Interpretation of the European Society of Endocrine Surgeons(ESES)consensus statement on advanced thyroid cancer:definitions and management
DONG Zhi-zhong
LIU Wen
CHENG Ruo-chuan
Abstract：The overall prognosis of thyroid cancer is favorable.However,once it progresses to advanced disease,it becomes a major threat to patient survival.Diagnosis and treatment of advanced thyroid cancer involve complex,multidisciplinary and multimodal processes.In 2024,the European Society of Endocrine Surgeons(ESES)convened an expert panel to address issues related to the definition,preoperative management,and therapeutic strategies for advanced thyroid cancer,culminating in a consensus statement that reflects the heightened attention of European and North American experts to this entity.The consensus defines advanced thyroid cancer across three domains-local,regional,and distant metastatic disease-and explicitly includes anaplastic thyroid carcinoma(ATC)within the advanced category.It emphasizes comprehensive preoperative evaluation using multimodal imaging,endoscopy,and molecular testing,together with optimization of comorbidities and nutritional status.Multidisciplinary team(MDT)care is central to crafting individualized treatment plans.Therapeutic strategies are anchored in achieving the greatest possible curative-intent resection of the primary tumor and metastatic foci,integrated with targeted therapy,radiotherapy,and neoadjuvant therapy as appropriate.For differentiated thyroid carcinoma(DTC),medullary thyroid carcinoma(MTC),and ATC,surgery remains pivotal,with careful attention to balancing local control and quality of life.Molecular testing guides the rational use of targeted agents,including multikinase inhibitors(MKIs)and therapies directed at RET,BRAF,and NTRK alterations.Overall,the consensus provides a structured framework for defining and managing advanced thyroid cancer and underscores the roles of precision medicine and MDT care in improving survival and quality of life.
Keywords：advanced thyroid cancerconsensus statementpreoperative assessmentmultidisciplinary team(MDT)targeted therapyanaplastic thyroid cancermolecular testingprecision medicine
Publication Date：2025-09-01
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：7( 989-995 )