Prognostic value of tumor size and minimal extrathyroidal extension in papillary thyroid carcinoma
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Chol-Ho Shin, Jong-Lyel Roh, Dong Eun Song, Kyung-Ja Cho, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon KimAbstractBackgroundTumour size and extrathyroidal extension (ETE) may impact papillary thyroid carcinoma (PTC) outcomes. We therefore examined the prognostic value of tumour size and ETE for predicting posttreatment recurrence in PTC patients.MethodsA total of 2,902 patients who underwent thyroidectomy for previously untreated T1–T3 PTC (7th edition American Joint Committee on Cancer) at our tertiary referral center were included. Univariate and multivariate Cox proportional hazard regression analyses were used to determine significant factors predictive of posttreatment recurrence-free survival (RFS).ResultsIn univariate analysis, tumour factors (including tumour size, multifocality, ETE, and lymphovascular invasion), nodal factors (including positive lymph node number, lymph node ratio, and extranodal extension), and MACIS (metastases, age, completeness of resection, invasion, and size) scores were significantly associated with RFS outcomes (P 4 cm (P
Horm Metab Res 2020; 52: 158-167 DOI: 10.1055/a-1111-8927The aim of the study was to evaluate the clinical impact of pre-ablation rhTSH-stimulated fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT in addition to post-therapeutic whole body radioiodine scanning in patients with intermediate to high risk differentiated thyroid carcinoma (DTC). This was a retrospective single center study including 73 patients with thyroid cancer (44 females, mean age 43.2±16.2 years, 62% papillary, 31% follicular, 7% poorly differentiated). All patients underwent ablative radioiodine treatment ...
Conclusions: The incidence of thyroid cancer was higher in patients who underwent surgery for GD. In addition to a careful physical examination in the follow-up of the patients with GD, ultrasonographic evaluation should be performed. Surgical treatment should not be delayed in patients with GD when indicated. PMID: 32190140 [PubMed]
Conclusions: The ATA 2015 Guidelines represent a cost-effective strategy regarding AS and extent of surgery.
This study aimed to evaluate the clinicopathological features and independent variables associated with survival in such patients with distant metastases.MethodsIn total, 10,992 consecutive differentiated thyroid cancer (DTC) patients treated with131I after total or near-total thyroidectomy from 2000 to 2018 were retrospectively reviewed.ResultsThirty-nine patients with initial pathologically proven benign follicular nodules of the thyroid were enrolled. Among them, 26 were pathologically diagnosed as thyroid adenoma, 8 as benign nodular goiter, 4 as thyroid adenoma combined with benign nodular goiter, and 1 as normal thyr...
The incidence of thyroid cancer has been on the rise in recent decades with approximately 90% of these being differentiated thyroid carcinomas (DTCs) (including papillary and follicular). The majority of DTCs have a good prognosis and are potentially curable with standard treatment, the cornerstone of which is thyroidectomy. Commonly, patients may also receive adjuvant thyroid stimulating hormone suppression or radioactive iodine-131 (RAI). Due to a lack of randomized clinical trials, the role of adjuvant external beam radiation therapy (EBRT) in DTC is not well-established.
CONCLUSIONS: These data suggest that central lymphadenectomy, performed only in case of positive intraoperative lymph node biopsy, ensures reduced incidence of postoperative complications and optimal loco-regional disease control. KEY WORDS: Bilateral central neck dissection, Intraoperative lymph node biopsy, Papillary thyroid carcinoma, Poor risk factors. PMID: 32149727 [PubMed - as supplied by publisher]
This study searched for factors related to the development of permanent HypoPT after total thyroidectomy and central neck lymphadenectomy in patients with thyroid carcinoma. MATERIAL AND METHODS: In total, 89 of 103 screened patients met the study's criteria and were put under prospective one-year observation. Demographic and surgical factors as well as the biochemical parameters of mineral homeostasis, controlled both preoperatively and postoperatively, were subject to statistical analysis. In line with contemporary guidelines, postoperative hypocalcemia, rather than an abnormally low serum parathormone (PTH) concent...
In this study, we evaluated predictive factors of skip LN metastasis in these patients. We reviewed the medical records of 68 PTC patients who underwent total thyroidectomy, central neck dissection, and lateral neck dissection at the initial operation. The relationships between skip LN metastasis and clinicopathologic factors were analyzed. After careful examination of electronic medical records of patients, 19 patients were excluded from the study. Of the remaining 49 patients, 9 (18.4%) had skip LN metastasis. Multivariate analysis showed that tumor size
ConclusionConcurrent radio- and/or chemotherapy in combination with surgery seems to result in improved survival in stage IVA/B ATC, whereas this is not the case in patients with stage IVC tumors. Novel treatment regimens are urgently needed to improve the dismal prognosis of ATC.
ConclusionIntensive step-sectioning reveals additional micrometastases. More detailed analysis did not identify clinically significant nodal disease likely to impact the clinical course of patients in this study. Our study supports current standards of pathology specimen handling related to LN assessment and the impact on ATA ROR classification. Nonetheless, it is important for clinicians to understand their institution ’s sectioning protocol utilized to report positive and total LN counts, which could impact ATA risk stratification and denote the comprehensive nature of the LN dissection that was performed.