Probability Data Could Better Direct Lymph Node Removal for Thyroid Cancer

Contact: Samiha Khanna Phone: 919-419-5069 Email:samiha.khanna@duke.eduhttps://www.dukehealth.orgFOR IMMEDIATE RELEASE on Tuesday, Aug. 16, 2016DURHAM, N.C. -- Surgeons operating on patients with advanced thyroid cancer are often conflicted when deciding how many lymph nodes they should remove to reduce the patient ’s risk of recurrence.If surgeons don ’t evaluate enough lymph nodes, they could leave cancer behind; but extensive surgery close to structures such as nerves, the voice box and parathyroid glands can carry serious risks.A new study from the Duke Clinical Research Institute and Duke Cancer Institute strives to establish objective, quantifiable information for patients and doctors regarding the minimum number of lymph nodes that should be analyzed around a tumor for thorough treatment without unnecessary risk. The retrospective study appears Aug. 15 in the Journal of Clinical Oncology.“In these procedures, a lot is left to the surgeon. If the tumor is large or there’s obvious evidence that the cancer is in the lymph nodes, you take them out,” said authorJulie Ann Sosa, M.D., chief of endocrine surgery and leader of the endocrine neoplasia diseases group at the Duke Clinical Research Institute and the Duke Cancer Institute.“If there is no evidence of obvious invasion, you can remove them preventatively, but you might not have to,” Sosa said. “That’s the quandary faced by the entire health care team -- for the surg...
Source: Duke Health Features - Category: Pediatrics Tags: Duke Medicine Source Type: news

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We report FDG PET/CT images of a 63-year-old woman referred for characterization of osteolytic lesions of the cervical spine. This patient with chronic renal failure had a history of follicular thyroid carcinoma with undifferentiated cells, treated by a total thyroidectomy, completed by radioactive iodine in 2017. Because of cancer history, a FDG PET/CT was performed and showed multiple moderately hypermetabolic osteolytic lesions of the spine from C3 to T1, with joint erosion on CT. A laminectomy was performed for cervical spinal cord decompression and revealed a gouty tophus.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
AbstractIn patients with thyroid fine-needle aspiration (FNA) report of suspicious for malignancy (SFM), both lobectomy and thyroidectomy might be considered. BRAF mutation analysis could guide towards accurate surgical therapy. The primary outcome was the reliability of BRAF (V600E) in detecting malignancy in nodules with FNA reading of SFM. The secondary outcome was to analyze its positive predictive value (PPV) and negative predictive value (NPV) considering the surgical histology as gold standard. A literature search of online databases was performed in June 2019. BRAF prevalence among thyroid nodules with FNA read as ...
Source: Endocrine Pathology - Category: Pathology Source Type: research
A 75-year-old lady with previously diagnosed moderate mixed aortic valve disease underwent surveillance transthoracic echocardiography (TTE). This showed raised trans-aortic gradients in the presence of normal aortic valve leaflet motion and turbulent colour flow across a calcified left ventricular outflow tract (LVOT). Therefore, in view of possible subaortic stenosis, she was referred for cardiac computed tomography for further characterisation. Past medical history included total thyroidectomy and 2 rounds of radioiodine ablation for follicular thyroid carcinoma 12 months prior.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Source Type: research
AbstractPurposeThe aim of our study was to compare the efficacy of thyroid remnant ablation using low (1.1  GBq) and intermediate-high radioiodine (RAI) activity (1.85–3.7 GBq) in low-risk differentiated thyroid carcinoma (DTC) and to evaluate the staging role of the whole body scan (WBS) in detection extrathyroidal disease.Materials and methodsWe retrospectively included 277 patients who underwent total thyroidectomy and RAI for low-risk DTC and divided them in two groups according to RAI activity at ablation: group 1 (n = 174) treated with low activity (1.1 GBq), and group 2 (n&th...
Source: Endocrine - Category: Endocrinology Source Type: research
Authors: Dalcı K, Topal U, Ünal AG, Eray İC, Yalav O, Güney İB, Sakman G Abstract OBJECTIVE: The aim of this study is to share the efficacy of the radionuclide occult lesion localization (ROLL) technique in secondary neck exploration in patients who had undergone neck exploration due to thyroid or parathyroid pathology and to share our clinical experience. MATERIAL AND METHOD: Data of 25 patients who underwent secondary neck exploration for recurrent thyroid cancer and parathyroid adenoma between January 2016 and December 2018 at the General Surgery Clinic of Balcalı Hospital, Çukurova Univ...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Authors: Chacón González M, Ibáñez Muñoz A, Rodríguez Vicente L, Ortega Renedo I, Rozanova Klecheva M, Yagüe Hernando A, Lizuaín Abadia ME, Jiménez Del Rio B Abstract The case is presented of 78 year-old who consulted due to decreased visual acuity in right eye for several months. Indirect ophthalmoscopy revealed an orange-yellow coloured choroidal mass at the posterior pole, without retinal detachment. Computed tomography showed a thyroid mass in the isthmus, as well as multiple pulmonary nodules and metastatic foci. The findings of transbronchial lung b...
Source: Archivos de la Sociedad Espanola de Oftalmologia - Category: Opthalmology Tags: Arch Soc Esp Oftalmol Source Type: research
Conclusions: Our data support the view that total thyroidectomy remains the first choice for the routine treatment of differentiated thyroid cancer. PMID: 31737363 [PubMed - in process]
Source: International Journal of Surgical Oncology - Category: Surgery Tags: Int J Surg Oncol Source Type: research
ConclusionTreatment decisions must be individualized, and depend on the presence of systemic disease. Selected patients may benefit from resection of metastases, and PET scan may be useful to identify patients who will benefit from resection.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSION: TOETVA is an acceptable approach for thyroid carcinoma. Poorly differentiated cancer, as well as extrathyroidal extension, result in patients being unsuitable for TOETVA. It is imperative to identify the circumstances under which conversion to open thyroidectomy must take place. PMID: 31749078 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
ConclusionThis case draws attention to the unique clinical value of molecular testing in the diagnosis of MTC. The authors believe this case supports the consideration for molecular testing to prevent missed diagnoses in cases of rare benign-appearing disease.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
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