covid
Buscar en
Revista Colombiana de Cancerología
Toda la web
Inicio Revista Colombiana de Cancerología Manejo multidisciplinario del cáncer diferenciado de tiroides en el Instituto N...
Información de la revista
Vol. 14. Núm. 2.
Páginas 65-77 (enero 2009)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 14. Núm. 2.
Páginas 65-77 (enero 2009)
Acceso a texto completo
Manejo multidisciplinario del cáncer diferenciado de tiroides en el Instituto Nacional de Cancerología
Differentiated Thyroid Cancer Multidisciplinary Management at the Colombian National Cancer Institute
Visitas
4591
Gloria Garavito1, Augusto Llamas Olier1,
Autor para correspondencia
allamas@cancer.gov.co

Correspondencia: Augusto Llamas Olier. Grupo de Medicina Nuclear, Instituto Nacional de Cancerología. Av. 1a No. 9-85. Tel.: 334 1122, exts: 5520 y 5521.
, Enrique Cadena1, Amelia De Los Reyes1, Gloria Hurtado1, Leonardo Rojas1, Alfredo Romero1, María Cristina Martínez1, Juan De Francisco1, María Consuelo Mejía1
1 Grupo de Tiroides, Instituto Nacional de Cancerología, Bogotá. Colombia
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen

El cáncer de la glándula tiroides es la enfermedad maligna más común del sistema endocrino. En 2006 se diagnosticaron 221 casos nuevos de cáncer en el Instituto Nacional de Cancerología: aproximadamente, el 4% de todos los casos nuevos de cáncer. La junta de manejo multidisciplinario del cáncer de tiroides del Instituto Nacional de Cancerología ha sesionado semanalmente desde 1994. En este artículo se ha condensado el conocimiento grupal, producto de muchos años de colaboración interdisciplinaria, donde la experiencia se ha combinado con la mejor evidencia disponible. Es el resultado de un proceso institucional de generación de conocimientos de 14 años de evolución.

Palabras clave:
neoplasias de la tiroides
tiroglobulina
radioisótopos de yodo
Abstract

Thyroid cancer is the most common malignant disease of the endocrine system. Two hundred and twenty-one new cases were diagnosed at the National Cancer Institute of Colombia (NCI) in 2006, roughly 4% of all new cancer cases. Weekly multidisciplinary decision-making meetings on thyroid cancer management have been held at the NCI since 1994. This article covers the body of knowledge gathered through 14 years of interdisciplinary collaboration where experience has been combined with the best available evidence.

Key words:
Thyroid neoplasms
thyroglobulin
iodine radioisotopes
El Texto completo está disponible en PDF
Referencias
[1.]
D.M. Parkin, F. Bray, J. Ferlay, P. Pisani.
Estimating the world cancer burd Globocan 2000.
Int J Cancer, 94 (2001), pp. 153-156
[2.]
Colombia, Ministerio de la Protección Social, Instituto Nacional de Cancerología.
Anuario Estadístico 2005.
Ministerio de la Protección Social, Instituto Nacional de Cancerología, (2006),
[3.]
P. Correa.
Pathology of endemic goiter.
Endemic goiter and endemic cretinism Iodine nutrition in health and disease,
[4.]
E. Otero, F. Martín.
Nódulos tiroideos.
Rev Fac Med, 38 (1972), pp. 66
[5.]
K.O. Franssila, H.R. Harach.
Occult papillary carcinoma of the thyroid in children and young adults. A systemic autopsy study in Finland.
Cancer, 58 (1986), pp. 715-719
[6.]
Tumours of the thyroid and parathyroid,
[7.]
R. Katoh, J. Sasaki, H. Kurihara, K. Suzuki, Y. Iida, A. Kawaoi.
Multiple thyroid involvement (intraglandular metastasis) in papillary thyroid carcinoma. A clinicopathologic study of 105 consecutive patients.
Cancer, 70 (1992), pp. 1585-1590
[8.]
F. Pacini, R. Elisei, M. Capezzone, P. Miccoli, E. Molinaro, F. Basolo, et al.
Contralateral papillary thyroid cancer is frequent at completion thyroidectomy with no difference in low- and high-risk patients.
Thyroid, 11 (2001), pp. 877-881
[9.]
