Advanced search

Vol 75, No 6 (2024)
Guidelines / Expert consensus
Published online: 2024-12-30

open access

View PDF (Polish) Download PDF file
Page views 898
Article views/downloads 566
Get Citation

Connect on Social Media

Connect on Social Media

The content of this article is also available in the following languages:
English

Diagnostics and treatment of differentiated thyroid carcinoma in children — Guidelines of the Polish National Scientific Societies, 2024 Update

Daria Handkiewicz-Junak1, Marek Niedziela2, Andrzej Lewiński3, Artur Bosowski4, Ewa Chmielik5, Agnieszka Czarniecka6, Marek Dedecjus7, Bożenna Dembowska-Bagińska8, Aneta Gawlik-Starzyk9, Wojciech Górecki10, Jerzy Harasymczuk11, Barbara Jarząb1, Jolanta Krajewska1, Aleksandra Kropińska1, Anna Kucharska12, Paweł Kurzawa13, Ewa Małecka-Tendera9, Przemysław Mańkowski14, Dariusz Polnik15, Lech Pomorski16, Andrzej Prokurat17, Anna Raciborska18, Renata Stawerska3, Anna Taczanowska-Niemczuk10, Magdalena Tarasińska8
DOI: 10.5603/ep.103845
Pubmed: 39829212
Endokrynol Pol 2024;75(6):565-591.

Abstract

The rapid progress made in recent years in thyroid cancer research has necessitated the systematic updating of current clinical recommendations. This update presents the evidence-based management of differentiated thyroid carcinoma (DTC) and medullary thyroid carcinoma in children, including preoperative diagnostics, surgical management, radioiodine therapy in DTC treatment with L-thyroxine, disease monitoring, treatment of advanced disease, and finally, consequences of thyroid cancer treatment. Each recommendation is evaluated regarding its strength (Strength of Recommendation; SoR) and the quality of supporting data (QoE — Quality of Evidence).

Keywords: differentiated thyroid cancerpapillary thyroid cancermedullary thyroid cancertotal thyroidectomythyroid lobectomyradioiodineL-thyroxine therapyguidelinesrecommendations

