UCSF’s Julie Ann Sosa, MD, co-led an international task force establishing new clinical guidelines for the management of differentiated thyroid cancer.
Differentiated thyroid cancer (DTC) is the most frequently diagnosed thyroid cancer in the U.S. Recently, the American Thyroid Association (ATA) released new practice guidelines for DTC to provide clinicians, patients, and researchers with a comprehensive and objective set of the latest management options for the disease.
Julie Ann Sosa, MD, MA, FACS, FSSO, the Leon Goldman MD Distinguished Professor of Surgery and Chair of the Department of Surgery at UCSF, served as co-chair of the ATA Differentiated Thyroid Cancer Guidelines Task Force, leading a diverse complement of stakeholders in developing revised clinical practice guidelines, which were originally published in 1996 and last updated a decade ago.
“The new guidelines bring important and significant evidence-based change to practice, highlighting the importance of patient-centered care, shared clinical decision-making between patients and their clinical teams and more personalized approaches to thyroid cancer management,” said Sosa.
The guidelines begin with an initial cancer diagnosis and continue with recommendations for staging and risk assessment; initial treatment decisions; assessment of treatment responses; monitoring approaches; diagnostic testing, and subsequent therapies based on the strength of evidence for response and consideration of side-effects and outcomes. Patient-reported outcomes, thyroid cancer survivorship, and areas of need for additional high-quality research are also reviewed in the guidelines.
DTC includes papillary, follicular, and oncocytic carcinomas, making up over 90% of all incident thyroid cancers. These cancers are typically slow-growing, and patients often achieve good long-term outcomes after treatment. While there have been significant advances in the diagnosis and treatment of DTC in the last 30 years, a lack of high-quality clinical trials for the disease have created uncertainty in some clinical management areas.
“The new guidelines are devised to enable providers individualized therapy for each patient based on the best application of clinical data to their unique case, said Sosa. “For example, a less aggressive approach might be recommended for individuals with early-stage DTC who have an excellent prognosis or for individuals at higher risk of side effects, while a more aggressive approach might be recommended for those patients with higher risk disease or those with inadequate response to initial therapy.”
UCSF Health’s thyroid cancer program is internationally known for its cutting-edge and collaborative care for patients with thyroid cancer, reflecting the transdisciplinary approach recommended in the guidelines to optimize clinical care and communication with the patient and between physicians. At UCSF, endocrinologists, thyroid cancer surgeons, pathologists, radiologists, medical and radiation oncologists, and genetics counselors, all of whom are thyroid cancer specialists working in tandem from diagnosis to treatment and follow up care. The program offers a full range of treatments for DTC, including surgery, active surveillance, radioactive iodine therapy, thyroid hormone therapy, percutaneous ablation, molecular testing, neoadjuvant and adjuvant small molecule therapies, and access to clinical trials. Leading edge science is conducted to allow our patients early access to novel approaches. When thyroidectomy (surgical removal of the thyroid gland) is recommended, high volume, experienced UCSF surgeons offer safe approaches to surgery that result in less discomfort and lower risk of complications, affording patients the best opportunity for optimized outcomes.
About the American Thyroid Association and the ATA Guidelines Task Force
The American Thyroid Association® (ATA) is dedicated to transforming thyroid care through clinical excellence, education, scientific discovery and advocacy in a collaborative and diverse community. ATA® is an international professional medical society with over 1,800 members from 43 countries around the world. The ATA® promotes thyroid awareness and information through Clinical Thyroidology®, a resource that summarizes research for patients and families, and extensive, authoritative resources on thyroid disease and thyroid cancer in both English and Spanish.
Sosa and the guidelines panel (including co-chair Matthew Ringel, MD, of Ohio State University) conducted systematic literature reviews to inform the recommendations and performed two additional systematic reviews. The guidelines panel had editorial independence from the ATA. Competing interests of task force members were pre-vetted, regularly updated, communicated with task force members, and assessed and managed by ATA leadership and the Clinical Practice Guidelines and Statements Committee.
About UCSF Health: UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies and pioneering research. It includes the flagship UCSF Medical Center, which is a top-ranked specialty hospital, as well as UCSF Benioff Children’s Hospitals, with campuses in San Francisco and Oakland; two community hospitals, UCSF Health St. Mary's and UCSF Health Saint Francis; Langley Porter Psychiatric Hospital and Clinics; UCSF Benioff Children’s Physicians; and the UCSF Faculty Practice. These hospitals serve as the academic medical center of the University of California, San Francisco, which is world-renowned for its graduate-level health sciences education and biomedical research. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. Visit http://www.ucsfhealth.org/. Follow UCSF Health on Facebook, Threads or LinkedIn.
