ATA Guidelines & Hemithyroidectomy for Pediatric Thyroid Cancer with Dr. Rastatter

We are honored to have Dr. Jeffrey Rastatter present "The 2015 ATA Guidelines & Trends in Hemithyroidectomy Utilization for Pediatric Thyroid Cancer." Dr. Andrew Bauer joins as the featured expert discussant. 0:00 Webinar 3:12 Dr. Rastatter presents 18:28 Trends in Surgical Approach Dr. Rastatter reveals an increasing trend in the proportion of patients receiving hemithyroidectomies as compared to total thyroidectomies in the past decade. Causal impact analysis models predicted hemithyroidectomy rates from 2008-2018, and after the 2015 ATA guidelines for hemithyroidectomy utilization in differentiated pediatric thyroid cancer were issued, significantly higher hemithyroidectomy rates were seen indicating greater physician willingness for the surgery. 24:35 Dr. Bauer presents 32:04 Added Risk of Metastasis Dr. Bauer presents Recommendation 11 of the 2015 ATA guidelines which suggests pediatric patients with papillary thyroid cancer should be considered for total thyroidectomies. The clinical-oncological risks that most support these preventative measures included the risk of developing bilateral disease, regional metastases, and pulmonary metastases which were found in 30-46%, 30-80%, and 10-20% of patients, respectively. 37:30 Risk Factors: Bilateral PTC in Kids Dr. Bauer discusses an overview of risk factors that need to be considered to determine the likelihood of bilateral disease in pediatric thyroid cancer. Beyond the most common factor being multifocal disease (found via ultrasound and histopathology), he underscores the importance of studying tumor size, extrathyroidal extension, lymphatic invasion/vascular invasion, N1 disease, and extranodal extension. 46:55 Discussion with Q&A ** Check out our other programs! ** The THANC Guide https://thancguide.org/ TIRO: Thyroid Int'l Recommendations Online https://tiro.expert/ ** Follow us on Twitter! ** @thancfoundation - https://shorturl.at/puwS0 THANC on FB - https://shorturl.at/svNY4