Article available in PDF format

View PDF (Polish) Download PDF file

References

  1. Jarząb B, Dedecjus M, Lewiński A, et al. Diagnosis and treatment of thyroid cancer in adult patients - Recommendations of Polish Scientific Societies and the National Oncological Strategy. 2022 Update [Diagnostyka i leczenie raka tarczycy u chorych dorosłych - Rekomendacje Polskich Towarzystw Naukowych oraz Narodowej Strategii Onkologicznej. Aktualizacja na rok 2022]. Endokrynol Pol. 2022; 73(2): 173–300.
    CrossRefPubMed
  2. Niedziela M, Handkiewicz-Junak D, Małecka-Tendera E, et al. Diagnostics and treatment of differentiated thyroid carcinoma in children - Guidelines of Polish National Societies. Endokrynol Pol. 2016; 67(6): 628–642.
    CrossRefPubMed
  3. Francis GL, Waguespack SG, Bauer AJ, et al. American Thyroid Association Guidelines Task Force. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2015; 25(7): 716–759.
    CrossRefPubMed
  4. Lebbink CA, Links TP, Czarniecka A, et al. 2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma. Eur Thyroid J. 2022; 11(6).
    CrossRefPubMed
  5. Bauer AJ, Wasserman JD, Waguespack SG. Pediatric thyroid cancer guidelines: challenges in stratifying care based on limited data. Eur Thyroid J. 2022; 11(6).
    CrossRefPubMed
  6. Burgers JS, Fervers B, Haugh M, et al. International assessment of the quality of clinical practice guidelines in oncology using the Appraisal of Guidelines and Research and Evaluation Instrument. J Clin Oncol. 2004; 22(10): 2000–2007.
    CrossRefPubMed
  7. Xie X, Wang Y, Li H. AGREE II for TCM: Tailored to evaluate methodological quality of TCM clinical practice guidelines. Front Pharmacol. 2022; 13: 1057920.
    CrossRefPubMed
  8. He Y, Li H, Wang K, et al. Fourteen years old as the best age cutoff to differentiate prepubertal from pubertal papillary thyroid carcinoma. Head Neck. 2023; 45(1): 85–94.
    CrossRefPubMed
  9. Kim SY, Yun HJ, Chang H, et al. Aggressiveness of Differentiated Thyroid Carcinoma in Pediatric Patients Younger Than 16 years: A Propensity Score-Matched Analysis. Front Oncol. 2022; 12: 872130.
    CrossRefPubMed
  10. Thiesmeyer JW, Egan CE, Greenberg JA, et al. Prepubertal Children with Papillary Thyroid Carcinoma Present with More Invasive Disease Than Adolescents and Young Adults. Thyroid. 2023; 33(2): 214–222.
    CrossRefPubMed
  11. Singh SS, Mittal BR, Sood A, et al. Applicability of Adults 2015 American Thyroid Association Differentiated Thyroid Cancer Guidelines for Postoperative Risk Stratification and Postradioiodine Treatment Dynamic Risk Stratification in Pediatric Population. World J Nucl Med. 2022; 21(2): 127–136.
    CrossRefPubMed
  12. Cheng S, Cheng R, Zhao S, et al. The impact of the initial operation of PTC in children on recurrence: 9-year experience in a single center. World J Surg Oncol. 2022; 20(1): 393.
    CrossRefPubMed
  13. Januś D, Wójcik M, Taczanowska A, et al. Follow-up of parenchymal changes in the thyroid gland with diffuse autoimmune thyroiditis in children prior to the development of papillary thyroid carcinoma. J Endocrinol Invest. 2019; 42(3): 261–270.
    CrossRefPubMed
  14. Martucci C, Crocoli A, De Pasquale MD, et al. Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors. Front Pediatr. 2022; 10: 914942.
    CrossRefPubMed
  15. Sandy JL, Titmuss A, Hameed S, et al. Thyroid nodules in children and adolescents: Investigation and management. J Paediatr Child Health. 2022; 58(12): 2163–2168.
    CrossRefPubMed
  16. Ștefan AI, Piciu A, Căinap SS, et al. Differentiated Thyroid Cancer in Children in the Last 20 Years: A Regional Study in Romania. J Clin Med. 2020; 9(11).
    CrossRefPubMed
  17. Yeker RM, Shaffer AD, Viswanathan P, et al. Chronic Lymphocytic Thyroiditis and Aggressiveness of Pediatric Differentiated Thyroid Cancer. Laryngoscope. 2022; 132(8): 1668–1674.
    CrossRefPubMed
