scholarly journals Optimal Surgical Extent in Patients with Unilateral Multifocal Papillary Thyroid Carcinoma

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 432
Author(s):  
Joohyun Woo ◽  
Hyungju Kwon
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Cox Regression ◽  
Papillary Thyroid ◽  
Cox Regression Analysis ◽  
Risk Of Recurrence ◽  
High Risk Factors ◽  
Thyroid Lobectomy

Multifocality increases the risk of recurrence in patients with papillary thyroid carcinoma (PTC); however, it is unclear whether multifocality justifies more extensive or aggressive surgical treatment. Here, we evaluated the effect of the operative extent on the recurrence-free survival (RFS) of patients with multifocal PTC. Between 2010 and 2019, 718 patients with unilateral multifocal PTC were enrolled; 115 patients (16.0%) underwent ipsilateral thyroid lobectomy, and 606 patients (84.0%) underwent total thyroidectomy. With a mean follow up of 5.2 years, RFS was comparable between the total thyroidectomy and lobectomy groups (p = 0.647) after adjusting for potential confounders. Multivariable Cox regression analysis also demonstrated that the operative extent was not an independent predictor of recurrence (HR 1.686, 95% CI: 0.321–8.852). Subgroup analyses further indicated that both total thyroidectomy and thyroid lobectomy resulted in comparable RFS for multifocal PTC patients with other high-risk factors, including tumor size > 1 cm (p = 0.711), lymph node metastasis (p = 0.536), and intermediate ATA risk of recurrence (p = 0.682). In conclusion, thyroid lobectomy was not associated with the risk of recurrence in patients with multifocal PTCs. Multifocality in PTC may not always require aggressive surgery.

scholarly journals Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma

2021 ◽  
Vol 10 (21) ◽  
pp. 5144
Author(s):  
Joohyun Woo ◽  
Hyeonkyeong Kim ◽  
Hyungju Kwon
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Cox Regression ◽  
Medical Center ◽  
Disease Free Survival ◽  
Prognostic Impact ◽  
Papillary Thyroid ◽  
Free Survival ◽  
Cox Regression Analysis

The incidence of thyroid cancer has dramatically increased over the last few decades, and up to 60% of patients have multifocal tumors. However, the prognostic impact of multifocality in patients with papillary thyroid carcinoma (PTC) remains unestablished and controversial. We evaluate whether multifocality can predict the recurrence of PTC. A total of 1249 patients who underwent total thyroidectomy for PTC at the Ewha Medical Center between March 2012 and December 2019 were reviewed. In this study, multifocality was found in 487 patients (39.0%) and the mean follow-up period was 5.5 ± 2.7 years. Multifocality was associated with high-risk features for recurrence, including extrathyroidal extension, lymph node metastasis, and margin involvement. After adjustment of those clinicopathological features, 10-year disease-free survival was 93.3% in patients with multifocal tumors, whereas those with unifocal disease showed 97.6% (p = 0.011). Multivariate Cox regression analysis indicated that male sex (HR 2.185, 95% CI 1.047–4.559), tumor size (HR 1.806, 95% CI 1.337–2.441), N1b LN metastasis (HR 3.603, 95% CI 1.207–10.757), and multifocality (HR 1.986, 95% CI 1.015–3.888) were independent predictors of recurrence. In conclusion, multifocality increased the risk of recurrence in patients with PTC. Patients with multifocal PTCs may need judicious treatment and follow-up approaches.

scholarly journals Concomitant thyroid Malt lymphoma and papillary thyroid carcinoma

2010 ◽  
Vol 54 (4) ◽  
pp. 425-428 ◽  
Author(s):  
Giulianno Molina de Melo ◽  
Danilo Anunciatto Sguilar ◽  
Cyntia Moniz Figueira Petiti ◽  
André Gustavo Gumz Eichstaedt ◽  
Rogério Ramos Caiado ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Male Patient ◽  
Malt Lymphoma ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid

The objective of this study was to describe the rare thyroid MALT lymphoma concomitant with papillary thyroid carcinoma in a male patient who was submitted to total thyroidectomy. Treatment and follow-up issues are addressed. Male patient complains of fast thyroid enlargement without lymphadenophaty and normal clinical exams. Total thyroidectomy was indicated and performed without any complications. The pathology showed multicentric papillary thyroid carcinoma, concomitant thyroid MALT lymphoma and Hashimoto's thyroiditis. The immunohistochemistry assay was positive for CD 20, CD 43, CD 79, AE1/AE3. The staging studies showed no evidence of both metastasis, Ann Harbor stage IE, without B symptoms. After RIT no further radiotherapy or chemotherapy was indicated. Nowadays the thyroglobulin is undetectable, without recurrences at two years of follow-up. It was concluded that primary thyroid MALT lymphoma is uncommon being the papillary thyroid carcinoma more frequent. Both occurring concomitantly is very rare and the treatment has to prioritize the tumor of worst prognosis at the discovery moment.

scholarly journals Identification of an Autophagy-Related Signature Predicting Overall Survival for Papillary Thyroid Carcinoma

Dose-Response ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 155932581989926 ◽  
Author(s):  
Gang Hu ◽  
Hong-fang Feng ◽  
Hui Zhan
Keyword(s):  
Overall Survival ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Scoring System ◽  
Cox Regression ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas ◽  
Differentially Expressed ◽  
Papillary Thyroid ◽  
Cox Regression Analysis