E.S. Kim, T.Y. Kim, J.M. Koh, Y.I. Kim, S.J. Hong, W.B. Kim, et al.
Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation.
Clin Endocrinol, 61 (2004), pp. 145-148
[10.]
D.S. Cooper, G.M. Doherty, B.R. Haugen, R.T. Kloos, S.L. Lee, S.J. Mandel, et al.
Management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
Thyroid, 16 (2006), pp. 109-142
[11.]
S. Leboulleux, C. Rubino, E. Baudin, B. Caillou, D.M. Hartl, J.M. Bidart, et al.
Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis.
J Clin Endocrinol Metab, 90 (2005), pp. 5723-5729
[12.]
E.Y. Soh, O.H. Clark.
Surgical considerations and approach to thyroid cancer.
Endocrinol Metab Clin North Am, 25 (1996), pp. 115-139
[13.]
L.J. DeGroot, E.L. Kaplan, M. McCormick, F.H. Straus.
Natural history, treatment, and course of papillary thyroid carcinoma.
J Clin Endocrinol Metab, 71 (1990), pp. 414-424
[14.]
M.A. Kouvaraki, S.E. Shapiro, B.D. Fornage, B.S. Edeiken-Monro, S.I. Sherman, R. Vassilopoulou-Sellin, et al.
Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer.
Surgery, 134 (2003), pp. 946-954
[15.]
J.C. Watkinson, J.A. Franklyn, J.F. Olliff.
Detection and surgical treatment of cervical lymph nodes in differentiated thyroid cancer.
Thyroid, 16 (2006), pp. 187-194
[16.]
H.R. Tollefsen, J.J. Decosse.
Papillary Carcinoma of the Thyroid Recurrence in the Thyroid Gland after Initial Surgical Treatment.
Am J Surg, 106 (1963), pp. 728-734
[17.]
L.J. DeGroot, E.L. Kaplan.
Second operations for “completion” of thyroidectomy in treatment of differentiated thyroid cancer.
Surgery, 110 (1991), pp. 936-939
[18.]
A. Frasoldati, M. Pesenti, M. Gallo, A. Caroggio, D. Salvo, R. Valcavi.
Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma.
Cancer, 97 (2003), pp. 90-96
[19.]
E. Cadena, B. Martínez.
Manejo del cáncer tiroideo invasivo del tracto aerodigestivo alto.
Rev Col Cancerol, 8 (2004), pp. 13-20
[20.]
G.H. Jossart, O.H. Clark.
Well-differentiated thyroid cancer.
Curr Probl Surg, 31 (1994), pp. 933-1012
[21.]
M. Friedman.
Surgical management of thyroid carcinoma with laryngotracheal invasion.
Otolaryngol Clin North Am, 23 (1990), pp. 495-507
[22.]
T.J. Musholt, P.B. Musholt, M. Behrend, R. Raab, G.F. Scheumann, J. Klempnauer.
Invasive differentiated thyroid carcinoma: tracheal resection and reconstruction procedures in the hands of the endocrine surgeon.
Surgery, 126 (1999), pp. 1078-1087
[23.]
AJCC Cancer staging manual, 6th ed.,
[24.]
Sherman SI, Ball DW, Byrd D, Clark OH, Daniels GH, Dilawari RA, et al. Thyroid Carcinoma [Internet]. Practice Guidelines In Oncology 2008 [citado: 2009 feb]. Disponible en www.nccn.org.
[25.]
E.L. Mazzaferri, R.T. Kloos.
Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer.
J Clin Endocrinol Metab, 86 (2001), pp. 1447-1463
[26.]
G. Garavito.
Factores pronósticos para recaída en pacientes con cáncer papilar de tiroides.
Rev Col Cancerol, 9 (2005), pp. 21-30
[27.]
K.A. Heemstra, Y.Y. Liu, M. Stokkel, J. Kievit, E. Corssmit, A.M. Pereira, et al.
Serum thyroglobulin concentrations predict disease-free remission and death in differentiated thyroid carcinoma.
Clin Endocrinol, 66 (2007), pp. 58-64
[28.]
T.Y. Kim, W.B. Kim, E.S. Kim, J.S. Ryu, J.S. Yeo, S.C. Kim, et al.