  18. Kropinska A, Ledwon A, Paliczka Cieslik E, et al. Changing Clinical Presentation of Pediatric Differentiated Thyroid Cancer in Poland: A Retrospective Cohort Study Spanning 45 Years. Thyroid. 2024; 34(10): 1234–1245.
    CrossRefPubMed
  19. Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer. 2006; 13(2): 427–453.
    CrossRefPubMed
  20. Ben-Skowronek I, Sieniawska J, Pach E, et al. Thyroid Cancer Risk Factors in Children with Thyroid Nodules: A One-Center Study. J Clin Med. 2021; 10(19).
    CrossRefPubMed
  21. Man TK, Aubert G, Richard MA, et al. Short NK- and Naïve T-Cell Telomere Length Is Associated with Thyroid Cancer in Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev. 2022; 31(2): 453–460.
    CrossRefPubMed
  22. Suzuki G. Communicating with residents about 10 years of scientific progress in understanding thyroid cancer risk in children after the Fukushima Dai-ichi Nuclear Power Station accident. J Radiat Res. 2021; 62(Supplement_1): i7–ii14.
    CrossRefPubMed
  23. Heinzel A, Müller D, van Santen HM, et al. The effect of surveillance for differentiated thyroid carcinoma in childhood cancer survivors on survival rates: a decision-tree-based analysis. Endocr Connect. 2022; 11(12).
    CrossRefPubMed
  24. van der Tuin K, de Kock L, Kamping EJ, et al. Clinical and Molecular Characteristics May Alter Treatment Strategies of Thyroid Malignancies in DICER1 Syndrome. J Clin Endocrinol Metab. 2019; 104(2): 277–284.
    CrossRefPubMed
  25. Balinisteanu I, Panzaru MC, Caba L, et al. Cancer Predisposition Syndromes and Thyroid Cancer: Keys for a Short Two-Way Street. Biomedicines. 2023; 11(8).
    CrossRefPubMed
  26. Caroleo AM, De Ioris MA, Boccuto L, et al. DICER1 Syndrome and Cancer Predisposition: From a Rare Pediatric Tumor to Lifetime Risk. Front Oncol. 2020; 10: 614541.
    CrossRefPubMed
  27. Ghossein CA, Dogan S, Farhat N, et al. Expanding the spectrum of thyroid carcinoma with somatic DICER1 mutation: a survey of 829 thyroid carcinomas using MSK-IMPACT next-generation sequencing platform. Virchows Arch. 2022; 480(2): 293–302.
    CrossRefPubMed
  28. Ozolek JA. Selected Topics in the Pathology of the Thyroid and Parathyroid Glands in Children and Adolescents. Head Neck Pathol. 2021; 15(1): 85–106.
    CrossRefPubMed
  29. Rangel-Pozzo A, Sisdelli L, Cordioli MI, et al. Genetic Landscape of Papillary Thyroid Carcinoma and Nuclear Architecture: An Overview Comparing Pediatric and Adult Populations. Cancers (Basel). 2020; 12(11).
    CrossRefPubMed
  30. Ricarte-Filho JC, Halada S, O'Neill A, et al. The clinical aspect of NTRK-fusions in pediatric papillary thyroid cancer. Cancer Genet. 2022; 262-263: 57–63.
    CrossRefPubMed
  31. Cozzolino A, Filardi T, Simonelli I, et al. Diagnostic accuracy of ultrasonographic features in detecting thyroid cancer in the transition age: a meta-analysis. Eur Thyroid J. 2022; 11(3).
    CrossRefPubMed
  32. Al Juraibah F, Al Noaim K, AlDbas A, et al. Prevalence of thyroid nodules and characteristics of thyroid ultrasound in children with goiter: a single center experience. BMC Pediatr. 2022; 22(1): 642.
    CrossRefPubMed
  33. Niedziela M. Thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2014; 28(2): 245–277.
    CrossRefPubMed
  34. Januś D, Wójcik M, Taczanowska-Niemczuk A, et al. Ultrasound, laboratory and histopathological insights in diagnosing papillary thyroid carcinoma in a paediatric population: a single centre follow-up study between 2000-2022. Front Endocrinol (Lausanne). 2023; 14: 1170971.
    CrossRefPubMed
  35. Niedziela M, Breborowicz D, Trejster E, et al. Hot nodules in children and adolescents in western Poland from 1996 to 2000: clinical analysis of 31 patients. J Pediatr Endocrinol Metab. 2002; 15(6): 823–830.
    CrossRefPubMed
  36. Borysewicz-Sańczyk H, Sawicka B, Bossowski F, et al. Elastographic Evaluation of Thyroid Nodules in Children and Adolescents with Hashimoto's Thyroiditis and Nodular Goiter with Reference to Cytological and/or Histopathological Diagnosis. J Clin Med. 2022; 11(21).
    CrossRefPubMed
