincil tedavilerinin ardından, rezidü (kalıntı) veya nüks hastalığın erken saptanması, sağlık profesyonellerinin mevcut tanı yöntemlerini en etkili şekilde kullanmasını gerektirir. Bu sayede hastalığın erken tespiti ve yönetimi sağlanabilir.
Ancak, diferansiye tiroid kanserlerinin genellikle yavaş seyretmesi nedeniyle, yüksek riskli hastalara uygulanan agresif tanı ve tedavi yaklaşımlarından kaçınılması önem taşır. Bu nedenle klinik uygulama kılavuzları, gereksiz tetkiklerin yol açabileceği riskleri en aza indirirken, aynı zamanda maliyet-etkin stratejileri teşvik etmektedir.
Bu bölümde, tiroid ve paratiroid kanserine yönelik laboratuvar testleri, görüntüleme yöntemleri ve en uygun takip yaklaşımları ele alınarak, tanı ve takip süreçlerinin daha etkin bir şekilde kullanılması hedeflenmiştir.
The aim of clinical practice guidelines is to provide physicians with the best available evidence to guide them in ensuring the highest standards of care for specific diseases and conditions. Following the primary treatment of patients with thyroid and parathyroid cancer, the early detection of residual or recurrent disease requires healthcare professionals to utilize existing diagnostic methods in the most effective way. This facilitates early diagnosis and management of the disease.
However, due to the typically slow progression of differentiated thyroid cancers, it is crucial to avoid aggressive diagnostic and therapeutic approaches in high-risk patients. Therefore, clinical practice guidelines aim to minimize the risks associated with excessive testing while promoting cost-effective strategies.
This section addresses laboratory tests, imaging methods, and the most appropriate follow-up approaches for thyroid and parathyroid cancer, aiming to enhance the effective use of diagnostic and follow-up procedures.
Referanslar
European Network of Cancer Registries Factsheets. https://www.encr.eu/sites/default/files/factsheets/ENCR_Factsheet_Thyroid_2017.pdf (12 June 2019, date last accessed).
Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol 2016; 12(11): 646–653.
Dal Maso L, Tavilla A, Pacini F et al. Survival of 86,690 patients with thyroid cancer: a population-based study in 29 European countries from EUROCARE-5. Eur J Cancer 2017; 77: 140–152.
Vaccarella S, Franceschi S, Bray F et al. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med 2016; 375(7): 614–617.
Ahn HS, Welch HG. South Korea’s thyroid-cancer “epidemic”–turning the tide. N Engl J Med 2015; 373(24): 2389–2390.
Bibbins-Domingo K, Grossman DC, Curry SJ et al. Screening for thyroid cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2017; 317: 1882–1887.
Pacini F, Schlumberger M, Dralle H et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 2006; 154(6): 787–803.
Haugen BR, Alexander EK, Bible KC et al. 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 2016; 26(1): 1–133.
Mitchell AL, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2): S150–S160.
Pacini F, Basolo F, Bellantone R et al. Italian consensus on diagnosis and treatment of differentiated thyroid cancer: joint statements of six Italian societies. J Endocrinol Invest 2018; 41(7): 849–876.
Lamartina L, Grani G, Durante C, Filetti S. Recent advances in managing differentiated thyroid cancer. F1000Res 2018; 7: 86.
Giovanella L, Clark PM, Chiovato L et al. Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer: a clinical position paper. Eur J Endocrinol 2014; 171(2): R33–R46.
Spencer CA. Clinical review: clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC). J Clin Endocrinol Metab 2011; 96(12): 3615–3627.
Crocetti U, Durante C, Attard M et al. Predictive value of recombinant human TSH stimulation and neck ultrasonography in differentiated thyroid cancer patients. Thyroid 2008; 18(10): 1049–1053.
Brassard M, Borget I, Edet-Sanson A et al. Long-term follow-up of patients with papillary and follicular thyroid cancer: a prospective study on 715 patients. J Clin Endocrinol Metab 2011; 96(5): 1352–1359.
Durante C, Montesano T, Attard M et al. Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation: is there a role for serum thyroglobulin measurement? J Clin Endocrinol Metab 2012; 97(8): 2748–2753.
Angell TE, Spencer CA, Rubino BD et al. In search of an unstimulated thyroglobulin baseline value in low-risk papillary thyroid carcinoma patients not receiving radioactive iodine ablation. Thyroid 2014; 24(7): 1127–1133.
Grani G, Fumarola A. Thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis of diagnostic accuracy. J Clin Endocrinol Metab 2014; 99: 1970–1982.
Torlontano M, Attard M, Crocetti U et al. Follow-up of low-risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases. J Clin Endocrinol Metab 2004; 89(7): 3402–3407.
Grani G, Lamartina L, Cantisani V et al. Interobserver agreement of various thyroid imaging reporting and data systems. Endocr Connect 2018; 7(1): 1–7.
Lamartina L, Grani G, Biffoni M et al. Risk stratification of neck lesions detected sonographically during the follow-up of differentiated thyroid cancer. J Clin Endocrinol Metab 2016; 101: 3036–3044.