Serum thyroglobulin levels at the time of 131I remnant ablation just after thyroidectomy are useful for early prediction of clinical recurrence in low-risk patients with differentiated thyroid carcinoma.
J Clin Endocrinol Metab, 90 (2005), pp. 1440-1445
[29.]
M. Luster, S.E. Clarke, M. Dietlein, M. Lassmann, P. Lind, W.J. Oyen, et al.
Guidelines for radioiodine therapy of differentiated thyroid cancer.
Eur J Nucl Med Mol Imaging, 35 (2008), pp. 1941-1959
[30.]
Silberstein EB, Alavi A, Balon HR, Becker DV, Brill DR, Clarke SEM, et al. Society of Nuclear Medicine Procedure Guideline for Therapy of Thyroid Disease with Iodine-131 (Sodium Iodide). Version 2.0. 2005.
[31.]
U.S. Nuclear Regulatory Commission. Model procedure for release of patients or human research subjects administered radioactive materials. Rev. 2nd ed; 2008.
[32.]
P.W. do Rosário, T.A. Fagundes, L.L. Rezende, E.L. Padrao, M.A.R. Borges, A.L. Barroso.
Assessing hypothyroidism in the preparation of patients with thyroid cancer: cardiovascular risk, renal function, drug metabolism, persistence of elevated thyroid-stimulating hormone and absence from work.
Endocrinologist, 16 (2006), pp. 25-29
[33.]
R.J. Robbins, R.M. Tuttle, R.N. Sharaf, S.M. Larson, H.K. Robbins, R.A. Ghossein, et al.
Preparation by recombinant human thyrotropin or thyroid hormone withdrawal are comparable for the detection of residual differentiated thyroid carcinoma.
J Clin Endocrinol Metab, 86 (2001), pp. 619-625
[34.]
D. Spencer.
Clinical utility of serum thyroglobulin measurement.
Curr Opin Endocrinol Diabetes, 9 (2002), pp. 401-406
[35.]
F. Pacini, P.W. Ladenson, M. Schlumberger, A. Driedger, M. Luster, R.T. Kloos, et al.
Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin in differentiated thyroid carcinoma: results of an international, randomized, controlled study.
J Clin Endocrinol Metab, 91 (2006), pp. 926-932
[36.]
D. Barbaro, G. Boni, G. Meucci, U. Simi, P. Lapi, P. Orsini, et al.
Radioiodine treatment with 30 mCi after recombinant human thyrotropin stimulation in thyroid cancer: effectiveness for postsurgical remnants ablation and possible role of iodine content in L-thyroxine in the outcome of ablation.
J Clin Endocrinol Metab, 88 (2003), pp. 4110-4115
[37.]
M.J. Schlumberger.
Papillary and follicular thyroid carcinoma.
N Engl J Med, 338 (1998), pp. 297-306
[38.]
D.S. Dean, I.D. Hay.
Prognostic indicators in differentiated thyroid carcinoma.
Cancer Control, 7 (2000), pp. 229-239
[39.]
A. Guana.
Protocolo de seguimiento en cáncer diferenciado de tiroides.
Universidad Nacional de Rosario, (2007),
[40.]
J. Jonklaas, N.J. Sarlis, D. Litofsky, K.B. Ain, S.T. Bigos, J.D. Brierley, et al.
Outcomes of patients with differentiated thyroid carcinoma following initial therapy.
Thyroid, 16 (2006), pp. 1229-1242
[41.]
G.C. Hovens, M.P. Stokkel, J. Kievit, E.P. Corssmit, A.M. Pereira, J.A. Romijn, et al.
Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer.
J Clin Endocrinol Metab, 92 (2007), pp. 2610-2615
[42.]
C. Spencer.
New insights for using serum thyroglobulin (Tg) measurement for managing patients with differentiated thyroid carcinomas.
Thyroid International, 4 (2003), pp. 1-14
[43.]
C.A. Spencer.
Challenges of serum thyroglobulin (Tg) measurement in the presence of Tg autoantibodies.
J Clin Endocrinol Metab, 89 (2004), pp. 3702-3704
[44.]
J.K. Chung, Y.J. Park, T.Y. Kim, Y. So, S.K. Kim, D.J. Park, et al.
Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation.
Clin Endocrinol, 57 (2002), pp. 215-221
[45.]
E.L. Mazzaferri.
