AHCI Grand Rounds Recorded 8-19-2026: Surgical Update in Endocrine Cancers

AHCI Grand Rounds Recorded Presentation. Expires 8/18/2027. Duration = 1 hour.

Dr. Rachel Aufforth delivered a comprehensive update on the contemporary surgical management of endocrine malignancies, with a primary focus on the 2025 American Thyroid Association (ATA) guidelines and their implications for differentiated thyroid cancer care. She reviewed major practice changes, including increased use of shared decision-making, active surveillance and percutaneous ablation for selected low-risk tumors, a trend toward less extensive thyroid surgery, revised recurrence risk stratification, individualized radioiodine therapy decisions, and updated surveillance recommendations. The presentation also examined emerging evidence supporting neoadjuvant targeted therapies for locally advanced differentiated thyroid cancer and anaplastic thyroid carcinoma, emphasizing the importance of multidisciplinary management, timely molecular testing, and rapid treatment initiation. Additional updates covered medullary thyroid carcinoma, including universal genetic testing, hereditary risk assessment, and postoperative calcitonin and CEA monitoring. Dr. Aufforth further highlighted the diagnosis and management of rare parathyroid and adrenal malignancies, stressing the critical importance of early recognition, appropriate initial surgical intervention, biochemical evaluation of adrenal nodules, achievement of complete (R0) resection for adrenocortical carcinoma, and careful multidisciplinary selection of patients who may benefit from adrenalectomy for isolated adrenal metastases.

1. Contrast the 2025 and 2015 ATA recommendations for extent of thyroidectomy, active surveillance, and prophylactic central neck dissection, and state which patterns are affected by each change.
2. Identify candidates for neoadjuvant systemic therapy in locally advanced differentiated and anaplastic thyroid carcinoma, and describe the effect on resectability and surgical morbidity.
3. Apply AAES criteria for the biochemical and radiographic evaluation of an adrenal mass and select an operative approach based on tumor size, functional status, and malignancy risk.
4. Describe the operative principles that distinguish resection of parathyroid carcinoma and adrenocortical carcinoma from resection of their benign counterparts.
5. Evaluate the selection criteria and expected outcomes for adrenal metastasectomy, and weigh surgery against stereotactic radiotherapy and systemic therapy alone.

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Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Rachel Aufforth, MD
Surgical Oncologist
Allina Health Cancer Institute
St. Paul, MN

Faculty

Nothing to disclose

Joleen Hubbard, MD
Oncologist
AHCI Cancer Center Minneapolis ANW
Minneapolis, MN

Lead Physician

Advisor-Amgen, Inc. (Relationship has ended)|Advisor-AstraZeneca (Any division) (Relationship has ended)|Advisor-Bayer (Any division) (Relationship has ended)|Advisor-BeOne (Relationship has ended)|Advisor-GlaxoSmithKline (Relationship has ended)|Advisor-Taiho Pharmaceutical (Relationship has ended)|Grant or research support-Biontech|Grant or research support-C4 Therapeutics (Relationship has ended)|Grant or research support-Exact Sciences|Speakers Bureau-Incyte Corporation Incyte Corporation

Elizabeth Loach, MSN, APRN, CNS, AGCNS-BC, OCN
Manager of Nursing Practice and Clinical Education
Allina Health, Allina Health Cancer Institute
Saint Paul, MN

Nurse Planner

Nothing to disclose