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Arquivos Brasileiros de Endocrinologia & Metabologia

Print version ISSN 0004-2730

Arq Bras Endocrinol Metab vol.51 no.5 São Paulo July 2007

http://dx.doi.org/10.1590/S0004-27302007000500001 

EDITORIAL

 

Thyroid cancer: past, present and future

 

 

James A. FaginI; Laura S. WardII; Edna T. KimuraIII

IDivision of Endocrinology, Memorial Sloan-Kettering Cancer Center, New York, NY
IIFaculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP
IIIDepartamento de Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP

 

 

OVER THE PAST DECADE we have witnessed important advances in our understanding of the pathogenesis of thyroid cancer, and in the approaches we use to diagnose and manage patients with the disease. Many of these have been the product of technological developments, which have given rise to both new opportunities and challenges. Take, for instance, the widespread use of cross-sectional imaging and the introduction of neck ultrasonography, which have improved the sensitivity for detection of thyroid cancer that is now often found incidentally as a result of imaging studies done for other indications. Consequently, this has led to the identification of many patients with microscopic papillary thyroid cancers of uncertain clinical significance. There are also new approaches for surveillance of patients with an established diagnosis of thyroid cancer, and their refinement is leading to the observation that many patients, previously thought to be cured, have evidence of minimal residual disease. Physicians taking care of patients with this disease now have to grapple with a new array of issues that directly affect decisions they make in their daily practice. This special issue of ABE&M on thyroid cancer is therefore particularly timely. Many of the most prominent Brazilian and international investigators and thought leaders working in this field provide updates on a wide spectrum of topics, including epidemiology, genetics, pathogenesis as well as surgical and clinical management of thyroid cancer. Breakthroughs arising from better understanding of the molecular genetics of thyroid cancer are now becoming relevant to the management of the disease, and it is increasingly important that clinicians understand them. This issue covers the most important aspects of thyroid cancer genetics, and how this applies to diagnosis, prognosis and treatment of patients with refractory disease. Indeed, development of targeted therapies results directly from the identification of the key oncogenic mutations that drive growth of thyroid cancer, and these will be reaching clinical practice in the very near future. Finally, the increasing complexity of issues affecting the management of patients with thyroid nodular disease and thyroid cancer requires that thought leaders reach consensus on guidelines for care. Also in this issue, a group of recognized Brazilian experts provide a comprehensive set of recommendations for care based on the evidence in the literature.

James A. FaginI; Laura S. WardII; Edna T. KimuraIII