  37. Borysewicz-Sańczyk H, Sawicka B, Karny A, et al. Suspected Malignant Thyroid Nodules in Children and Adolescents According to Ultrasound Elastography and Ultrasound-Based Risk Stratification Systems-Experience from One Center. J Clin Med. 2022; 11(7).
    CrossRefPubMed
  38. Ali SZ, Baloch ZW, Cochand-Priollet B, et al. The 2023 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2023; 33(9): 1039–1044.
    CrossRefPubMed
  39. Heider A, Arnold S, Jing X. Bethesda System for Reporting Thyroid Cytopathology in Pediatric Thyroid Nodules: Experience of a Tertiary Care Referral Center. Arch Pathol Lab Med. 2020; 144(4): 473–477.
    CrossRefPubMed
  40. Vuong HG, Suzuki A, Na HY, et al. Application of the Bethesda System for Reporting Thyroid Cytopathology in the Pediatric Population. Am J Clin Pathol. 2021; 155(5): 680–689.
    CrossRefPubMed
  41. Hess JR, Van Tassel DC, Runyan CE, et al. Performance of ACR TI-RADS and the Bethesda System in Predicting Risk of Malignancy in Thyroid Nodules at a Large Children's Hospital and a Comprehensive Review of the Pediatric Literature. Cancers (Basel). 2023; 15(15).
    CrossRefPubMed
  42. Radebe L, van der Kaay DCM, Wasserman JD, et al. Predicting Malignancy in Pediatric Thyroid Nodules: Early Experience With Machine Learning for Clinical Decision Support. J Clin Endocrinol Metab. 2021; 106(12): e5236–e5246.
    CrossRefPubMed
  43. Guleria P, Srinivasan R, Rana C, et al. Molecular Landscape of Pediatric Thyroid Cancer: A Review. Diagnostics (Basel). 2022; 12(12).
    CrossRefPubMed
  44. Mitsutake N, Saenko V. Molecular pathogenesis of pediatric thyroid carcinoma. J Radiat Res. 2021; 62(Supplement_1): i71–i77.
    CrossRefPubMed
  45. Onder S, Mete O, Yilmaz I, et al. DICER1 Mutations Occur in More Than One-Third of Follicular-Patterned Pediatric Papillary Thyroid Carcinomas and Correlate with a Low-Risk Disease and Female Gender Predilection. Endocr Pathol. 2022; 33(4): 437–445.
    CrossRefPubMed
  46. Rogounovitch TI, Mankovskaya SV, Fridman MV, et al. Major Oncogenic Drivers and Their Clinicopathological Correlations in Sporadic Childhood Papillary Thyroid Carcinoma in Belarus. Cancers (Basel). 2021; 13(13).
    CrossRefPubMed
  47. Stenman A, Backman S, Johansson K, et al. Pan-genomic characterization of high-risk pediatric papillary thyroid carcinoma. Endocr Relat Cancer. 2021; 28(5): 337–351.
    CrossRefPubMed
  48. Li Y, Wang Y, Li L, et al. The clinical significance of BRAFV600E mutations in pediatric papillary thyroid carcinomas. Sci Rep. 2022; 12(1): 12674.
    CrossRefPubMed
  49. Cordioli MI, Moraes L, Cury AN, et al. Are we really at the dawn of understanding sporadic pediatric thyroid carcinoma? Endocr Relat Cancer. 2015; 22(6): R311–R324.
    CrossRefPubMed
  50. Gallant JN, Chen SC, Ortega CA, et al. Evaluation of the Molecular Landscape of Pediatric Thyroid Nodules and Use of a Multigene Genomic Classifier in Children. JAMA Oncol. 2022; 8(9): 1323–1327.
    CrossRefPubMed
  51. Niciporuka R, Nazarovs J, Ozolins A, et al. Can We Predict Differentiated Thyroid Cancer Behavior? Role of Genetic and Molecular Markers. Medicina (Kaunas). 2021; 57(10).
    CrossRefPubMed
  52. Paulson VA, Rudzinski ER, Hawkins DS. Thyroid Cancer in the Pediatric Population. Genes (Basel). 2019; 10(9).
    CrossRefPubMed
  53. Perreault S, Chami R, Deyell RJ, et al. Canadian Consensus for Biomarker Testing and Treatment of TRK Fusion Cancer in Pediatric Patients. Curr Oncol. 2021; 28(1): 346–366.
    CrossRefPubMed
  54. Seminati D, Ceola S, Pincelli AI, et al. The Complex Cyto-Molecular Landscape of Thyroid Nodules in Pediatrics. Cancers (Basel). 2023; 15(7).
    CrossRefPubMed
  55. WHO Classification of Tumours Editorial Board.
  56. Keane A, Bann DV, Wilson MN, et al. Pediatric Thyroid Cancer: To Whom Do You Send the Referral? Cancers (Basel). 2021; 13(17).
    CrossRefPubMed
  57. Sudoko CK, Jenks CM, Bauer AJ, et al. Thyroid Lobectomy for T1 Papillary Thyroid Carcinoma in Pediatric Patients. JAMA Otolaryngol Head Neck Surg. 2021; 147(11): 943–950.
