AACE Advances in Medical and Surgical Management of Thyroid Cancer

FRIDAY, JANUARY 23, 2015
7:00-7:30 a.m. Registration and Continental Breakfast with Exhibits
AM Moderator: Daniel S. Duick, MD, FACP, MACE, ECNU
7:30-8:00 a.m. Overview and Epidemiology of Thyroid Cancer
Daniel S. Duick, MD, FACP, MACE, ECNU
Objectives:
  1. Discuss the increasing prevalence of DTC
  2. Identify selection bias and potential concern of over-diagnosis
  3. Emerging biomarker utility in diagnosis and treatment
  4. New options for advanced cancer treatment
8:00-8:30 a.m. The Microcancer Conundrum
Robert A. Levine, MD, FACE, ECNU
Objectives:
  1. Define papillary microcancer
  2. Review morbidity/mortality of microcancer
  3. Discuss observation versus intervention
8:30-9:00 a.m. Utility of FNA derived Molecular Biomarkers for the Analysis and Disposition of Indeterminate Thyroid Nodule Management and Surgical Selection
Mark Lupo, MD, FACE, ECNU
Objectives:
  1. Review ultrasound imaging characteristics for assessment of risk of malignancy in thyroid nodules.
  2. Discuss current guidelines for UGFNA of thyroid nodules.
  3. Consider other clinical factors in making decisions regarding performing biopsy of nodules.
9:00-9:45 a.m. Cytologically Indeterminate Thyroid Nodule Evaluation
Jennifer Sipos, MD
Objectives:
  1. Discuss the risk of malignancy in indeterminate cytology
  2. Review clinical/imaging considerations
  3. Summarize diagnostic utility of the currently available FNA derived molecular markers
9:45-10:15 a.m. Coffee Break and Exhibits
10:15-11:00 a.m. Molecular Pathways in the Development of Differentiated Thyroid Cancer
Michael Mingzhao Xing, MD, PhD
Objectives:
  1. To provide an overview of molecular pathways involved in thyroid cancer.
  2. To discuss the implication of molecular markers in thyroid fine needle aspiration (FNA) samples in surgical and I-131 planning.
  3. To discuss the prognostic utility of specific molecular markers for management of patients with thyroid cancer
11:00 -11:45 a.m. Preoperative Ultrasound and Primary Surgery for DTC
Martha Zeiger, MD, FACS, FACE
Objectives:
  1. Review the appropriate extent of initial surgery for thyroid cancer and considerations in this surgical decision-making.
  2. To demonstrate how pre-operative US is useful in guiding primary surgery for thyroid cancer.
  3. To illustrate challenging patient case scenarios.
11:45 a.m. -12:30 p.m. US and FNA Cases
Moderator: Mark Lupo, MD, FACE, ECNU
Panel: Robert A. Levine, MD, FACE, ECNU: Jennifer Sipos, MD; Martha Zeiger, MD, FACS, FACE; Daniel S. Duick, MD, FACP, MACE, ECNU; Michael Mingzhao Xing, MD, PhD
Objectives:
  1. Understand appropriate selection of nodule for FNA.
  2. Discuss implications of FNA molecular marker results.
  3. Highlight importance of pre-operative ultrasound.
12:30-1:30 p.m. Lunch Break - Visit Exhibits
PM Moderator: Mark Lupo, MD, FACE, ECNU
1:30-2:15 p.m. Intraoperative and Postoperative Management of Complications
Ashok R. Shaha, MD, FACS
Objectives:
  1. Review intraoperative complications
  2. Discuss RLN monitoring
  3. Explore options of parathyroid function preservation and management of postoperative hypocalcemia.
  4. 4. Identify patients with spinal accessory nerve damage.
