Advances in Medical and Surgical Management of Thyroid Cancer

January 12, 2018 to January 13, 2018

Upon successful completion of the activity, participants should be better able to:

  • Discuss evidence-based practices and current guidelines for the management of thyroid nodules and cancer
  • Evaluate recent advances in imaging and surveillance in thyroid cancer
  • Discuss clinical decision-making and the latest evidence for surgical and systemic management of thyroid cancer

http://syllabus.aace.com/2018/Arizona_Advanced_Neck/content/Accreditation-Statement.html

Target Audience

This program is specifically designed for endocrine surgeons, ENT and head and neck surgeons; radiologists; thyroidologists and endocrinologists; nuclear medicine physicians; nurse practitioners, physician assistants and sonographers

Learning Objectives

  1. Highlight the role of pattern recognition for risk of malignancy assessment (TIRADS)
  2. Discuss current guidelines for nodule FNA
  3. Review management after initial evaluation/FNA
  4. Review the frequency of incidental thyroid nodules and cancers in the general population
  5. Management of micro-cancers – What we can learn from the south Korean experience
  6. Does observation strategy apply to USA? What are the possible cultural barriers?
  7. Discuss progress in understanding genetic basis of thyroid cancer
  8. Discuss diagnostic use of melocular markers for thyroid nodules
  9. Duscuss the use of molecular markers for thyroid cancer prognostication
  10. Be Aware of the current guidelines for imaging prior to thyroid cancer surgery
  11. Recognize the pre-operative ultrasonographic features of thyroid nodules and thyroid cancers that confer the higher probability of aggressive disease
  12. Understand the importance of comprehensive cervical ultrasound for lymph node mapping prior to primary and repeat thyroid cancer surgery
  13. Define the indications for total vs. partial thyroidectomy
  14. Define the indications for centra and lateral neck dissection, including difference between intial surgery for differentiated and medullary thyroid cancer
  15. Understand the relative benefits and risks of complications from surgery.
  16. Recognize ultrasound features that are suspicious
  17. Emphasize the importance of ultrasound detection of lymph nodes
  18. Discuss the potential role of molecular markers in surgical decision making
  19. Determine optimal initial surgery for thyroid cancer
  20. Understand how initial risk stratification is organized in the ATA guidelines
  21. Understand how the risk groups have changed from 2009 to 2015
  22. Understand how AJCC TNM (and other) staging symptons fit in with the ATA risk stratification
  23. Utilization of Tg in post operative management of DTC
  24. Understand relevance of Tg in post operative state and long term surveillance
  25. Review applicability of US in Management of DTC
  26. Understand true goals and purpose of radioactive iodine
  27. Understand who are candidates for radioactive iodine
  28. Understand when to stop and when to continue using repeated radioactive iodine doses
  29. Diagnosis of recurrent neck disease
  30. Method of neck re-operations
  31. Management of sequelae/complications
  32. Understand the role of observation versus surgery for limited recurrent well-differentiated thyroid cancer
  33. Utility and limitations and utility of radioactive iodine treatment of recurrent well-differentiated thyroid cancer
  34. Discuss the role of ultrasound and thyroglobulin in monitoring for recurrent thyroid cancer
  35. To reacquaint partipants with the basic concepts of dynamic risk stratification in the follow-up of differentiated thyroid cancer
  36. To evaluate the roles on contrasted CT scanning, 131 I total body scanning and RDG PET CT as supplements to neck imaging with high resolution US
  37. To use clinical cases to demonstrate the efficacy of each of these imaging modalities and how they complement high resolution neck US
  38. Describe the components of the consultation process for genetic syndrome evaluation and genetic testing
  39. Review genetic syndromes which include thyroid cancer, both differentiated and medullary thyropid cancers
  40. Understand the role of clinicians such as endocrinologists and surgeons in the evaluation of genetic syndromes
  41. Hereditary and Sporadic MTC
  42. Workup of patient and family
  43. Timing, prioritization and extent of surgery
  44. Discuss the effect of introduction of NIFTP on malignancy risk in indeterminate thyroid cytology
  45. Discuss the new WHO classification ot thyroid tumors
  46. Discuss challenges in cytological detection of thyroid cancer with low-grade morphology
  47. Understand definition of RAI refractory
  48. Understand who are candiditaes for TKIs
  49. Understand when to stop and when to continue suing repeated radioactive iodine doses
  50. Recognize the optimal initial evaluation/surgery and post treatment follow-up of medullary thyroid cancer
  51. Review features of high risk differentiated thyroid cancer
  52. Highlight the importance of appropriate imaging to detect aggressive or metastatic disease
  53. Discuss the role of localized therapy as well as TKIs in managing progressive/symptomatic disease
  54. To demonstrate available pathologies in real time
  55. Review the surgical levels of neck and a demonstration of how to perform lymph node mapping
  56. Demonstrate how to perform post operative surveillance in thyroidectomized subject.
  57. Understand what has changed in the 2015 guidelines regarding nodules
  58. Understand what has changed regading the extent of thyroid surgery
  59. Understand what has changed regarding radioactive Iodine
  60. To facilitate discussion between multi-disciplinary thyroid cancer experts
  61. Allow audience participation in the discussion of cases presented
  62. To highlight and incorporate salient recommendations into thyroid cancer management.
Additional information
Available for MOC Points?: 
No
Practice Area: 
Thyroid
Course summary
Available credit: 
  • 13.25 AMA
  • 13.25 Attendance
Course opens: 
01/12/2018
Course expires: 
01/13/2019
Event starts: 
01/12/2018 - 8:00am
Event ends: 
01/13/2018 - 5:30pm
Cost:
$0.00

