Endocrinology and Metabolism

Review Articles

Thyroid
Active Surveillance for Low-Risk Thyroid Cancers: A Review of Current Practice Guidelines: Min Joo Kim, Jae Hoon Moon, Eun Kyung Lee, Young Shin Song, Kyong Yeun Jung, Ji Ye Lee, Ji-hoon Kim, Kyungsik Kim, Sue K. Park, Young Joo Park; Endocrinol Metab. 2024;39(1):47-60. Published online February 15, 2024; DOI: https://doi.org/10.3803/EnM.2024.1937

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The indolent nature and favorable outcomes associated with papillary thyroid microcarcinoma have prompted numerous prospective studies on active surveillance (AS) and its adoption as an alternative to immediate surgery in managing low-risk thyroid cancer. This article reviews the current status of AS, as outlined in various international practice guidelines. AS is typically recommended for tumors that measure 1 cm or less in diameter and do not exhibit aggressive subtypes on cytology, extrathyroidal extension, lymph node metastasis, or distant metastasis. To determine the most appropriate candidates for AS, factors such as tumor size, location, multiplicity, and ultrasound findings are considered, along with patient characteristics like medical condition, age, and family history. Moreover, shared decision-making, which includes patient-reported outcomes such as quality of life and cost-effectiveness, is essential. During AS, patients undergo regular ultrasound examinations to monitor for signs of disease progression, including tumor growth, extrathyroidal extension, or lymph node metastasis. In conclusion, while AS is a feasible and reliable approach for managing lowrisk thyroid cancer, it requires careful patient selection, effective communication for shared decision-making, standardized follow-up protocols, and a clear definition of disease progression.

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2023 Update of the Korean Thyroid Association Guidelines for the Management of Thyroid Nodules
Eun Kyung Lee, Young Joo Park
Clinical Thyroidology®.2024; 36(4): 153. CrossRef

Diabetes, Obesity and Metabolism
Human Tissue-Engineered Skeletal Muscle: A Tool for Metabolic Research: Ji-Hoon Kim, Seung-Min Yu, Jang Won Son; Endocrinol Metab. 2022;37(3):408-414. Published online June 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.302

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Skeletal muscle is now regarded as an endocrine organ based on its secretion of myokines and exerkines, which, in response to metabolic stimuli, regulate the crosstalk between the skeletal muscle and other metabolic organs in terms of systemic energy homeostasis. This conceptual basis of skeletal muscle as a metabolically active organ has provided insights into the potential role of physical inactivity and conditions altering muscle quality and quantity in the development of multiple metabolic disorders, including insulin resistance, obesity, and diabetes. Therefore, it is important to understand human muscle physiology more deeply in relation to the pathophysiology of metabolic diseases. Since monolayer cell lines or animal models used in conventional research differ from the pathophysiological features of the human body, there is increasing need for more physiologically relevant in vitro models of human skeletal muscle. Here, we introduce recent studies on in vitro models of human skeletal muscle generated from adult myogenic progenitors or pluripotent stem cells and summarize recent progress in the development of three-dimensional (3D) bioartificial muscle, which mimics the physiological complexity of native skeletal muscle tissue in terms of maturation and functionality. We then discuss the future of skeletal muscle 3D-organoid culture technology in the field of metabolic research for studying pathological mechanisms and developing personalized therapeutic strategies.

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Human‐based new approach methodologies to accelerate advances in nutrition research
Manuela Cassotta, Danila Cianciosi, Maria Elexpuru‐Zabaleta, Inaki Elio Pascual, Sandra Sumalla Cano, Francesca Giampieri, Maurizio Battino
Food Frontiers.2024;[Epub] CrossRef
Key indicators of beef safety and quality as important aspects of conservation
S. V. Furman, I. M. Sokulskyi, D. V. Lisohurska, O. V. Lisohurska, B. V. Gutyj
Ukrainian Journal of Veterinary and Agricultural Sciences.2024; 7(1): 68. CrossRef

