Shlomo Koyfman, MD

Shlomo Koyfman, MD, a radiation oncologist at the Cleveland Clinic, discusses registry data on thyroid cancer and how data from the registry can improve practice for oncologists.

Oncologists are beginning to think more about aggressive thyroid cancer and how histologies, such as tall cell and hobnail histologies, can recur locally and require multiple surgeries. In some cases, tumors cannot be surgically resected, and patients require radiation instead, says Koyfman.

At the 2019 American Society of Oncology (ASCO) Annual Meeting, an abstract on hobnail thyroid cancers was presented. Because hobnail is a more aggressive variant of thyroid cancer that does not respond well to radioactive iodine, a group of physicians at the Cleveland Clinic identified factors that contribute to recurrence and death in this patient population. They also identified which patients are considered high-risk and should be treated with radiation.

Koyfman states that this is a novel practice that will move the field in a good direction.

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Shlomo Koyfman, MD, discusses registry data on thyroid cancer and how data from the registry can improve practice for oncologists.

Rethinking the Treatment of Aggressive Thyroid Cancer

Shlomo Koyfman, MD, the director of head and neck and skin cancer radiation at Cleveland Clinic, discusses factors that are associated with the risk of recurrence and death in patients with papillary thyroid cancer (PTC) with hobnail morphology, an aggressive variant that has been associated with poorer outcomes.

Patients with the hobnail variant and other aggressive histologies often do not do as well as those with other forms of thyroid cancers, and local recurrences may be more likely in these patient populations. They often do not respond to therapy, require many more surgeries, or require radiation. Hobnail morphology, specifically, doesn&rsquo;t respond to standard radioactive iodine, so it is important to identify this population.

The Cleveland Clinic presented data at the 2019 ASCO Annual Meeting that demonstrated several factors that are potentially associated with recurrence and mortality in these patients with hobnail morphology. In their analysis of 45 patients with hobnail morphology, they found that age above 55 years old, clinical stage T3/T4 disease, and positive surgical margins were associated with inferior event-free survival rates.

Although researchers believe this is the largest reported investigation of this patient population, further analysis is necessary to validate these findings.

Shlomo Koyfman, MD, discusses factors that are associated with the risk of recurrence and death in patients with papillary thyroid cancer with hobnail morphology, an aggressive variant that has been associated with poorer outcomes.

Cleveland Clinic Investigates Recurrence in Aggressive Variants of Thyroid Cancer

Shlomo Koyfman, MD, associate staff, radiation oncology, Cleveland Clinic, discusses intensity-modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT) reirradiation for patients with head and neck cancer.

Shlomo Koyfman, MD | Authors

Articles

Rethinking the Treatment of Aggressive Thyroid Cancer

Cleveland Clinic Investigates Recurrence in Aggressive Variants of Thyroid Cancer

Evaluating IMRT and SBRT in Head and Neck Cancer