Friday, January 12, 2018

7:00 - 7:50 AMREGISTRATION / BREAKFAST 
7:50 - 8:00 AMWelcome and Introduction 
8:00 - 8:45 AMThyroid Nodule Risk Stratification and Management 
Mark A. Lupo, MD, FACP, ECNU
Objectives:
  1. Highlight the role of pattern recognition for risk of malignancy assessment (TIRADS)
  2. Discuss current guidelines for nodule FNA
  3. Review management after initial evaluation/FNA
8:45 - 9:15 AMManagement of micro-nodules and micro-thyroid cancers: Is less more? 
Dev Abraham, MD, MRCP, FACE, ECNU
Objectives:
  1. Review the frequency of incidental thyroid nodules and cancers in the general population
  2. Management of micro-cancers – What we can learn from the south Korean experience
  3. Does observation strategy apply to USA? What are the possible cultural barriers?
9:15 - 10:00 AMUtilization of Molecular Markers 
Yuri Nikioforov, MD
No CME for this Session
Objectives:
  1. Discuss progress in understanding genetic basis of thyroid cancer
  2. Discuss diagnostic use of melocular markers for thyroid nodules
  3. Duscuss the use of molecular markers for thyroid cancer prognostication
10:00 - 10:30 AMCOFFEE BREAK & EXHIBITS 
10:30-11:00 AMPre-operative Ultrasound in Thyroid Cancer – More than Just Lymph Nodes 
Robert A Levine, MD, FACE, ECNU
Objectives:
  1. Be Aware of the current guidelines for imaging prior to thyroid cancer surgery
  2. Recognize the pre-operative ultrasonographic features of thyroid nodules and thyroid cancers that confer the higher probability of aggressive disease
  3. Understand the importance of comprehensive cervical ultrasound for lymph node mapping prior to primary and repeat thyroid cancer surgery
11:00 - 11:30 AMExtent of Initial Surgery for DTC 
Mira Milas, MD, FACE, ECNU
Objectives:
  1. Define the indications for total vs. partial thyroidectomy
  2. Define the indications for centra and lateral neck dissection, including difference between intial surgery for differentiated and medullary thyroid cancer
  3. Understand the relative benefits and risks of complications from surgery.
11:30 AM - 12:30 PMPanel discussion – Moderator: Mark Lupo, MD, FACE, ECNU 
Panel: Dev Abraham, MD, Bob Levine, MD, Mira Milas, MD
Objectives:
  1. Recognize ultrasound features that are suspicious
  2. Emphasize the importance of ultrasound detection of lymph nodes
  3. Discuss the potential role of molecular markers in surgical decision making
  4. Determine optimal initial surgery for thyroid cancer
12:30 – 1:30 PMLunch and Exhibits 
1:30 - 2:00 PMATA Initial Risk Stratifiction and updated AJCC TNM Staging 
Brian Kim, MD
Objectives:
  1. Understand how initial risk stratification is organized in the ATA guidelines
  2. Understand how the risk groups have changed from 2009 to 2015
  3. Understand how AJCC TNM (and other) staging symptons fit in with the ATA risk stratification
2:00 - 2:30 PMPost Op Surveillance: US and TG – Managing Cervical Nodes 
Daniel S Duick, MD
Objectives:
  1. Utilization of Tg in post operative management of DTC
  2. Understand relevance of Tg in post operative state and long term surveillance
  3. Review applicability of US in Management of DTC
2:30 - 3:00 PMRadioactive Iodine Therapy Considerations, including Post Op 
Mimi Hu, MD
Objectives:
  1. Understand true goals and purpose of radioactive iodine
  2. Understand who are candidates for radioactive iodine
  3. Understand when to stop and when to continue using repeated radioactive iodine doses
3:00 - 3:30 PMCOFFEE BREAK & EXHIBITS 
3:30 - 4:00 PMSurgery for Recurrent Cervical Disease – When, Where and How Much? 
Michael W. Yeh, MD, FACE 
Objectives:
  1. Diagnosis of recurrent neck disease
  2. Method of neck re-operations
  3. Management of sequelae/complications
4:00 - 5:00 PMPanel discussion – Moderator: Daniel S Duick, MD, FACP, MACE, ECNU 
Panel: Michael W. Yeh, MD: Mimi Hu, MD; Brian Kim, MD
Objectives:
  1. Understand the role of observation versus surgery for limited recurrent well-differentiated thyroid cancer
  2. Utility and limitations and utility of radioactive iodine treatment of recurrent well-differentiated thyroid cancer
  3. Discuss the role of ultrasound and thyroglobulin in monitoring for recurrent thyroid cancer
5:00 PMAdjourn for the day