Leboulleux S, Girard E, Rose M et al. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab 2007; 92(9): 3590–3594.
Leenhardt L, Erdogan MF, Hegedus L et al. 2013 European Thyroid Association guidelines for cervical ultrasound scan and ultrasoundguided techniques in the postoperative management of patients with thyroid cancer. Eur Thyroid J 2013; 2(3): 147–159.
Lamartina L, Deandreis D, Durante C, Filetti S. ENDOCRINE TUMOURS: imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach. Eur J Endocrinol 2016; 175(5): R185–R202.
Leboulleux S, Schroeder PR, Schlumberger M, Ladenson PW. The role of PET in follow-up of patients treated for differentiated epithelial thyroid cancers. Nat Rev Endocrinol 2007; 3(2): 112–121.
Robbins RJ, Wan Q, Grewal RK et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F] fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab 2006; 91(2): 498–505.
Nascimento C, Borget I, Al Ghuzlan A et al. Postoperative fluorine-18- fluorodeoxyglucose positron emission tomography/computed tomography: an important imaging modality in patients with aggressive histology of differentiated thyroid cancer. Thyroid 2015; 25(4): 437–444.
Deandreis D, Al Ghuzlan A, Leboulleux S et al. Do histological, immunohistochemical, and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer 2011; 18(1): 159–169.
Robbins RJ, Larson SM. The value of positron emission tomography (PET) in the management of patients with thyroid cancer. Best Pract Res Clin Endocrinol Metab 2008; 22(6): 1047–1059.
Terroir M, Borget I, Bidault F et al. The intensity of 18FDG uptake does not predict tumor growth in patients with metastatic differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2017; 44(4): 638–646.
Grani G, Ramundo V, Falcone R et al. Thyroid cancer patients with no evidence of disease: the need for repeat neck ultrasound. J Clin Endocrinol Metab 2019; 104(11): 4981–4989.
Tuttle RM, Tala H, Shah J et al. Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid 2010; 20(12): 1341–1349.
Durante C, Attard M, Torlontano M et al. Identification and optimal postsurgical follow-up of patients with very low-risk papillary thyroid microcarcinomas. J Clin Endocrinol Metab 2010; 95(11): 4882–4888.
Grani G, Lamartina L, Durante C et al. Follicular thyroid cancer and Hurthle cell carcinoma: challenges in diagnosis, treatment, and clinical management. Lancet Diabetes Endocrinol 2018; 6: 500–514
iyauchi A, Kudo T, Miya A et al. Prognostic impact of serum thyroglobulin doubling-time under thyrotropin suppression in patients with papillary thyroid carcinoma who underwent total thyroidectomy. Thyroid 2011; 21(7): 707–716
Meijer JA, le Cessie S, van den Hout WB et al. Calcitonin and carcinoembryonic antigen doubling times as prognostic factors in medullary thyroid carcinoma: a structured meta-analysis. Clin Endocrinol (Oxf) 2010; 72(4): 534–542.
Elisei R, Alevizaki M, Conte-Devolx B et al. 2012 European Thyroid Association guidelines for genetic testing and its clinical consequences in medullary thyroid cancer. Eur Thyroid J 2013; 1; 216–231.
Wells SA, Asa SL, Dralle H et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015; 25(6): 567–610.
Calcitonin A. Carcinoembryonic Antigen Doubling Time Calculator; https://www.thyroid.org/professionals/calculators/thyroid-cancer-carcinoma/ (12 June 2019, date last accessed).
Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2): 228–247.
Hadoux J, Pacini F, Tuttle RM, Schlumberger M. Management of advanced medullary thyroid cancer. Lancet Diabetes Endocrinol 2016; 4: 64–71.
Treglia G, Rufini V, Salvatori M et al. PET imaging in recurrent medullary thyroid carcinoma. Int J Mol Imaging 2012; 2012: 1.
155. Romero-Lluch AR, Cuenca-Cuenca JI, Guerrero-Va´zquez R et al. Diagnostic utility of PET/CT with 18F-DOPA and 18F-FDG in persistent or recurrent medullary thyroid carcinoma: the importance of calcitonin and carcinoembryonic antigen cutoff. Eur J Nucl Med Mol Imaging 2017; 44(12): 2004–2013
Bodei L, Handkiewicz-Junak D, Grana C et al. Receptor radionuclide therapy with 90Y-DOTATOC in patients with medullary thyroid carcinomas. Cancer Biother Radiopharm 2004; 19(1): 65–71.
Lee PK, Jarosek SL, Virnig BA, et al. Trends in the incidence and treatment of parathyroid cancer in the United States. Cancer. 2007;109(9):1736-1741.
Carpten JD, Robbins CM, Villablanca A, et al. HRPT2, encoding parafibromin, is mutated in hyperparathyroidism-jaw tumor syndrome. Nat Genet. 2002;32(4):676-680.
Cardoso L, Stevenson M, Thakker RV. Molecular genetics of syndromic and non-syndromic forms of parathyroid carcinoma. Hum Mutat. 2017;38(12):1621-1648.
