Role of primary tumor resection in patients with metastatic medullary thyroid cancer who have unresectable distant metastases

Head & Neck ◽  
2021 ◽  
Vol 43 (11) ◽  
pp. 3386-3392
Author(s):  
Shi‐Min Zhuang ◽  
Liang‐En Xie ◽  
Feng Pang ◽  
Qian‐Yi Zhong ◽  
Xiao‐Mei Sun ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Primary Tumor ◽  
Medullary Thyroid Cancer ◽  
Tumor Resection ◽  
Distant Metastases ◽  
Primary Tumor Resection ◽  
Medullary Thyroid

scholarly journals Metastatic Risk Profile of Microscopic Lymphatic and Venous Invasion in Medullary Thyroid Cancer

2021 ◽  
Vol 53 (09) ◽  
pp. 588-593
Author(s):  
Andreas Machens ◽  
Kerstin Lorenz ◽  
Frank Weber ◽  
Henning Dralle
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Primary Tumor ◽  
Medullary Thyroid Cancer ◽  
Venous Invasion ◽  
Distant Metastases ◽  
Lymphatic Invasion ◽  
Medullary Thyroid ◽  
Primary Tumor Size

AbstractThe metastatic risk profile of microscopic lymphatic and venous invasion in medullary thyroid cancer is ill-defined. This evidence gap calls for evaluation of the suitability of microscopic lymphatic and venous invasion at thyroidectomy for prediction of lymph node and distant metastases in medullary thyroid cancer. In this study of 484 patients with medullary thyroid cancer who had≥5 lymph nodes removed at initial thyroidectomy, microscopic lymphatic and venous invasion were significantly associated with greater primary tumor size (27.6 vs. 14.5 mm, and 30.8 vs. 16.2 mm) and more frequent lymph node metastasis (97.0 vs. 25.9%, and 85.2 vs. 39.5%) and distant metastasis (25.0 vs. 5.1%, and 32.8 vs. 7.3%). Prediction of lymph node metastases by microscopic lymphatic invasion was better than prediction of distant metastases by microscopic venous invasion regarding sensitivity (97.0 vs. 32.8%) and positive predictive value (58.4 vs. 39.2%); comparable regarding negative predictive value (98.5 vs. 90.5%) and accuracy (80.4 vs. 85.1%); and worse regarding specificity (74.1 vs. 92.7%). On multivariable logistic regression, microscopic lymphatic invasion predicted lymph node metastasis better (odds ratio [OR] 65.6) than primary tumor size (OR 4.6 for tumors>40 mm and OR 2.7 for tumors 21–40 mm, relative to tumors≤20 mm), whereas primary tumor size was better in predicting distant metastasis (OR 8.3 for tumors>40 mm and OR 3.9 for tumors 21–40 mm, relative to tumors≤20 mm) than microscopic venous invasion (OR 3.2). These data show that lymphatic invasion predicts lymph node metastases better in medullary thyroid cancer than venous invasion heralds distant metastases.

YAP confers resistance to vandetanib in medullary thyroid cancer

2020 ◽  
Vol 98 (3) ◽  
pp. 443-448
Author(s):  
Huan Wang ◽  
Jian Tang ◽  
Zhiwei Su
Keyword(s):  
Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
Critical Role ◽  
Acquired Resistance ◽  
Resistant Cell ◽  
Resistant Cell Line ◽  
Antitumor Effects ◽  
Medullary Thyroid ◽  
Tt Cells