Saturday, January 13, 2018

7:00 – 7:50 AMBreakfast and Exhibits
7:50 - 8:00 AMWelcome and Introduction
8:00 - 8:30 AMDynamic Risk Stratification in DTC: Imaging Beyond Ultrasound 
R. Mack Harrell, MD, FACP, FACE, ECNU
Objectives:
  1. To reacquaint partipants with the basic concepts of dynamic risk stratification in the follow-up of differentiated thyroid cancer
  2. To evaluate the roles on contrasted CT scanning, 131 I total body scanning and RDG PET CT as supplements to neck imaging with high resolution US
  3. To use clinical cases to demonstrate the efficacy of each of these imaging modalities and how they complement high resolution neck US
8:30 - 9:00 AMGenetic Syndromes 
Mira Milas, MD
Objectives:
  1. Describe the components of the consultation process for genetic syndrome evaluation and genetic testing
  2. Review genetic syndromes which include thyroid cancer, both differentiated and medullary thyropid cancers
  3. Understand the role of clinicians such as endocrinologists and surgeons in the evaluation of genetic syndromes
9:00 - 9:45 AMMTC – Diagnosis, Surgery and Follow up 
Michael W. Yeh, MD, FACE
Objectives:
  1. Hereditary and Sporadic MTC
  2. Workup of patient and family
  3. Timing, prioritization and extent of surgery
9:45 - 10:15 AMDilemmas in Cytopathology and Histopathology 
Yuri Nikioforov, MD
No CME for this Session
Objectives:
  1. Discuss the effect of introduction of NIFTP on malignancy risk in indeterminate thyroid cytology
  2. Discuss the new WHO classification ot thyroid tumors
  3. Discuss challenges in cytological detection of thyroid cancer with low-grade morphology
10:15 - 10:45 AMCOFFEE BREAK & EXHIBITS
10:45 - 11:30 AMMetastatic DTC/MTC – TKIs – When to Start and How to Monitor
Mimi Hu, MD
Objectives:
  1. Understand definition of RAI refractory
  2. Understand who are candiditaes for TKIs
  3. Understand when to stop and when to continue suing repeated radioactive iodine doses
11:30 AM – 12:30 PMPanel: Michael W Yeh, MD; Mimi Hu, MD 
Objectives:
  1. Recognize the optimal initial evaluation/surgery and post treatment follow-up of medullary thyroid cancer
  2. Review features of high risk differentiated thyroid cancer
  3. Highlight the importance of appropriate imaging to detect aggressive or metastatic disease
  4. Discuss the role of localized therapy as well as TKIs in managing progressive/symptomatic disease
12:30 - 1:30 PMLunch and Exhibits
1:30 - 5:30 PMLab and Lectures: Divide into 2 groups for lab and concurrent lectures
 GROUP 1:
1:30 - 3:15 PMLab with patients 
Lab Proctors: Dev Abraham, MD; Mark Lupo, MD; Mack Harrell, MD; Mira Milas, MD; Bob Levine, MD
Objectives:
  1. To demonstrate available pathologies in real time
  2. Review the surgical levels of neck and a demonstration of how to perform lymph node mapping
  3. Demonstrate how to perform post operative surveillance in thyroidectomized subject.
 GROUP 2:
1:30 – 2:00 PMATA Guidelines– Brian Kim, MD 
Objectives:
  1. Understand what has changed in the 2015 guidelines regarding nodules
  2. Understand what has changed regading the extent of thyroid surgery
  3. Understand what has changed regarding radioactive Iodine
2:00 – 3:15 PMHands on Mgmt Cases -
Moderator: Daniel S Duick, MD, FACP, MACP, ECNU
Case panels: Michael W Yeh, MD; Mimi Hu, MD; Brian Kim, MD 