Adrenal gland
Embryonic Development and Adult Regeneration of the Adrenal Gland: Ji-Hoon Kim, Man Ho Choi; Endocrinol Metab. 2020;35(4):765-773. Published online December 23, 2020; DOI: https://doi.org/10.3803/EnM.2020.403

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The adrenal gland plays a pivotal role in an organism’s health span by controlling the endocrine system. Decades of research on the adrenal gland have provided multiscale insights into the development and maintenance of this essential organ. A particularly interesting finding is that founder stem/progenitor cells participate in adrenocortical development and enable the adult adrenal cortex to regenerate itself in response to hormonal stress and injury. Since major advances have been made in understanding the dynamics of the developmental process and the remarkable regenerative capacity of the adrenal gland, understanding the mechanisms underlying adrenal development, maintenance, and regeneration will be of interest to basic and clinical researchers. Here, we introduce the developmental processes of the adrenal gland and discuss current knowledge regarding stem/progenitor cells that regulate adrenal cortex remodeling and regeneration. This review will provide insights into the fascinating ongoing research on the development and regeneration of the adrenal cortex.

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L. Barrea, L. Verde, E. Camajani, A. S. Šojat, L. Marina, S. Savastano, A. Colao, M. Caprio, G. Muscogiuri
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Microscopy Research and Technique.2023; 86(11): 1461. CrossRef
Interactive metabolic signatures of testicular testosterone with bilateral adrenalectomy in mice
Hae Lim Cho, Ji-Hoon Kim, Seuk-Min Ryu, Jongsung Noh, Sang Won Lee, Man Ho Choi
The Journal of Steroid Biochemistry and Molecular Biology.2023; 231: 106333. CrossRef
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Regulation of Morphogenetic Processes during Postnatal Development and Physiological Regeneration of the Adrenal Medulla
S. S. Obernikhin, N. V. Yaglova, E. P. Timokhina, S. V. Nazimova, V. V. Yaglov
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Kyleigh A. Rodgers, Kristina A. Kigerl, Jan M. Schwab, Phillip G. Popovich
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Clinical and Technical Aspects in Free Cortisol Measurement
Man Ho Choi
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Surrénalectomies
Isabelle Valin, Dan Rosenberg
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Adrenal medulla development and medullary-cortical interactions
Nicole Bechmann, Ilona Berger, Stefan R. Bornstein, Charlotte Steenblock
Molecular and Cellular Endocrinology.2021; 528: 111258. CrossRef
Theory: Treatments for Prolonged ICU Patients May Provide New Therapeutic Avenues for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
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Unravelling Polycystic Ovary Syndrome and Its Comorbidities
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Corrigendum

Miscellaneous
Corrigendum: Author's Name Correction. Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro): Jae Hoon Moon, Ji-hoon Kim, Eun Kyung Lee, Kyu Eun Lee, Sung Hye Kong, Yeo Koon Kim, Woo-Jin Jeong, Chang Yoon Lee, Roh-Eul Yoo, Yul Hwangbo, Young Shin Song, Min Joo Kim, Sun Wook Cho, Su-jin Kim, Eun-Jae Chung, June Young Choi, Chang Hwan Ryu, You Jin Lee, Jeong Hun Hah, Yuh-Seog Jung, Junsun Ryu, Yunji Hwang, Sue K. Park, Ho Kyung Sung, Ka Hee Yi, Do Joon Park, Young Joo Park; Endocrinol Metab. 2018;33(3):427. Published online August 14, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.3.427

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Citations

Citations to this article as recorded by

Invasiveness and Metastatic Aggressiveness in Small Differentiated Thyroid Cancers: Demography of Small Papillary Thyroid Carcinomas in the Swedish Population
Haytham Bayadsi, Martin Bergman, Malin Sund, Joakim Hennings
World Journal of Surgery.2020; 44(2): 461. CrossRef
Clinical and pathologic predictors of lymph node metastasis in papillary thyroid microcarcinomas
Ling Zhao, Xiaoya Sun, Yukun Luo, Fulin Wang, Zhaohui Lyu
Annals of Diagnostic Pathology.2020; 49: 151647. CrossRef