Medullary thyroid cancer (MTC) is the third most common thyroid cancer. RET (Rearranged in Transformation) gene mutations are considered as one of the major drivers of MTC. Vandetanib suppresses RET activity, and has shown promise in clinical trials. Unfortunately, acquired resistance to vandetanib has been observed in MTC, although the mechanism was largely unknown. We investigated the critical role of YAP (Yes-Associated Protein) on vandetanib resistance in MTC. For this, TT cells (medullary thyroid cancer cells) were treated with vandetanib for 3 months to generate a vandetanib-resistant cell line (TT-R). We investigated the role of YAP on vandetanib-resistance in TT-R cells by performing cell proliferation and colony formation assays, and examined the antitumor effects of YAP inhibitor and vandetanib in a mouse model of xenografted MTC. The TT-R cells displayed 6-fold higher IC50 to vandetanib than the TT cells. Overexpression of YAP resulted in resistance to vandetanib, whereas knockdown of YAP re-sensitized the TT-R cells to vandetanib. The YAP inhibitor synergized with vandetanib on tumor inhibition. Our results suggest that YAP plays an important role in acquired resistance to vandetanib in MTC, providing basis for combating MTC with YAP inhibitor and vandetanib.

scholarly journals Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis

2013 ◽  
Vol 18 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Walter Y Tsang ◽  
Argyrios Ziogas ◽  
Bruce S. Lin ◽  
Tara E. Seery ◽  
William Karnes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Analysis ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer

Medullary Thyroid Cancer: The Role of External Beam Therapy

2016 ◽  
pp. 151-155
Author(s):  
Meredith Elana Giuliani ◽  
James Brierley
Keyword(s):  
Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
External Beam ◽  
Medullary Thyroid

scholarly journals Association of a Palliative Surgical Approach to Stage IV Pancreatic Neuroendocrine Neoplasms with Survival: A Systematic Review and Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2246
Author(s):  
Marina Tsoli ◽  
Maria-Eleni Spei ◽  
Göran Wallin ◽  
Gregory Kaltsas ◽  
Kosmas Daskalakis
Keyword(s):  
Random Effects ◽  
Primary Tumor ◽  
Survival Benefit ◽  
Tumor Resection ◽  
Stage Iv ◽  
Distant Metastases ◽  
Primary Tumor Resection ◽  
Cochrane Library ◽  
Neuroendocrine Neoplasms ◽  
Pancreatic Neuroendocrine Neoplasms

The role of primary tumor resection in patients with pancreatic neuroendocrine neoplasms (PanNENs) and unresectable distant metastases remains controversial. We aimed to evaluate the effect of palliative primary tumor resection (PPTR) on overall survival (OS) in this setting. We searched the MEDLINE, Embase, Cochrane Library, Web of Science and SCOPUS databases up to January 2020 and used the Newcastle–Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5661 articles were screened. In 10 studies, 5551 unique patients with stage IV PanNEN and unresectable metastases were included. The five-year OS for PanNEN patients undergoing PPTR in stage IV was 56.6% vs. 23.9% in the non-surgically treated patients (random effects relative risk (RR): 1.70; 95% CI: 1.53–1.89). Adjusted analysis of pooled hazard ratios (HR) confirmed longer OS in PanNEN patients undergoing PPTR (random effects HR: 2.67; 95% CI: 2.24–3.18). Cumulative OS analysis confirmed an attenuated survival benefit over time. The complication rate of PPTR was as high as 27%. In conclusion, PPTR may exert a survival benefit in stage IV PanNEN. However, the included studies were subject to selection bias, and special consideration should be given to PPTR anchored to a multimodal treatment strategy. Further longitudinal studies are warranted, with long-term follow-up addressing the survival outcomes associated with surgery in stage IV disease.

The role of human achaete-scute homolog-1 in medullary thyroid cancer cells

Surgery ◽  
2003 ◽  
Vol 134 (6) ◽  
pp. 866-871 ◽  
Author(s):  
Rebecca S Sippel ◽  
Jennifer E Carpenter ◽  
Muthusamy Kunnimalaiyaan ◽  
Herbert Chen
Keyword(s):  
Thyroid Cancer ◽  
Cancer Cells ◽  
Medullary Thyroid Cancer ◽  
Medullary Thyroid ◽  
Thyroid Cancer Cells
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