Objectives:
  1. To facilitate discussion between multi-disciplinary thyroid cancer experts
  2. Allow audience participation in the discussion of cases presented
  3. To highlight and incorporate salient recommendations into thyroid cancer management.
3:15 – 3:45 PMbreak with exhibits
 GROUP 1:
3:45 - 4:15 PMATA Guidelines – Brian Kim, MD 
Objectives:
  1. Understand what has changed in the 2015 guidelines regarding nodules
  2. Understand what has changed regading the extent of thyroid surgery
  3. Understand what has changed regarding radioactive Iodine
4:15 - 5:30 PMHands on Mgmt Cases -
Moderator: Daniel S Duick, MD, FACP, MACP, ECNU
Cases : Michael Yeh, MD; Mimi Hu, MD; Brian Kim, MD
Panel - 

Objectives:
  1. To facilitate discussion between multi-disciplinary thyroid cancer experts
  2. Allow audience participation in the discussion of cases presented
  3. To highlight and incorporate salient recommendations into thyroid cancer management.
 GROUP 2:
3:45 - 5:30 PMLab with patients 
Lab Proctors: Dev Abraham, MD; Mark Lupo, MD; Mack Harrell, MD; Mira Milas, MD; Bob Levine, MD
Objectives:
  1. To demonstrate available pathologies in real time
  2. Review the surgical levels of neck and a demonstration of how to perform lymph node mapping
  3. Demonstrate how to perform post operative surveillance in thyroidectomized subject.
5:30 PMAdjourn
Phoenix, AZ
United States

*Devaprabu Abraham, MD, MRCP (UK), FACE, ECNU
Professor of Clinical Medicine (Clinical)
Adjunct Professor of Surgery and Pathology
Assistant Dean of Academic Affairs, School of Medicine
University of Utah
Salt Lake City, UT

* Daniel S. Duick, MD, FACP, MACE, ECNU
Program Co-Chair
Clinical Professor of Medicine
University of Arizona Health Sciences Center
Endocrinology Associates, PA
Phoenix, AZ

R. Mack Harrell, MD, FACP, FACE, ECNU
Co-Director, Medical Center for Integrative Endocrine surgery
Hollywood, Pembroke Pines, Weston and Boca Raton, Florida

Mimi Hu, MD
Associate Professor
Department of Endocrine Neoplasia and Hormonal Disorders
University of Texas M. D. Anderson Cancer Center
Houston, TX

Brian W Kim, MD
Chief, Division of Endocrinology, Diabetes and Metabolism
Director, Thyroid Cancer Program
Associate Professor of Medicine
Rush University Medical Center
Chicago, IL

Robert A. Levine, MD, FACE, ECNU
Adjunct Assistant Professor of Medicine
Geisel School of Medicine Dartmouth Medical School
Thyroid Center of New Hampshire
St. Joseph Hospital Endocrinology
Nashua NH

* Mark A. Lupo, MD, FACE, ECNU
Thyroid & Endocrine Center of Florida
Assistant Clinical Professor of Medicine
Florida State University, College of Medicine
Sarasota, Florida

Mira Milas, MD, FACS
Professor of Surgery
Chief, Section of Endocrine Surgery
University of Arizona College of Medicine
Banner University of Arizona medical Center
Phoenix AZ

Yuri Nikiforov, MD, PhD
Professor of Pathology
Vice Chair, Department of Pathology and Laboratory Medicine
Director, Division of Molecular and Genomic Pathology
University of Pittsburgh Medical Center
Pittsburgh, PA

Michael Yeh, MD, FACE
Professor of Surgery and Medicine
Chief, Section of Endocrine Surgery
UCLA David Geffen School of Medicine
Los Angeles, CA

*Indicates individual is also a member of the program committee

The American Association of Clinical Endocrinologists (AACE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Clinical Endocrinologists (AACE) designates this live activity for a maximum of 13.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity

Available Credit

  • 13.25 AMA
  • 13.25 Attendance

Accreditation Period

Course opens: 
01/12/2018
Course expires: 
01/13/2019

Price

Cost:
$0.00
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