Empirically treating high serum thyroglobulin levels.
J Nucl Med, 46 (2005), pp. 1079-1088
[46.]
C.A. Spencer, C.C. Wang.
Thyroglobulin measurement Techniques, clinical benefits, and pitfalls.
Endocrinol Metab Clin North Am, 24 (1995), pp. 841-863
[47.]
M. Schlumberger, G. Berg, O. Cohen, L. Duntas, F. Jamar, B. Jarzab, et al.
Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective.
Eur J Endocrinol, 150 (2004), pp. 105-112
[48.]
F. Pacini, L. Agate, R. Elisei, M. Capezzone, C. Ceccarelli, F. Lippi, et al.
Outcome of differentiated thyroid cancer with detectable serum Tg and negative diagnostic (131)I whole body scan: comparison of patients treated with high (131)I activities versus untreated patients.
J Clin Endocrinol Metab, 86 (2001), pp. 4092-4097
[49.]
E. Baudin, C. Do Cao, A.F. Cailleux, S. Leboulleux, J.P. Travagli, M. Schlumberger.
Positive predictive value of serum thyroglobulin levels, measured during the first year of follow-up after thyroid hormone withdrawal, in thyroid cancer patients.
J Clin Endocrinol Metab, 88 (2003), pp. 1107-1111
[50.]
R.T. Sutton, C.C. Reading, J.W. Charboneau, E.M. James, C.S. Grant, I.D. Hay.
US-guided biopsy of neck masses in postoperative management of patients with thyroid cancer.
Radiology, 168 (1988), pp. 769-772
[51.]
E.L. Mazzaferri, R.J. Robbins, C.A. Spencer, L.E. Braverman, F. Pacini, L. Wartofsky, et al.
A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma.
J Clin Endocrinol Metab, 88 (2003), pp. 1433-1441
[52.]
R.J. Robbins, J.T. Chon, M. Fleisher, S.M. Larson, R.M. Tuttle.
Is the serum thyroglobulin response to recombinant human thyrotropin sufficient, by itself, to monitor for residual thyroid carcinoma?.
J Clin Endocrinol Metab, 87 (2002), pp. 3242-3247
[53.]
D.M. Gor, J.E. Langer, L.A. Loevner.
Imaging of cervical lymph nodes in head and neck cancer: the basics.
Radiol Clin North Am, 44 (2006), pp. 101-110
[54.]
P.W. do Rosário, T.A. Fagundes, F.F. Maia, A.C. Franco, M.B. Figueiredo, S. Purisch.
Sonography in the diagnosis of cervical recurrence in patients with differentiated thyroid carcinoma.
J Ultrasound Med, 23 (2004), pp. 915-920
[55.]
T. Chikui, K. Yonetsu, T. Nakamura.
Multivariate feature analysis of sonographic findings of metastatic cervical lymph nodes: contribution of blood flow features revealed by power Doppler sonography for predicting metastasis.
AJNR Am J Neuroradiol, 21 (2000), pp. 561-567
[56.]
S. Leboulleux, E. Girard, M. Rose, J.P. Travagli, N. Sabbah, B. Caillou, et al.
Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer.
J Clin Endocrinol Metab, 92 (2007), pp. 3590-3594
[57.]
M.E. Kupferman, D.M. Patterson, S.J. Mandel, V. LiVolsi, R.S. Weber.
Safety of modified radical neck dissection for differentiated thyroid carcinoma.
Laryngoscope, 114 (2004), pp. 403-406
[58.]
S. Noguchi, H. Yamashita, N. Murakami, I. Nakayama, M. Toda, H. Kawamoto.
Small carcinomas of the thyroid. A long-term follow-up of 867 patients.
Arch Surg, 131 (1996), pp. 187-191
[59.]
M. Marchesi, M. Biffoni, F. Biancari, A. Berni, F.P. Campana.
Predictors of outcome for patients with differentiated and aggressive thyroid carcinoma.
Eur J Surg Suppl, (2003), pp. 46-50
[60.]
M. Graham, Y. Menda.
Positron emision tomography/computed tomography imaging of head and neck tumors: an atlas.
Semin Nucl Med, 35 (2005), pp. 220-252
Copyright © 2010. Instituto Nacional de Cancerología
Descargar PDF
Opciones de artículo