Background: Papillary thyroid carcinoma usually shows an excellent prognosis. However, its recurrence or persistence rate is high. In this study, we used bioinformatics to identify autophagy-related genes (ARGs) and establish a novel scoring system for papillary thyroid carcinoma. Methods: We collected ARGs sequencing data of patients with papillary thyroid carcinoma from The Cancer Genome Atlas database. Differentially expressed ARGs were identified by the “Limma” package in R language. After univariate and multivariate Cox regression analysis, an ARG signature was developed. The established prognostic signature was evaluated by Kaplan-Meier curve and time-dependent receiver operating characteristic. Results: A sum of 26 differentially expressed ARGs were identified. Gene set enrichment analysis revealed that several significantly oncological signatures were enriched, such as autophagy, p53 signaling pathway, apoptosis, human cytomegalovirus infection, and platinum drug resistance. After univariate and multivariate analysis, 3 ARGs ( ITPR1, CCL2, and CDKN2A) were selected to develop autophagy-related signature. Patients with high risk had significantly shorter overall survival than those with low risk. The areas under the curve indicated that the signature showed good accuracy of prediction. Conclusions: We established a novel scoring system based on 3 ARGs, which provides a promising tool for the development of personalized therapy.

scholarly journals Calcaneus Metastasis from Follicular Thyroid Carcinoma 12 Years after Total Thyroidectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Mohammad Jawad H. Rahal ◽  
Karam M. Karam ◽  
Selim M. Nasser ◽  
Jihad A. Daher ◽  
Hicham G. Abdel Nour ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Case Reports ◽  
Rare Condition ◽  
Surgical Excision ◽  
X Rays ◽  
Papillary Thyroid ◽  
Calcaneal Cyst

We report the case of a sixty-eight-year-old female patient who presented for left ankle pain; X-rays and MRI showed a benign calcaneal cyst, found to be delayed distant metastasis from primary papillary thyroid carcinoma. Patient required surgical excision of the cyst. Results of histological examination showed metastatic papillary thyroid carcinoma. The patient underwent total thyroidectomy 12 years prior to presentation, with the same pathology. Postoperatively, she was treated with radioactive iodine. At 10-year follow-up post calcaneal mass excision, she was found to have a right proximal tibial mass and found to be recurrent with the same pathology. This case reports a rare condition that will be taken into consideration in bone metastasis with thyroid cancer.

scholarly journals Hashimoto Thyroiditis Coexistent with Papillary Thyroid Carcinoma

2005 ◽  
Vol 71 (10) ◽  
pp. 874-878 ◽  
Author(s):  
Calogero Cipolla ◽  
Luigi Sandonato ◽  
Giuseppa Graceffa ◽  
Salvatore Fricano ◽  
Adriana Torcivia ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Hashimoto Thyroiditis ◽  
Control Group ◽  
Papillary Thyroid ◽  
Thyroid Carcinomas ◽  
Significant Difference

Several studies report a higher rate of papillary thyroid carcinomas (PTC) in patients with Hashimoto thyroiditis (HT), indicating a possible correlation between the two diseases. We studied a group of 89 subjects undergoing surgery for thyroid carcinomas compared with a control group of 89 subjects operated on for normofunctioning goiter, and a second group of 47 patients undergoing total thyroidectomy for HT. Association with HT was found in 19 of the 71 PTC subjects (26.7%) and in 8 goiter patients (8.9%), which was a significant difference ( P < 0.02). Thirteen of the HT patients, mostly with the nodular form, showed coexistent PTC (27.6%). HT and PTC coexisted in several morphological, immunohistochemical, and biomolecular aspects; increased incidence of PTC in HT patients might therefore indicate that HT is a precursor of thyroid cancer. Further studies are required, however, in order to confirm this hypothesis; until then, HT patients should undergo careful clinical and technical follow-up.

scholarly journals A population-based study of the three major variants of papillary thyroid carcinoma

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098461
Author(s):  
Junming Xu ◽  
Yingying Zhang ◽  
Jun Liu ◽  
Shenglong Qiu ◽  
Min Wang
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Cox Regression ◽  
Locally Advanced ◽  
Treatment Strategies ◽  
Clinicopathological Characteristics ◽  
Disease Specific Survival ◽  
Papillary Thyroid ◽  
Cox Regression Analysis ◽  
Disease Specific

Objective To explore the clinicopathological features and relative prognostic risks of the three major variants of papillary thyroid carcinoma (PTC). Methods We retrospectively analyzed the clinicopathological characteristics and prognoses of patients with the three major PTC variants, conventional papillary thyroid carcinoma (CPTC), follicular-variant papillary carcinoma (FVPTC), and tall-cell papillary thyroid carcinoma (TCPTC), based on data from the Surveillance, Epidemiology, and End Results database from 2005 to 2009. Results A total of 29,555 patients were enrolled. In terms of their demographic and clinicopathological characteristics, TCPTC had the highest prevalence of older patients, men, patients with locally advanced stage (T stage and N stage), and mortality, while FVPTC had the lowest prevalence in relation to these factors. The three variants differed significantly in terms of 5-year overall survival and 5-year disease-specific survival. Cox regression analysis identified male sex, age ≥45 years, and higher American Joint Committee on Cancer and TNM stage as independent factors predicting a poor prognosis in relation to both overall and disease-specific survival. Conclusions CPTC, FVPTC, and TCPTC have different clinicopathological characteristics and prognoses, indicating the need for different treatment strategies for these three variants of PTC.

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