Endocrine Abstracts

International best practice guidelines provide well-defined recommendations for the management of differentiated thyroid cancer (DTC) measuring ≤1 cm, >4 cm and for those with defined risk factors. However, the extent of surgery and requirement for radioiodine remnant ablation (RRA) are less clearly defined for tumours 1–4 cm in size. Guidelines recommend a ‘personalised decision making’ approach for this cohort, with therapeutic decisions based on patient preference, recurrence risk and multi-disciplinary discussion. This study aims to assess adherence to guidelines and investigate treatment patterns in the ‘personalised decision making’ cohort for thyroid cancers in an Irish tertiary referral centre. A random subset of 97 patients treated for DTC between 2009 and 2014 were assessed. Data were obtained from a prospectively maintained thyroid cancer database. 92 out of 97 patients (95%) were managed in accordance with guidelines (Table 1). Out of those whose management did not adhere to guidelines, three were over treated with total thyroidectomy, while two were under treated with lobectomy only. 28 patients (29%) had tumour characteristics requiring ‘personalised decision making’, of which 26 underwent total thyroidectomy rather than lobectomy. Similarly for RRA, 39 out of 41 patients (95%) in the ‘personalised decision making’ group were treated with radioactive iodine.

These data suggest that management of thyroid cancer at our institution closely adheres to guidelines, with a trend towards more aggressive management in those where personalised decision making is required.