Original Article

Thyroid
Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro): Jae Hoon Moon, Ji-hoon Kim, Eun Kyung Lee, Kyu Eun Lee, Sung Hye Kong, Yeo Koon Kim, Woo-jin Jung, Chang Yoon Lee, Roh-Eul Yoo, Yul Hwangbo, Young Shin Song, Min Joo Kim, Sun Wook Cho, Su-jin Kim, Eun Jae Jung, June Young Choi, Chang Hwan Ryu, You Jin Lee, Jeong Hun Hah, Yuh-Seog Jung, Junsun Ryu, Yunji Hwang, Sue K. Park, Ho Kyung Sung, Ka Hee Yi, Do Joon Park, Young Joo Park; Endocrinol Metab. 2018;33(2):278-286. Published online June 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.2.278

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Background

The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups.

Methods

This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis.

Results

Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014).

Conclusion

The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.

Citations

Citations to this article as recorded by

2023 Update of the Korean Thyroid Association Guidelines for the Management of Thyroid Nodules
Eun Kyung Lee, Young Joo Park
Clinical Thyroidology®.2024; 36(4): 153. CrossRef
Psychological adjustment to initial treatment for low‐risk thyroid cancer: Preliminary study
Gabriella T. Seo, Mark L. Urken, Lauren E. Wein, Michael P. Saturno, Danielle Kapustin, Monica H. Xing, Lauren E. Yue, Eric M. Dowling, Tracey A. Revenson, Katherine J. Roberts, Robert Michael Tuttle
Head & Neck.2023; 45(2): 439. CrossRef
Response to Letter to the Editor on Surgical Outcomes in Patients With Low-Risk Papillary Thyroid Microcarcinoma From MAeSTro Study: Immediate Operation Versus Delayed Operation Following Active Surveillance: A Multicenter Prospective Cohort Study
Hyeonuk Hwang, June Young Choi, Jae Hoon Moon, Eun Kyung Lee, Young Joo Park, Su-jin Kim, Yuh-Seog Jung
Annals of Surgery Open.2023; 4(3): e311. CrossRef
Lower Thyroid Cancer Mortality in Patients Detected by Screening: A Meta-Analysis
Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Young Joo Park
Endocrinology and Metabolism.2023; 38(1): 93. CrossRef
To Screen or Not to Screen?
Do Joon Park
Endocrinology and Metabolism.2023; 38(1): 69. CrossRef
Surgical Outcomes in Patients With Low-risk Papillary Thyroid Microcarcinoma From MAeSTro Study
Hyeonuk Hwang, June Young Choi, Hyeong Won Yu, Jae Hoon Moon, Ji-hoon Kim, Eun Kyung Lee, Yeo Koon Kim, Chang Yoon Lee, Sun Wook Cho, Eun-Jae Chung, Chang Hwan Ryu, Junsun Ryu, Ka Hee Yi, Do Joon Park, Kyu Eun Lee, Young Joo Park, Su-jin Kim, Yuh-Seog Jun
Annals of Surgery.2023; 278(5): e1087. CrossRef
US Predictors of Papillary Thyroid Microcarcinoma Progression at Active Surveillance
Ji Ye Lee, Ji-hoon Kim, Yeo Koon Kim, Chang Yoon Lee, Eun Kyung Lee, Jae Hoon Moon, Hoon Sung Choi, Hwangbo Yul, Sun Wook Cho, Su-jin Kim, Kyu Eun Lee, Do Joon Park, Young Joo Park
Radiology.2023;[Epub] CrossRef
MET-receptor targeted fluorescent imaging and spectroscopy to detect multifocal papillary thyroid cancer
Madelon J. H. Metman, Pascal K. C. Jonker, Luc H. J. Sondorp, Bettien M. van Hemel, Mark S. Sywak, Anthony J. Gill, Liesbeth Jansen, Paul J. van Diest, Tessa M. van Ginhoven, Clemens W. G. M. Löwik, Anh H. Nguyen, Dominic J. Robinson, Gooitzen M. van Dam,