    CrossRefPubMed
  58. Chernock RD, Rivera B, Borrelli N, et al. Poorly differentiated thyroid carcinoma of childhood and adolescence: a distinct entity characterized by DICER1 mutations. Mod Pathol. 2020; 33(7): 1264–1274.
    CrossRefPubMed
  59. Zeng X, Wang Z, Gui Z, et al. High Incidence of Distant Metastasis Is Associated With Histopathological Subtype of Pediatric Papillary Thyroid Cancer - a Retrospective Analysis Based on SEER. Front Endocrinol (Lausanne). 2021; 12: 760901.
    CrossRefPubMed
  60. Baran JA, Bauer AJ, Halada S, et al. Clinical Course of Early Postoperative Hypothyroidism Following Thyroid Lobectomy in Pediatrics. Thyroid. 2021; 31(12): 1786–1793.
    CrossRefPubMed
  61. Schneider R, Machens A, Sekulla C, et al. Recurrent Laryngeal Nerve Preservation Strategies in Pediatric Thyroid Oncology: Continuous vs. Intermittent Nerve Monitoring. Cancers (Basel). 2021; 13(17).
    CrossRefPubMed
  62. 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.
    CrossRefPubMed
  63. Ciancia S, van Rijn RR, Högler W, et al. Osteoporosis in children and adolescents: when to suspect and how to diagnose it. Eur J Pediatr. 2022; 181(7): 2549–2561.
    CrossRefPubMed
  64. Kowalska A, Walczyk A, Pałyga I, et al. The Delayed Risk Stratification System in the Risk of Differentiated Thyroid Cancer Recurrence. PLoS One. 2016; 11(4): e0153242.
    CrossRefPubMed
  65. Tuttle RM, Alzahrani AS. Risk Stratification in Differentiated Thyroid Cancer: From Detection to Final Follow-Up. J Clin Endocrinol Metab. 2019; 104(9): 4087–4100.
    CrossRefPubMed
  66. Banik GL, Shindo ML, Kraimer KL, et al. Prevalence and Risk Factors for Multifocality in Pediatric Thyroid Cancer. JAMA Otolaryngol Head Neck Surg. 2021; 147(12): 1100–1106.
    CrossRefPubMed
  67. Kim K, Kang SW, Lee J, et al. Clinical Implications of Age in Differentiated Thyroid Cancer: Comparison of Clinical Outcomes between Children and Young Adults. Int J Endocrinol. 2022; 2022: 7804612.
    CrossRefPubMed
  68. Liu Y, Wang S, Li Y, et al. Clinical Heterogeneity of Differentiated Thyroid Cancer between Children Less than 10 Years of Age and Those Older than 10 Years: A Retrospective Study of 70 Cases. Eur Thyroid J. 2021; 10(5): 364–371.
    CrossRefPubMed
  69. Sapuppo G, Hartl D, Fresneau B, et al. Differentiated Thyroid Cancer in Children and Adolescents: Long Term Outcome and Risk Factors for Persistent Disease. Cancers (Basel). 2021; 13(15).
    CrossRefPubMed
  70. Vaisman F, Tuttle RM. Clinical Assessment and Risk Stratification in Differentiated Thyroid Cancer. Endocrinol Metab Clin North Am. 2019; 48(1): 99–108.
    CrossRefPubMed
  71. Krajewska J, Chmielik E, Jarząb B. Dynamic risk stratification in the follow-up of thyroid cancer: what is still to be discovered in 2017? Endocr Relat Cancer. 2017; 24(11): R387–R402.
    CrossRefPubMed
  72. Candido MF, Medeiros M, Veronez LC, et al. Drugging Hijacked Kinase Pathways in Pediatric Oncology: Opportunities and Current Scenario. Pharmaceutics. 2023; 15(2).
    CrossRefPubMed
  73. Kim M, Kim BoH. Current Guidelines for Management of Medullary Thyroid Carcinoma. Endocrinol Metab (Seoul). 2021; 36(3): 514–524.
    CrossRefPubMed
  74. Matrone A, Gambale C, Prete A, et al. Sporadic Medullary Thyroid Carcinoma: Towards a Precision Medicine. Front Endocrinol (Lausanne). 2022; 13: 864253.
    CrossRefPubMed
  75. Kiriakopoulos A, Dimopoulou A, Nastos C, et al. Medullary thyroid carcinoma in children: current state of the art and future perspectives. J Pediatr Endocrinol Metab. 2022; 35(1): 1–10.
    CrossRefPubMed
  76. Wiench M, Wygoda Z, Gubala E, et al. Estimation of risk of inherited medullary thyroid carcinoma in apparent sporadic patients. J Clin Oncol. 2001; 19(5): 1374–1380.
    CrossRefPubMed
  77. Toledo RA, Hatakana R, Lourenço DM, et al. Comprehensive assessment of the disputed RET Y791F variant shows no association with medullary thyroid carcinoma susceptibility. Endocr Relat Cancer. 2015; 22(1): 65–76.