Shattuck TM, Välimäki S, Obara T, et al. Somatic and germ-line mutations of the HRPT2 gene in sporadic parathyroid carcinoma. N Engl J Med. 2003;349(18):1722-1729.
Wilkins BJ, Lewis JS Jr. Non-functional parathyroid carcinoma: a review of the literature and report of a case requiring extensive surgery. Head Neck Pathol. 2009;3(2):140-149.
Rubin MR, Bilezikian JP, Birken S, et al. Human chorionic gonadotropin measurements in parathyroid carcinoma. Eur J Endocrinol. 2008;159(4):469-474.
Christakis I, Vu T, Chuang HH, et al. The diagnostic accuracy of neck ultrasound, 4D-computed tomographyand sestamibi imaging in parathyroid carcinoma. Eur J Radiol. 2017;95:82-88.
Carral F, Jiménez AI, Tomé M, et al. Safety and diagnostic performance of parathyroid hormone assay in fine-needle aspirate in suspicious parathyroid adenomas. Endocrinol Diabetes Nutr (Engl Ed). 2021;68(7):481-488
Shah KS, Ethunandan M. Tumour seeding after fine-needle aspiration and core biopsy of the head and neck–a systematic review. Br J Oral Maxillofac Surg. 2016;54(3):260-265.
Hu Y, Zhang X, Wang O, et al. The genomic profile of parathyroid carcinoma based on whole-genome sequencing. Int J Cancer. 2020;147(9):2446-2457.
Petranovic Ov cari cek P, Giovanella L, Carrió Gasset I, et al. The EANM practice guidelines for parathyroid imaging. Eur J Nucl Med Mol Imaging. 2021;48(9):2801-2822.
Erickson LA, Mete O, Juhlin CC, et al. Overview of the 2022 WHO classification of parathyroid tumors. Endocr Pathol. 2022;33(1):64-89.
International Agency for Research on Cancer. WHO Classification of Tumours. Endocrine tumours. 2022. Available at https:// tumourclassification.iarc.who.int/welcome/#. Accessed May 12, 2023.
Williams MD, DeLellis RA, Erickson LA, et al. Pathology data set for reporting parathyroid carcinoma and atypical parathyroid neoplasm: recommendations from the International Collaboration on Cancer Reporting. Hum Pathol. 2021; 110:73-82.
Erickson LA, Jin L, Papotti M, et al. Oxyphil parathyroid carcinomas: a clinicopathologic and immunohistochemical study of 10 cases. Am J Surg Pathol. 2002;26(3):344-349.
Nacamuli R, Rumore GJ, Clark G. Parathyroid carcinosarcoma: a previously unreported entity. Am Surg. 2002;68(10):900-903.
Cetani F, Banti C, Pardi E, et al. CDC73 mutational status and loss of parafibromin in the outcome of parathyroid cancer. Endocr Connect. 2013;2(4):186-195.
Pandya C, Uzilov AV, Bellizzi J, et al. Genomic profiling reveals mutational landscape in parathyroid carcinomas. JCI Insight. 2017;2(6): e92061.
Erickson LA, Mete O. Immunohistochemistry in diagnostic parathyroid pathology. Endocr Pathol. 2018;29(2):113-129.
Harari A, Waring A, Fernandez-Ranvier G, et al. Parathyroid carcinoma: a 43-year outcome and survival analysis. J Clin Endocrinol Metab. 2011;96(12):3679-3686.
Hundahl SA, Fleming ID, Fremgen AM, et al. Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985- 1995: a national cancer data base report. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1999;86(3):538-544.
Sadler C, Gow KW, Beierle EA, et al. Parathyroid carcinoma in more than 1000 patients: a population-level analysis. Surgery. 2014;156(6): 1622-1629.
Villar-del-Moral J, Jiménez-García A, Salvador-Egea P, et al. Prognostic factors and staging systems in parathyroid cancer: a multicenter cohort study. Surgery. 2014;156(5):1132-1144.
Sabra MM, Sherman EJ, Tuttle RM. Tumor volume doubling time of pulmonary metastases predicts overall survival and can guide the initiation of multikinase inhibitor therapy in patients with metastatic, follicular cell-derived thyroid carcinoma. Cancer 2017; 123(15): 2955–2964.
Haugen BR, Alexander EK, Bible KC et al. 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 2016; 26(1): 1–133.
Grani G, Lamartina L, Durante C et al. Follicular thyroid cancer and Hurthle cell carcinoma: challenges in diagnosis, treatment, and clinical management. Lancet Diabetes Endocrinol 2018; 6: 500–514.
Moon S, Song YS, Kim YA et al. Effects of coexistent BRAF(V600E) and TERT promoter mutations on poor clinical outcomes in papillary thyroid cancer: a meta-analysis. Thyroid 2017; 27(5): 651–660.
Vuong HG, Altibi AMA, Duong UNP, Hassell L. Prognostic implication of BRAF and TERT promoter mutation combination in papillary thyroid carcinoma-a meta-analysis. Clin Endocrinol (Oxf) 2017; 87(5): 411–417.
Laure Giraudet A, Al Ghulzan A, Aupe´rin A et al. Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times. Eur J Endocrinol 2008; 158(2): 239–24
Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2): 228–247.
