The American Thyroid Association Guidelines: Do We All Agree?

Program Description: The theme of this audience interactive miniseminar is to incorporate what is new and controversial in the management of differentiated thyroid cancer as well as to examine the level that molecular biology is incorporated into the management of thyroid neoplasms. The American Thyroid Guidelines for differentiated thyroid cancer are a widely quoted document. The level of evidence on which these recommendations are made varies extensively leaving considerable room for debate. Some aspects of surgical management such as laryngoscopy, bronchoscopy, and neuro-monitoring are left out of the document. The moderator will provide a brief background power-point presentation on the pertinent ATA guideline as a template. Expert panelists will debate case presentations germane to the given guideline and determine the level of agreement. Audience interactive opinion will be sought. The specific guidelines (where applicable) and case presentations will include: 1) Ultrasound indications for fine needle aspiration and the use of molecular markers from the FNA; 2) Laryngoscopy and neuro-monitoring; 3) Extent of initial surgical therapy for low-risk differentiated thyroid neoplasms and the potential role for molecular markers; 4) Bronchoscopy, preparation for airway management and extent of surgery for high risk patients with extra-thyroidal spread; and 5) Surgery for recurrent differentiated thyroid cancer and the role of molecular targeted therapy. Panelists and the interactive audience will give opinions on the relevance of the ATA guidelines to their thyroid surgical practice. Educational Objectives: 1) Learn the benefits and limitations of the American Thyroid Association Guidelines. 2) Learn about molecular markers for diagnosis, prognostication, and molecular-targeted therapy. 3) Learn about ultrasound-guided FNA, management of low- and high-risk patients, and recurrence.