    CrossRefPubMed
  78. Gawlik T, d'Amico A, Szpak-Ulczok S, et al. The prognostic value of tumor markers doubling times in medullary thyroid carcinoma - preliminary report. Thyroid Res. 2010; 3(1): 10.
    CrossRefPubMed
  79. Califano I, Pitoia F, Chirico R, et al. Prospective study on the clinical relevance of F-DOPA positron emission tomography/computed tomography in patients with medullary thyroid carcinoma. Endocrine. 2022; 77(1): 143–150.
    CrossRefPubMed
  80. Hadoux J, Elisei R, Brose MS, et al. LIBRETTO-531 Trial Investigators. Phase 3 Trial of Selpercatinib in Advanced -Mutant Medullary Thyroid Cancer. N Engl J Med. 2023; 389(20): 1851–1861.
    CrossRefPubMed
  81. Pasqual E, Schonfeld S, Morton LM, et al. Association Between Radioactive Iodine Treatment for Pediatric and Young Adulthood Differentiated Thyroid Cancer and Risk of Second Primary Malignancies. J Clin Oncol. 2022; 40(13): 1439–1449.
    CrossRefPubMed
  82. Dong P, Wang Li, Huang R, et al. Bone marrow suppression in pediatric patients with differentiated thyroid cancer following empirical radioiodine therapy. Medicine (Baltimore). 2020; 99(31): e21398.
    CrossRefPubMed
  83. Devine KA, Christen S, Mulder RL, et al. International Guidelines Harmonization Group Psychological Late Effects Group. Recommendations for the surveillance of education and employment outcomes in survivors of childhood, adolescent, and young adult cancer: A report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Cancer. 2022; 128(13): 2405–2419.
    CrossRefPubMed
  84. Christen S, Roser K, Mulder RL, et al. IGHG psychological late effects group. Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. J Cancer Surviv. 2020; 14(6): 923–938.
    CrossRefPubMed
  85. You JiY, An SW, Kim HY, et al. Considerations for Balance Between Fundamental Treatment and Improvement of Quality of Life of Pediatric Thyroid Cancer Patient: Comparative Analysis With Adult Using Propensity Score Matching. Front Pediatr. 2022; 10: 840432.
    CrossRefPubMed
  86. Goldfarb M, Franco AT. Survivorship, Quality of Life, and Transition to Adult Care for Pediatric and Adolescent Thyroid Cancer Survivors. Thyroid. 2022; 32(12): 1471–1476.
    CrossRefPubMed
  87. Haddad R.I., Bischoff L., Salgado S.A. et al. NCCN Clinical Practice Guidelines in Oncology. Thyroid Carcinoma — Version 3.2024.
  88. Filetti S, Durante C, Hartl D, et al. ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019; 30(12): 1856–1883.
    CrossRefPubMed
  89. Filetti S, Durante C, Hartl DM, et al. ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer. Ann Oncol. 2022; 33(7): 674–684.
    CrossRefPubMed
  90. Momesso DP, Vaisman F, Yang SP, et al. Dynamic Risk Stratification in Patients with Differentiated Thyroid Cancer Treated Without Radioactive Iodine. J Clin Endocrinol Metab. 2016; 101(7): 2692–2700.
    CrossRefPubMed
  91. Wells SA, Asa SL, Dralle H, et al. American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015; 25(6): 567–610.
    CrossRefPubMed

About cookies

Necessary cookies

Allways active

These cookies are necessary for the proper display and operation of the website. Blocking them may cause the website to malfunction.

Analytical cookies

As part of our website, we use analytical tools, such as Google Analytics, that allow us to verify website traffic. These tools may require the use of cookies.

Community cookies

These are cookies associated with the social networks we use. Accepting them will allow us to associate your visit to the site with our social media profiles.

Marketing cookies

These are cookies responsible for carrying out advertising and marketing activities - consenting to their use will allow us to target you with advertisements based on your previous activities within our website.

Copyright © 2023-2025 Via Medica Regulations Cookie policy Privacy Statement Legal Note