Download - The Hong Kong College of Otorhinolaryngologists

Books, Articles and Websites
Revised American Thyroid Association Management
Guidelines for Patients with Thyroid Nodules
and Differentiated Thyroid Cancer
http://www.liebertpub.com/products/product.aspxpid=55
Thyroid nodule is a common clinical condition that we encounter every now and
then. In North America, the prevalence of palpable thyroid nodules is 3% to 7%; the
prevalence is as high as 50% based on ultrasonography or autopsy data. While most
of them are benign, around 10% are malignant. The diagnostic capability has been
greatly improved by the use of fine needle aspiration cytology and the advent of high
resolution ultrasonography. Despite that, there are still a significant proportion of
patients who will require diagnostic lobectomy because of uncertain pre-operative
diagnosis. Controversies exist on the optimal diagnostic work up that can maximize
the yield of surgery without under-treating patients with malignant disease. Even
after the diagnosis of malignancy is confirmed, some other controversies exist on
the extent of surgery, post-operative adjuvant treatment and the follow up strategies.
Therefore, a well-accepted set of clinical guidelines is very welcome by practicing
clinicians.
In 1996, the American Thyroid Association (ATA) published treatment guidelines for patients with thyroid nodules
and thyroid cancer (Arch Intern Med 28;156:2165–2172). Later, because of the advances in the diagnosis and
therapy of both thyroid nodules and differentiated thyroid cancer, a task force was appointed by the ATA to update
the guidelines using principles of evidence-based medicine. Members of the taskforce included experts in thyroid
nodule and thyroid cancer management with representation by endocrinology, surgery, and nuclear medicine.
The recommendations made were linked to the levels of available evidence and they were published in 2006
(THYROID,Volume 16, Number 2, 2006).
Very recently, the ATA has published another update of the 2006 management guidelines. This final document was
approved by the ATA Board of Directors and endorsed by the American Association of Clinical Endocrinologists,
American College of Endocrinology, British Association of Head and Neck Oncologists, The Endocrine Society,
European Association for Cranio-Maxillo-Facial Surgery, EuropeanAssociation of Nuclear Medicine, European
Society of Endocrine Surgeons, European Society for Paediatric Endocrinology, International Association of
Endocrine Surgeons, and Latin American Thyroid Society.
This latest set of guidelines and 4 accompanying editorials are available and downloadable from the above website.
This is a very valuable resource and I hope you find it useful and interesting.
NG Siu Kwan
33
SENSES July 2010