Neoadjuvant therapy to improve resectability of advanced thyroid cancer: A real-world experience

Marika Russell; Matti L Gild; Lori J Wirth; Bruce Robinson; Amanda Silver Karcioglu; Ayaka Iwata; Tejas S Athni; Amr H Abdelhamid Ahmed; Gregory W Randolph

doi:10.1002/hed.27735

Neoadjuvant therapy to improve resectability of advanced thyroid cancer: A real-world experience

Head Neck. 2024 Mar 15. doi: 10.1002/hed.27735. Online ahead of print.

Authors

Marika Russell^{1

2}, Matti L Gild^{3

4

5}, Lori J Wirth⁶, Bruce Robinson^{3

4

5}, Amanda Silver Karcioglu^{1

2

7

8

9}, Ayaka Iwata^{1

2

10}, Tejas S Athni¹¹, Amr H Abdelhamid Ahmed^{1

2}, Gregory W Randolph^{1

2

12}

Affiliations

¹ Division of Thyroid and Parathyroid Endocrine Surgery, Harvard Medical School, Boston, Massachusetts, USA.
² Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia.
⁴ Cancer Genetics Laboratory, Kolling Institute of Medical Research, Sydney, Australia.
⁵ Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁶ Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁷ Division of Otolaryngology-Head and Neck Surgery, North Shore University HealthSystem, Evanston, Illinois, USA.
⁸ Department of Surgery, North Shore University HealthSystem, Evanston, Illinois, USA.
⁹ The University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California, USA.
¹¹ Harvard Medical School, Boston, Massachusetts, USA.
¹² Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 38488238
DOI: 10.1002/hed.27735

Abstract

Background: Experience with targeted neoadjuvant treatment for locoregionally advanced thyroid cancer is nascent.

Methods: Multicenter retrospective case series examining targeted neoadjuvant treatment for locoregionally advanced thyroid cancer. The primary outcome was change in surgical morbidity as measured by two metrics developed for use in clinical trials to characterize surgical complexity and morbidity. Secondary outcomes included percentage of patients proceeding to surgery and percentage receiving an R0/R1 resection.

Results: Seventeen patients with varied molecular alterations, pathologies, and treatment regimens were included. Mean surgical complexity scores decreased between time points for baseline and postneoadjuvant treatment, postneoadjuvant treatment and surgery, and between baseline and surgery. Eleven patients (64.7%) underwent surgical resection, with 10 (58.8%) receiving an R0/R1 resection.

Conclusions: Neoadjuvant treatment of advanced thyroid cancer improves resectability and decreases the morbidity of required surgical procedures. However, treatment is not uniformly effective.

Keywords: advanced thyroid cancer; morbidity; neoadjuvant; surgery.

Grants and funding

T32 GM144273/GM/NIGMS NIH HHS/United States