American Thyroid Association: Presentations at 87th Annual Meeting Regarding Surgical and Alternative Treatments ATA Abstracts

October 13, 2017—The American Thyroid Association (ATA) will hold its 87^th Annual Meeting on October 18‒22, 2017, in Victoria, British Columbia. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns thyroid surgical and alternative treatments.

1. Mingbo Zhang of General Hospital of Chinese PLA in Beijing will present a clinical oral abstract entitled "Ultrasound-guided radiofrequency ablation of low-risk papillary thyroid microcarcinoma (PTMC): a prospective study on 421 " Y. Luo also participated in this study, which questioned whether surgery to such low-risk cancers might be overtreatment. However, rather than relying solely on active surveillance, minimally invasive treatment could be used to eliminate PTMC and reduce the tumor-related risk of growth and metastasis. The objective of this study was to evaluate the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) of low-risk PTMC on a large scale of patients with over 1-year follow-up. The ablation area exceeded the tumor edge to prevent marginal residue and recurrence.
   
   The result of the study was that RFA can indeed effectively eliminate low risk PTMC with a very small complication rate. Very low recurrent PTMC and cervical lymph nodes were detected, which could be treated by second RFA. RFA may be an alternative strategy for the treatment of low-risk PTMC, especially in patients with heavy mental burden. No distant metastasis was detected in the study patients and no major complications were encountered.
   
2. Raquel Villavicencio of the Indiana University School of Medicine in Indianapolis will present a poster describing the "Effects of Hypothyroidism on Surgical Outcomes." Cary N. Mariash of the same medical school also participated. They began with the hypothesis that, between hypothyroid surgery patients in the United States and other surgical patients, no differences would appear in lengths of hospital stay, deaths, or postoperative cardiac complications. They queried surgical databases for patients who underwent an operative procedure between January 1, 2010, and December 31, 2015.
   
   In contrast to the initial hypothesis, hypothyroidism is associated with a markedly increased length of hospital stay (14.4 versus 6.6 days). However, absolute incidence of hypotension, bradycardia, and hyponatremia did not significantly differ. The study was not sufficiently powered to discern differences in mortality or postoperative cardiac complications but does show that, even with modern techniques and anesthesia, a significant increased risk remains when operating on a hypothyroid patient.
   
3. Tanaz Vaghaiwalla of the Department of Surgery, University of Miami, will present a poster showing the influence of various socioeconomic and demographic factors on the decision to surgically manage patients with Graves' disease (GD). The study hypothesized that, while disease acuity and presentation ultimately determine management, demographic and socioeconomic factors may also affect access to treatment and influence the decision for surgical management. Vaghaiwalla examined the association of sociodemographic factors to emergency hospitalizations and the use of thyroidectomies for GD. She performed a cross-sectional analysis using the Nationwide Inpatient Sample (2006‒2011) to identify hospitalizations for GD, and univariate and logistic regression analyses to evaluate factors associated with the use of thyroidectomies during emergency and elective hospitalizations for GD.
   
   The conclusion of this study was that race, sex, income, and insurance status affect the rate of emergent hospitalizations for GD, and such factors may influence the use of Increased access to definitive care for GD may improve outcomes and reduce emergency healthcare utilization.
   
4. Megan Saucke of the University of Wisconsin in Madison will present a poster examining providers' views on active surveillance (AS) as an alternative to surgery for patients with papillary thyroid microcarcinomas (PTMC). Additional researchers from the same university worked on this study, entitled "Barriers and Facilitators of Active Surveillance: Informational and Emotional." Because data were lacking on attitudes and beliefs about the acceptability of this nonsurgical option, the researchers performed a mixed-methods study using semi-structured interviews and a survey of 12 endocrinologists and 12 surgeons who treat patients with They analyzed interview transcripts using content analysis.
   
   Providers' primary barriers to favoring AS as a management option included: worry about metastasis, fear of worse outcomes, the instinct to remove cancer, and reassurance provided by surgical removal. Providers believed these barriers were also significant to patients. Other barriers included the assumption that patients do not want AS, lack of resources to perform AS, ultrasound reliability, skepticism about data on AS, fear of patients not following up, expectation of surgery, and patients getting surgery elsewhere.
   
   Providers also described facilitators of patients' consideration of AS, including: physician recommendation, patients' fear of surgery, life circumstances, and desire to avoid thyroid hormone replacement.
   
   The study concluded that barriers to AS include practice limitations, but also patients' and providers' reactions to a cancer diagnosis and uncertainty about outcomes. Findings suggest that reassurance by providers and/or utilization of a decision-support tool may facilitate patients' consideration of AS.
   

The ATA will welcome authors from over 40 countries coming to present their unpublished thyroid research at the 87^th Annual Meeting of the American Thyroid Association in Victoria, BC, Canada. 2017 had a record breaking number of abstract submissions (up 10% from 2016). Forty-five oral abstracts and 457 posters will be presented from Thursday, October 19 through Saturday, October 21.

Over 228 of the abstracts submitted were from thyroid trainees (students, residents, and fellows). The top three rated trainee posters have been invited to present during the Highlighted Trainee Abstracts Short Oral session on Saturday, October 21 in addition to their poster display.  An additional 30 of top rated posters have been selected to participate in the 5^th Annual Trainee Poster Contest.

For the first time at an ATA Annual Meeting, the abstracts accepted for oral presentation will also be presented as iPosters. iPosters are large interactive posters displayed on high definition touch-screen monitors that will be displayed onsite. Attendees will be able to scroll through select abstracts, click on images to enlarge them, and watch and listen to video and audio files. For those unable to attend, iPosters will be available in an electronic poster gallery online after the meeting to increase the visibility of thyroid research and bring the wealth of science to those around the world.

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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94^th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

 The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology

• Annual scientific meetings
• Biennial clinical and research symposia
• Research grant programs for young investigators
• Support of online professional, public, and patient educational programs
• Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

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