Wouter Zandee

It was great to be able to elaborate on our new Dutch guideline for thyroid cancer!

Happy to find @eurojendo.bsky.social on Bluesky. A large part of my X addiction is journals. Hopefully this is a cure and more journals will follow.

Thyroid Lobectomy for Low‐Risk 1–4 CM Papillary Thyroid Cancer is not Associated with Increased Recurrence Rates in the Dutch Population with a Restricted Diagnostic Work‐Up Introduction The 2015 American Thyroid Association guidelines recommend to de-escalate treatment such as Thyroid lobectomy instead of total thyroidectomy for 1–4 cm papillary thyroid cancer (PTC). D...

So with a restrictive strategy the likelihood of finding a low-risk thyroid cancer is lower and endocrinologists should be aware of this in the diagnostic phase.
However, when after proper diagnostics low risk thyroid cancer is confirmed: a hemithyreoidectomy is still safe

doi.org/10.1007/s002...

Tumor size and presence of metastases in differentiated thyroid cancer: comparing cohorts from two countries AbstractObjective. Incidence of thyroid cancer varies widely, even across neighboring countries. Data on this phenomenon are largely lacking but are likely

A second study from the Erasmus MC comparing Germany and the Netherlands demostrated that the incidence of lymph node metastases is also higher in the remaining patients with thyroid cancer (don't forget the selection from the restrictive diagnostic strategy).

doi.org/10.1093/ejen...

With a restrictive diagnostic strategy the incidence of thyroid cancer in the NL is low, without an increase in thyroid cancer mortality.

But, the among the remaining patients the incidence of advanced tumors is higher (doi.org/10.1002/wjs....)

So let's make a start with Bluesky: are thyroid cancer guideline applicable for all countries?

ATA guidelines recommend a hemithyreodectomy for low risk thyroid cancer, however in the Netherlands we have a very restrictive diagnostic strategy for thyroid nodes.

Importance of Complete Pathology Reporting for Neuroendocrine Carcinoma: WHO Guidelines Are a Good Start but Not Enough - PubMed Implementation of the WHO 2010 guideline is associated with a significant increase in reporting parameters needed for classification. Stratification of patients is more reliable based on reports conta...

You adres an important issue. I performed an extensive review of pathology reports several years ago (pubmed.ncbi.nlm.nih.gov/31995804/). And a significant number of tumors with NED were named NEC or NET by non experts. Hope it’s better now.