{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:19:44Z","timestamp":1789579184271,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy and its incidence has increased in recent decades. In locally advanced thyroid carcinoma (LATC), disease may be unresectable or require highly morbid surgical procedures. Lenvatinib has demonstrated rapid tumor shrinkage in radioiodine\u2010refractory DTC, suggesting a potential role as neoadjuvant therapy to facilitate surgical management. However, optimal patient selection for this approach remains unclear. We evaluated the role of lenvatinib as neoadjuvant therapy to achieve resectability or surgical de\u2010escalation in patients with locally advanced or recurrent DTC, using computed tomography (CT)\u2010based anatomical complexity scores for patient selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective study was conducted in 23 patients with locally advanced or recurrent DTC treated with neoadjuvant lenvatinib at a tertiary referral center. Based on pretreatment CT findings, patients were classified as unresectable (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) or resectable only through major surgery (RMS) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911). Disease complexity was assessed using the MMM surgical morbidity and complexity score and the thyroid neck morbidity and complexity (TNMC) classification. Radiologic response was evaluated according to RECIST 1.1 criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median lenvatinib treatment duration was 10\u2009months (range 2\u201325). Partial or complete radiologic response was achieved in 16 patients (69%). Surgery was performed in 13 patients (56%): 7\/12 (58%) from the initially unresectable group and 6\/11 (55%) from the RMS group. Among unresectable cases undergoing surgery, complete resection was achieved in 6\/7 (86%). In the RMS group, surgical de\u2010escalation was achieved in 5\/6 (83%), avoiding procedures such as laryngectomy or pharyngolaryngectomy. Overall, R0\/R1 margins were obtained in 11\/13 operated patients (85%). The 24\u2010month overall survival was 89.7%, and treatment was generally well tolerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neoadjuvant lenvatinib enabled conversion to resectability and meaningful surgical de\u2010escalation in selected patients with LATC, with acceptable toxicity. CT\u2010based complexity scores were useful tools for patient selection. Prospective multicenter studies integrating molecular profiling are needed to refine indications and optimal treatment duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70221","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:53:12Z","timestamp":1772985192000},"page":"2009-2018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lenvatinib as Neoadjuvant Therapy in Locally Advanced Thyroid Cancer:\n                    <scp>CT<\/scp>\n                    \u2010Based Selection and Outcomes From a 23\u2010Patient Cohort"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-6575","authenticated-orcid":false,"given":"J. J.","family":"Santiva\u00f1ez","sequence":"first","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Betancourt","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"},{"name":"Centro de Excelencia en Enfermedades de Cabeza y Cuello, CEXCA  Medell\u00edn Colombia"},{"name":"Head and Neck Surgery Section Hospital Alma M\u00e1ter de Antioquia  Medell\u00edn Colombia"},{"name":"Head and Neck Surgery Section Hospital San Vicente Fundaci\u00f3n  Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"},{"name":"Head and Neck Surgery Section Hospital Alma M\u00e1ter de Antioquia  Medell\u00edn Colombia"},{"name":"Head and Neck Surgery Section Hospital San Vicente Fundaci\u00f3n  Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G.","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Figueroa\u2010Bohorquez","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"},{"name":"Centro de Excelencia en Enfermedades de Cabeza y Cuello, CEXCA  Medell\u00edn Colombia"},{"name":"Head and Neck Surgery Section Hospital Alma M\u00e1ter de Antioquia  Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Mendieta","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rom\u00e1n\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Endocrine Section University of Antioquia  Medellin Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5563-8840","authenticated-orcid":false,"given":"A.","family":"Sanabria","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Section University of Antioquia  Medellin Colombia"},{"name":"Centro de Excelencia en Enfermedades de Cabeza y Cuello, CEXCA  Medell\u00edn Colombia"},{"name":"Head and Neck Surgery Section Hospital San Vicente Fundaci\u00f3n  Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(24)00343\u20107"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.00102"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27735"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13195769"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406470"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2015.11.003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2017.10.010"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1466"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/6438352"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/md9.0000000000000240"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2025.1902"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.21873\/cdp.10421"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1590086"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0090"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0504"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0033"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/10507256251363120"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.04.009"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2025.0040"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010024\u201004061\u20102"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/10507256251367286"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2024.08.046"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2217\/ije\u20102020\u20100014"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.05.031"}],"container-title":["Head &amp; 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