2:15-2:45 p.m. Update in Thyroglobulin Testing for the Surveillance of DTC
Devaprabu Abraham, MD, MRCP, ECNU
Objectives:
  1. Review role of Tg in pre/post-operative management
  2. Compare available Tg assays
  3. What to do when the lab changes assay (re-baseline, etc)
  4. Discuss management of Tg-Ab positive patients
  5. With highly sensitive assays, what is the role of stim-Tg?
2:45-3:30 p.m. I-131 Ablation and Adjunctive Therapy of DTC
Leonard Wartofsky, MD, MPH, MACP
Objectives:
  1. Rationale and regimens for I -131 ablation and adjunctive therapy of DTC.
  2. To describe the differences between RAI ablation and RAI as adjuvant therapy.
  3. To describe the proper selection of patients for ablation and/or adjuvant therapy.
  4. To describe the proper method of preparation for RAI ablation and/or adjuvant therapy.
3:30-4:00 p.m. Coffee Break and Exhibits
4:00-4:45 p.m. Evaluation and Surgical Management of Recurrent/Persistent DTC and MTC; and Advancing, Structurally Invasive Thyroid Cancer
Ashok R. Shaha, MD, FACS
Objectives:
  1. Understand the indications for surgical reintervention in patients with recurrent DTC.
  2. Describe the surgical management for recurrent DTC.
  3. Describe the imaging modalities used in patients with recurrent DTC.
4:45-5:30 p.m. Cases: Local/Regional Recurrent DTC and MTC
Moderator:Robert A. Levine, MD, FACE, ECNU
Panel:Jennifer Sipos, MD; Ashok R. Shaha, MD, FACS; Leonard Wartofsky, MD, MPH, MACP; Mark Lupo, MD,FACE,ECNU Martha Zeiger, MD, FACS, FACE; Devaprabu Abraham, MD, MRCP, ECNU
Objectives:
  1. Understand role of surgery and I-131 for local/regional, persistent/recurrent disease.
  2. Understand utility of imaging for persistent, recurrent disease.
  3. Understand utility of thyroglobulin (Tg) in the management of DTC
5:30 p.m. Adjourn for day
6:30 p.m.-9:00 p.m. ONYX DINNER PROGRAM
SATURDAY, JANUARY 24, 2015
7:00-7:30 a.m. Continental Breakfast and Exhibits
AM Moderator: Robert A. Levine, MD, FACE, ECNU
7:30-8:30 a.m. Current Management for Low, Medium and High Risk DTC
Michael Tuttle, MD
Objectives:
  1. To describe a risk stratification system that predicts risk of recurrence in DTC.
  2. To describe a risk adapted approach to initial clinical management in DTC.
  3. To describe a response to therapy adapted approach to long term follow-up in DTC
8:30-9:00 a.m. Inherited Thyroid Cancer Syndromes
Bryan McIver, MD, MBChB, PhD
Objectives:
  1. Discuss familial MTC and MEN2A/B
  2. Review Cowden Syndrome and highlight clinical detection
  3. Summarize other nonmedullary familial thyroid cancer syndromes (FAP, Carney, Pendred, Werner)
9:00 - 9:45 a.m. Primary Surgery and Follow-up for Medullary Thyroid Cancer (MTC)
Jeffrey F. Moley, MD
Objectives:
  1. To understand the management of patients with hereditary and sporadic medullary thyroid cancer.
  2. To understand current surgical and medical therapy of advanced medullary thyroid cancer
9:45-10:15 a.m. Coffee Break and Exhibits
10:15-11:00 a.m. Management of Advancing and Progressive Thyroid Cancer
Naifa L. Busaidy, MD, FACP, FACE
Objectives:
  1. Discuss I-131 Treatment; Define I-131 non-avid disease and Restoration of I-131 Avidity
  2. Review selection of patients for EBT and palliative treatment
  3. Understand the current available medical therapies for advanced or metastatic thyroid carcinoma
11:00 a.m.-12:00 p.m. Case Management Discussions
Moderator: Daniel S. Duick, MD, FACP, FACE, ECNU
Panel: Michael Tuttle, MD; Jeffrey F. Moley, MD, Bryan McIver, MD,
MBChB, PhD; Naifa L. Busaidy, MD, FACP, FACE
Objectives:
  1. Understand management of metastatic disease.
  2. Rationale for various imaging technologies.
  3. Rationale for palliative therapies.
12:00-1:00 p.m. LUNCH and Exhibits
Hands-On Lab and Concurrent Lectures
Lab Director: Devaprabu Abraham, MD, MRCP, ECNU
1:00 -2:45 p.m. Hands-On Laboratory (Group 1)
Drs. Abraham, Levine, Lupo, Sipos, McIver, Tourtelot, Geck
Objectives:
  1. To demonstrate US evaluation of various thyroid disorders in patients.
  2. Demonstration of US guided biopsy using phantoms.
  3. Smear preparation, processing and on site evaluation.
1:00 -2:45 p.m. Concurrent Lectures (Group 2)
1:00-1:25 p.m. I-131 Dosing – Practical Issues and Concerns
Devaprabu Abraham, MD, MRCP, ECNU
Objectives:
  1. Review need for low iodine diet and urinary iodine assessment.
  2. Preventing and managing side effects.
  3. Dose calculation for renal failure and dialysis
1:25 - 1:50 p.m. Hands on with Multikinase Inhibitors for Advanced Thyroid Cancer
Naifa L. Busaidy, MD, FACP, FACE
Objectives:
  1. Review common side effects
  2. Discuss importance of a standard in patient safety and monitoring
  3. Highlight importance of preventing side effects
1:25-1:50 p.m. Peri-Operative Communication
Jeffrey F. Moley, MD
Objectives:
  1. Review key discussion points between surgeon and endocrinologist pre- and post-surgery
  2. When is pre-operative cross-sectional imaging required?
2:15 -2:45 p.m. Case Discussions
Moderator:Daniel S. Duick, MD, MACE, ECNU
Panel: Naifa L. Busaidy, MD, FACP, FACE; Jeffrey F. Moley, MD; Michael Tuttle, MD
Objectives:
  1. Understand imaging and clinical evaluation of advancing thyroid cancer.
  2. Discuss timing of intervention with systemic targeted multikinase inhibitor therapy.
  3. Review palliative treatment options for symptomatic progressive disease
2:45 - 3:15p.m. Coffee Break – Groups 1 and 2 Rotate
3:15 - 5:00 p.m. Hands-On Laboratory repeated for Group 2
Concurrent Lectures repeated for Group 1
3:15 - 5:00 p.m. Hands-On Laboratory (Group 2)
Drs. Abraham, Levine, Lupo, Sipos, McIver, Tourtelot, Geck
Objectives:
  1. To demonstrate US evaluation of various thyroid disorders in patients.
  2. Demonstration of US guided biopsy using phantoms.
  3. Smear preparation, processing and on site evaluation.
3:15-5:00 p.m. Concurrent Lectures (Group 1)
3:15-3:40 p.m. I-131 Dosing – Practical Issues and Concerns
Michael Tuttle, MD
Objectives:
  1. Review need for low iodine diet and urinary iodine assessment.
  2. Preventing and managing side effects.
  3. Dose calculation for renal failure and dialysis.
3:40 - 4:05 p.m. Hands on with Multikinase Inhibitors for Advanced Thyroid Cancer
Naifa L. Busaidy, MD, FACP, FACE
Objectives:
  1. Review common side effects
  2. Discuss importance of a standard in patient safety and monitoring
  3. Highlight importance of preventing side effects
4:05-4:30 p.m. Peri-Operative Communication
Jeffrey F. Moley, MD
Objectives:
  1. Review key discussion points between surgeon and endocrinologist pre- and post-surgery
  2. When is pre-operative cross-sectional imaging required?
4:30-5:00 p.m. Case Discussions
Moderator:Daniel S. Duick, MD, MACE, ECNU
Panel:Naifa L. Busaidy, MD, FACP, FACE; Jeffrey F. Moley, MD; Michael Tuttle, MD
Objectives:
  1. Understand imaging and clinical evaluation of advancing thyroid cancer.
  2. Discuss timing of intervention with systemic targeted multikinase inhibitor therapy.
  3. Review palliative treatment options for symptomatic progressive disease
5:00 p.m. Meeting Adjourns
AACE Advances in Medical and Surgical Management of Thyroid Cancer
January 23-24, 2015


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