Thyroid cancer is the most frequent endocrine neoplasia, and its incidence has been increasing in the past few decades. Although most patients with thyroid cancer have a good outcome when treated with standard therapies, the prognosis for those with resistant or recurrent disease is poor. Owing to the lack of effective therapies for advanced, recurrent or metastatic thyroid cancer, the mortality associated with these conditions is higher than that of all other cancers of the endocrine system combined.
Management options for thyroid cancer include observation, surgery, radioiodine therapy and pharmacotherapy. Some controversies exist with regards to the optimal management approaches in patients with differing types of thyroid cancer. The origin and characteristics of thyroid cancers are important factors influencing disease progression and response to therapy. Therefore, novel findings on the etiology and pathophysiology of these neoplasms and the identification of new disease biomarkers are likely to substantially improve disease management and contribute to tailored therapeutic decisions. Research advances in the past decade have also uncovered additional therapeutic targets and new classes of drugs are becoming available and being tested in clinical trials.
The Nature Reviews Endocrinology Focus issue on thyroid cancer includes specially commissioned Reviews and opinion articles, written by leading experts in the field of thyroid cancer research and clinical practice. The Focus issue provides an overview of the pathophysiology of thyroid cancer and current and future clinical management strategies. This collection of articles will be a welcome resource to researchers and practitioners alike.
An NPG library of relevant Research Highlights, News & Views, Reviews and Original Research is also provided.
RESEARCH HIGHLIGHTS
Cancer: Reduced serum VEGF-D levels in metastatic differentiated thyroid cancer
Andy McLarnon
doi:10.1038/nrendo.2011.144
Nature Reviews Endocrinology 7, 560 (2011)
Thyroid cancer: Delayed risk stratification in differentiated thyroid cancer
Linda Koch
doi:10.1038/nrendo.2011.131
Nature Reviews Endocrinology 7, 560 (2011)
NEWS & VIEWS
Thyroid cancer: Finding the malignant thyroid nodule in the haystack
Kristien Boelaert & Christopher J. McCabe
doi:10.1038/nrendo.2011.152
Nature Reviews Endocrinology 7, 563-564 (2011)
REVIEWS
Molecular genetics and diagnosis of thyroid cancer
Yuri E. Nikiforov & Marina N. Nikiforova
doi:10.1038/nrendo.2011.142
Nature Reviews Endocrinology 7, 569-580 (2011)
Knowledge of genetic alterations occurring in thyroid cancer has rapidly expanded in the past decade. This Review discusses genetic alterations in follicular cell-derived thyroid cancers and outlines new insights into thyroid cancer etiology; in addition, the article describes how mutational markers can be used to improve cancer diagnosis and prognostication.
Advances in surgical therapy for thyroid cancer
Haggi Mazeh & Herbert Chen
doi:10.1038/nrendo.2011.140
Nature Reviews Endocrinology 7, 581-588 (2011)
Thyroid cancer is the most common malignancy of the endocrine system and well-differentiated thyroid cancers (DTCs) represent >90% of thyroid malignancies. This Review outlines the current surgical management of DTC and provides an overview of the controversies surrounding the optimal surgical scheme. The recent advances in thyroid surgery, the arguments for and against each surgical approach, and the authors’ personal opinions are also presented.
Radioiodine for remnant ablation and therapy of metastatic disease
Christoph Reiners, Heribert Hänscheid, Markus Luster, Michael Lassmann & Frederik A. Verburg
doi:10.1038/nrendo.2011.134
Nature Reviews Endocrinology 7, 589-595 (2011)
Many questions remain about the efficacy of radioiodine treatment for thyroid remnant ablation and therapy of advanced differentiated thyroid cancer. This Review intends to answer some of these questions taking into account novel insights into the treatment and (re)staging of patients with metastatic disease.
Management of medullary thyroid carcinoma and MEN2 syndromes in childhood
Steven G. Waguespack, Thereasa A. Rich, Nancy D. Perrier, Camilo Jimenez & Gilbert J. Cote
doi:10.1038/nrendo.2011.139
Nature Reviews Endocrinology 7, 596-607 (2011)
Medullary thyroid carcinoma is a rare endocrine malignancy that, when diagnosed during childhood, is almost always associated with multiple endocrine neoplasia type 2 and a germline mutation in the RET proto-oncogene. This Review discusses a contemporary approach to the diagnosis and treatment of medullary thyroid carcinoma and multiple endocrine neoplasia type 2 syndromes in the pediatric population.
Thyroid cancer stem cells
Reigh-Yi Lin
doi:10.1038/nrendo.2011.127
Nature Reviews Endocrinology 7, 609-616 (2011)
The cellular origin of thyroid cancer has not been fully elucidated. The author of this Review discusses the different mechanisms by which thyroid cancer stem cells might contribute to the development of thyroid cancer and the potential of stem-cell-based diagnostic and therapeutic strategies to improve the management of patients with thyroid cancer.
Multikinase inhibitors: a new option for the treatment of thyroid cancer
Matti L. Gild, Martyn Bullock, Bruce G. Robinson & Roderick Clifton-Bligh
doi:10.1038/nrendo.2011.141
Nature Reviews Endocrinology 7, 617-624 (2011)
Preclinical models have shown that inhibition of kinases in mitogenic and angiogenic signaling pathways can have antitumoral effects. Starting with a brief synopsis of a malignancy that responds well to kinase inhibition (chronic myeloid leukemia) compared with one with less durable responses as yet (melanoma), this Review highlights challenges that must be overcome in order to successfully translate small-molecule therapies to thyroid cancer in the future.
PERSPECTIVE
Treatment and follow-up of low-risk patients with thyroid cancer
Martin Schlumberger, Isabelle Borget, Camila Nascimento, Maryse Brassard & Sophie Leboulleux
doi:10.1038/nrendo.2011.133
Nature Reviews Endocrinology 7, 625-628 (2011)
This Perspectives re-evaluates the role of radioiodine treatment following surgery in low-risk patients with undetectable serum thyroglobulin levels after TSH stimulation and without evidence of disease. Moreover, the authors discuss the methods used for preparing low-risk patients for the administration of radioiodine after surgery and the activity of radioiodine that should be administered.
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