A study of variation in therapeutic approach to low-risk differentiated thyroid cancer in the UK

J Laryngol Otol. 2024 Jan;138(1):83-88. doi: 10.1017/S0022215123000841. Epub 2023 May 17.

Abstract

Background: The British Thyroid Association and American Thyroid Association guideline definitions for low-risk differentiated thyroid cancers are susceptible to differing interpretations, resulting in different clinical management in the UK.

Objective: To explore the national effect of these guidelines on the management of low-risk differentiated thyroid cancers.

Methods: Anonymised questionnaires were sent to multidisciplinary teams performing thyroidectomies in the UK. Risk factors that multidisciplinary teams considered important when managing low-risk differentiated thyroid cancers were established.

Results: Most surgeons (71 out of 75; 94.7 per cent) confirmed they were core multidisciplinary team members. More than 80 per cent of respondents performed at least 30 hemi- and/or total thyroidectomies per annum. A majority of multidisciplinary teams (50 out of 75; 66.7 per cent) followed British Thyroid Association guidelines. Risk factors considered important when managing low-risk differentiated thyroid cancers included: type of tumour histology findings (87.8 per cent), tumour size of greater than 4 cm (86.5 per cent), tumour stage T3b (85.1 per cent) and central neck node involvement (85.1 per cent). Extent of thyroid surgery (e.g. hemi- or total thyroidectomy) was highly variable for low-risk differentiated thyroid cancers.

Conclusion: Management of low-risk differentiated thyroid cancers is highly variable, leading to a heterogeneous patient experience.

Keywords: Thyroid neoplasms; risk; therapeutics; thyroidectomy.

MeSH terms

  • Adenocarcinoma*
  • Humans
  • Thyroid Neoplasms* / epidemiology
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy / methods
  • United Kingdom / epidemiology