Endo-ERN webinar: Challenges in the management of non-metastatic thyroid carcinoma

On Thursday November 25th at 15:00 – 17:00 CET an Endo-ERN webinar with multiple speakers within the main thematic group of Thyroid is organised.

Program:

15.00-15.10 Non-metastatic thyroid carcinoma – how to define? – Jolanta Krajewska (endocrinologist)
15.10-15.15 Discussion
15.15-15.35 Difficulties in optimization of surgical treatment in differentiated thyroid carcinoma – Agnieszka Czarniecka (surgeon, endocrinologist)
15.35-15.40 Discussion
15.40-16.00 Borderline thyroid tumors – challenges in histopathological diagnosis – Ewa Chmielik (pathologist)
16.00-16.05 Discussion
16.05-16.25 Molecular markers – are they helpful in treatment-decision making? – Dagmara Rusinek (molecular biologist)
16.25-16.30 Discussion
16.35-16.55 Is postoperative radioiodine treatment necessary for all intermediate-risk patients? – Daria Handkiewicz-Junak (radiotherapist, medical oncologist, nuclear medicine specialist)
16.55-17.00 Discussion
17.00-17.10 Closing remarks – Barbara Jarzab (endocrinologist, nuclear medicine specialist)

Non-metastatic thyroid carcinoma is selected among rare thyroid diseases as a separate subthematic group within the Endo-ERN (European Reference Network on endocrine conditions). However, it is neither a clinical nor histopathological entity. On the contrary to metastatic thyroid carcinoma, which is the area of interest of EURACAN, the ERN for Rare Cancers involving mainly oncologists, non- metastatic thyroid carcinoma seems to be more endocrine disease. Although no clear definition of this term exists, it involves a heterogeneous group of patients with low, intermediate, and high-risk thyroid cancer.

Some crucial changes regarding diagnostics and treatment of thyroid carcinoma have been introduced in recent years, including a new WHO histopathological classification of thyroid tumors, which separated a group of borderline tumors of uncertain malignant potential. However, no changes in the guidelines recommending how to manage these patients followed WHO classification.

Moreover, we are still witnessing a vibrant discussion regarding the optimal treatment of thyroid cancer, particularly in low and intermediate-risk patients. Despite the crucial limitations in the extent of surgery proposed by the current ATA guidelines, the vast majority of patients, even with low-risk tumors, are still subjected to total thyroidectomy.

Similar controversies are related to postoperative radioiodine therapy. It is not recommended for low-risk patients, and it is definitely recommended for high-risk ones. However, the question arises if it is necessary for all intermediate-risk patients?

Molecular tumor profile, like in some other malignancies, may be helpful in the treatment-decision making. However, we still do not have reliable molecular markers which unequivocally influence our clinical management.

The webinar will be an attempt to summarize the issues given above or even, if possible, to answer some of these important clinical questions.

The speakers, deeply involved in thyroid cancer research, diagnostics, and treatment come from M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch in Gliwice, Poland, the biggest and comprehensive thyroid cancer center in Poland. The multidisciplinary team, led by Prof, Barbara Jarzab, includes surgeons, endocrinologists, nuclear medicine specialists, radiotherapists, medical oncologists, pathologists, psychologists, and nurses.