Overall survival of patients with thyroid cancer in Martinique (2008-2018).

BACKGROUND: Thyroid cancer (TC) overall survival at 5 years was estimated at 97% in mainland France over 2010-2015. Its prognosis is known to be affected by patient age, tumor histology, size, and extension. This study aims to describe overall survival of thyroid cancer patients diagnosed between 2008 and 2018 in Martinique. METHODS: We included in this retrospective analytical study all patients who were diagnosed with thyroid cancer. An overall survival analysis at 1, 3 and 5 years of thyroid cancer patients diagnosed in Martinique from 2008 to 2018 was conducted. Prognostic factors associated with survival have been identified. Stage at diagnosis and patterns of care among thyroid cancer patients were analyzed. RESULTS: A total of 323 thyroid cancer patients were registered between 2008 and 2018. Papillary carcinomas represented 83% of diagnoses. Local stage or locally advanced invasion was found in 264 (88%) patients. 221 Multidisciplinary Teams reports files were reviewed. The overall survival observed in this population is 97% [93-99] at 1 year, 93% [88-97] at 3 years and 91% [85-95] at 5 years. Anaplastic, poorly differentiated and medullar tumors had lower survival rates at 5 years (39% [13-65]) compared to papillary tumors (93% [89-96]). We found that metastatic stage at diagnosis (HR = 3.1[1.3-7.6]; p = 0.01) and tumor size > 3 cm (HR = 2.7 [1.1-6.3]) were independent prognostic factors for OS in our population. CONCLUSIONS: The survival rates of thyroid cancer in Martinique are comparable to those observed in France.

Role of Dietary and Environmental Factors on Thyroid Cancer in Romania: A Brief Review.

Thyroid cancer is the most common endocrine tumor, accounting for about 1% of all human malignancies. There are environmental factors that can potentiate the onset of thyroid cancer, in particular pollutants, lifestyle or radiation exposure. Another major cause responsible for the appearance of thyroid cancer is the habitat in endemic areas where there is a deficit of iodine in the soil, drinking water and food. We operated using the PubMed database in order to find the articles of interest. After a wary review of the literature, we designated the relevant articles necessary for our study including various factors such as alimentation, effects of the Chernobyl fallout radiation and the iodine and vitamin D deficiency in Romania. The aim of this article is to make a correlation between the different environmental and dietary factors in Romania, and the increased incidence of thyroid cancer.

A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer.

Background: The American Thyroid Association (ATA), the European Association of Nuclear Medicine, the European Thyroid Association, and the Society of Nuclear Medicine and Molecular Imaging have established an intersocietal working group to address the current controversies and evolving concepts in thyroid cancer management and therapy. The working group annually identifies topics that may significantly impact clinical practice and publishes expert opinion articles reflecting intersocietal collaboration, consensus, and suggestions for further research to address these important management issues. Summary: In 2019, the intersocietal working group identified the following topics for review and interdisciplinary discussion: (i) perioperative risk stratification, (ii) the role of diagnostic radioactive iodine (RAI) imaging in initial staging, and (iii) indicators of response to RAI therapy. Conclusions: The intersocietal working group agreed that (i) initial patient management decisions should be guided by perioperative risk stratification that should include the eighth edition American Joint Committee on Cancer staging system to predict disease specific mortality, the modified 2009 ATA risk stratification system to estimate structural disease recurrence, with judicious incorporation of molecular theranostics to further refine management recommendations; (ii) diagnostic RAI scanning in ATA intermediate risk patients should be utilized selectively rather than being considered mandatory or not necessary for all patients in this category; and (iii) a consistent semiquantitative reporting system should be used for response evaluations after RAI therapy until a reproducible and clinically practical quantitative system is validated.

Controversies, Consensus, and Collaboration in the Use of 131I Therapy in Differentiated Thyroid Cancer: A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association.

BACKGROUND: Publication of the 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer was met with disagreement by the extended nuclear medicine community with regard to some of the recommendations related to the diagnostic and therapeutic use of radioiodine (131I). Because of these concerns, the European Association of Nuclear Medicine and the Society of Nuclear Medicine and Molecular Imaging declined to endorse the ATA guidelines. As a result of these differences in opinion, patients and clinicians risk receiving conflicting advice with regard to several key thyroid cancer management issues. SUMMARY: To address some of the differences in opinion and controversies associated with the therapeutic uses of 131I in differentiated thyroid cancer constructively, the ATA, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association each sent senior leadership and subject-matter experts to a two-day interactive meeting. The goals of this first meeting were to (i) formalize the dialogue and activities between the four societies; (ii) discuss indications for 131I adjuvant treatment; (iii) define the optimal prescribed activity of 131I for adjuvant treatment; and (iv) clarify the definition and classification of 131I-refractory thyroid cancer. CONCLUSION: By fostering an open, productive, and evidence-based discussion, the Martinique meeting restored trust, confidence, and a sense of collegiality between individuals and organizations that are committed to optimal thyroid disease management. The result of this first meeting is a set of nine principles (The Martinique Principles) that (i) describe a commitment to proactive, purposeful, and inclusive interdisciplinary cooperation; (ii) define the goals of 131I therapy as remnant ablation, adjuvant treatment, or treatment of known disease; (iii) describe the importance of evaluating postoperative disease status and multiple other factors beyond clinicopathologic staging in 131I therapy decision making; (iv) recognize that the optimal administered activity of 131I adjuvant treatment cannot be definitely determined from the published literature; and (v) acknowledge that current definitions of 131I-refractory disease are suboptimal and do not represent definitive criteria to mandate whether 131I therapy should be recommended.