European Journal of Nuclear Medicine and Molecular Imaging.2023;[Epub] CrossRef
Active Surveillance of Thyroid Microcarcinomas: a Critical View
Claudio R. Cernea, Leandro Luongo Matos, Cecília Eugênio, Giovanna Mattos Ferreira, Yasmin Sa Cerqueira, Ana Kober N. Leite, Felipe A. B. Vanderlei, Dorival de Carlucci, Renato N. Gotoda, Flávio C. Hojaij, Vergilius J. F. Araújo-Filho
Current Oncology Reports.2022; 24(1): 69. CrossRef
Active Surveillance Versus Thyroid Surgery for Differentiated Thyroid Cancer: A Systematic Review
Roger Chou, Tracy Dana, Megan Haymart, Angela M. Leung, Ralph P. Tufano, Julie Ann Sosa, Matthew D. Ringel
Thyroid.2022; 32(4): 351. CrossRef
A Review of Active Surveillance of Papillary Thyroid Microcarcinoma
Cho Rok Lee
Journal of Endocrine Surgery.2022; 22(1): 1. CrossRef
Active Surveillance Versus Immediate Surgery for Low-Risk Papillary Thyroid Microcarcinoma Patients in South Korea: A Cost-Minimization Analysis from the MAeSTro Study
Kyungsik Kim, June Young Choi, Su-jin Kim, Eun Kyung Lee, Young Ki Lee, Jun Sun Ryu, Kyu Eun Lee, Jae Hoon Moon, Young Joo Park, Sun Wook Cho, Sue K. Park
Thyroid.2022; 32(6): 648. CrossRef
A cross-sectional survey of patient treatment choice in a multicenter prospective cohort study on active surveillance of papillary thyroid microcarcinoma (MAeSTro)
Yul Hwangbo, June Young Choi, Eun Kyung Lee, Chang Hwan Ryu, Sun Wook Cho, Eun Jae Chung, Jeong Hun Hah, Woo-Jin Jeong, Sue K. Park, Yuh-Seog Jung, Ji-hoon Kim, Min Joo Kim, Su-jin Kim, Yeo Koon Kim, Chang Yoon Lee, Ji Ye Lee, You Jin Lee, Hyeong Won Yu,
Thyroid.2022;[Epub] CrossRef
Progression of Low-Risk Papillary Thyroid Microcarcinoma During Active Surveillance: Interim Analysis of a Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma in Korea
Eun Kyung Lee, Jae Hoon Moon, Yul Hwangbo, Chang Hwan Ryu, Sun Wook Cho, June Young Choi, Eun-Jae Chung, Woo-Jin Jeong, Yuh-Seog Jung, Junsun Ryu, Su-jin Kim, Min Joo Kim, Yeo Koon Kim, Chang Yoon Lee, Ji Ye Lee, Hyeong Won Yu, Jeong Hun Hah, Kyu Eun Lee,
Thyroid.2022; 32(11): 1328. CrossRef
Indications and Strategy for Active Surveillance of Adult Low-Risk Papillary Thyroid Microcarcinoma: Consensus Statements from the Japan Association of Endocrine Surgery Task Force on Management for Papillary Thyroid Microcarcinoma
Iwao Sugitani, Yasuhiro Ito, Dai Takeuchi, Hirotaka Nakayama, Chie Masaki, Hisakazu Shindo, Masanori Teshima, Kazuhiko Horiguchi, Yusaku Yoshida, Toshiharu Kanai, Mitsuyoshi Hirokawa, Kiyomi Y. Hames, Isao Tabei, Akira Miyauchi
Thyroid.2021; 31(2): 183. CrossRef
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Endocrinology and Metabolism.2021; 36(4): 717. CrossRef
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Genomic and Transcriptomic Characteristics According to Size of Papillary Thyroid Microcarcinoma
Young Shin Song, Byung-Hee Kang, Seungbok Lee, Seong-Keun Yoo, Young Sik Choi, Jungsun Park, Dong Yoon Park, Kyu Eun Lee, Jeong-Sun Seo, Young Joo Park
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Thyroid.2020; 30(7): 985. CrossRef
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Endocrinología, Diabetes y Nutrición.2019; 66(8): 469. CrossRef
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