Anaplastic Thyroid Cancer: Surgery or Not in Locally Advanced Disease

2020 ◽  
pp. 383-390
Author(s):  
Ashish V. Chintakuntlawar ◽  
Keith C. Bible ◽  
Robert C. Smallridge
Keyword(s):  
Thyroid Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Anaplastic Thyroid Cancer ◽  
Cancer Surgery ◽  
Locally Advanced Disease

scholarly journals The Age Threshold of the 8th Edition AJCC Classification Is Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice. 

2020 ◽  
Author(s):  
Krzysztof Kaliszewski ◽  
Dorota Diakowska ◽  
Łukasz Nowak ◽  
Beata Wojtczak ◽  
Jerzy Rudnicki
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Papillary Thyroid Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Papillary Thyroid ◽  
Locally Advanced Disease ◽  
In Series ◽  
8Th Edition

Abstract Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification is to increase the age cut off for risk stratification in PTC from 45 to 55 years. However, whether this cut off is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of patients with PTC admitted to and surgically treated at a single surgical center. The study protocol was divided into two series. In each series all patients (n=523) were divided in 2 groups according to age cut off. In the first series (cut off 45) patients <45 (n=193) vs. ≥45 (n=330) were compared, and in the second series (cut off 55) patients <55 (n=306) vs. ≥55 (n=217) were compared.Results: The rate of the prevalence of locally advanced disease (pT3 and pT4) was significantly higher in the patients above 55 years old than in those below 55 years old (p=0.013). No significant differences were found for this parameter in series with cut off point 45 years old. A significantly higher risk of locally advanced disease T3+T4 (OR=4.87) and presence of LNM (N1) (OR=3.78) was observed in ≥45 years old group (p=0.021 and p<0.0001, respectively). More expressive results were found for the patients ≥55 years old group, where the risk of locally advanced disease (T3+T4) was higher (OR=5.21) and LNM presence was OR=4.76 (p<0.001 and p<0.0001, respectively). None of the patients below 55 years old showed distant metastasis, but 19 patients above 55 years old showed M1 (p<0.0001). In older patients group (≥55 years old) we observed deaths related thyroid cancer in 11 individuals.Conclusions: The age cut off of 55 years old for risk stratification proposed by the 8th Edition of AJCC effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

scholarly journals The Age Threshold of the 8th Edition AJCC Classification Is Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice. 

2020 ◽  
Author(s):  
Krzysztof Kaliszewski ◽  
Dorota Diakowska ◽  
Łukasz Nowak ◽  
Beata Wojtczak ◽  
Jerzy Rudnicki
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Papillary Thyroid Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Papillary Thyroid ◽  
Locally Advanced Disease ◽  
In Series ◽  
8Th Edition

Abstract Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification is to increase the age cut off for risk stratification in PTC from 45 to 55 years. However, whether this cut off is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of patients with PTC admitted to and surgically treated at a single surgical center. The study protocol was divided into two series. In each series all patients (n=523) were divided in 2 groups according to age cut off. In the first series (cut off 45) patients <45 (n=193) vs. ≥45 (n=330) were compared, and in the second series (cut off 55) patients <55 (n=306) vs. ≥55 (n=217) were compared.Results: The rate of the prevalence of locally advanced disease (pT3 and pT4) was significantly higher in the patients above 55 years old than in those below 55 years old (p=0.013). No significant differences were found for this parameter in series with cut off point 45 years old. A significantly higher risk of locally advanced disease T3+T4 (OR=4.87) and presence of LNM (N1) (OR=3.78) was observed in ≥45 years old group (p=0.021 and p<0.0001, respectively). More expressive results were found for the patients ≥55 years old group, where the risk of locally advanced disease (T3+T4) was higher (OR=5.21) and LNM presence was OR=4.76 (p<0.001 and p<0.0001, respectively). None of the patients below 55 years old showed distant metastasis, but 19 patients above 55 years old showed M1 (p<0.0001). In older patients group (≥55 years old) we observed deaths related thyroid cancer in 11 individuals.Conclusions: The age cut off of 55 years old for risk stratification proposed by the 8th Edition of AJCC effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

scholarly journals The Age Threshold of the 8th Edition AJCC ClassificationIs Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice.

2020 ◽  
Author(s):  
Krzysztof Kaliszewski ◽  
Dorota Diakowska ◽  
Łukasz Nowak ◽  
Beata Wojtczak ◽  
Jerzy Rudnicki
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Papillary Thyroid Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Papillary Thyroid ◽  
Locally Advanced Disease ◽  
In Series ◽  
8Th Edition

Abstract Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classificationis to increase the age cutoff for risk stratification in PTC from 45 to 55 years. However, whether this cutoff is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of patients with PTC admitted to and surgically treated at a single surgical center. The study protocol was divided into two series. In each series all patients (n=523) were divided in 2 groups according to age cutoff. In the first series (cutoff 45) patients <45 (n=193) vs. ≥45 (n=330) were compared, and in the second series (cutoff 55) patients <55 (n=306) vs. ≥55 (n=217) were compared.Results: The rate of the prevalence of locally advanced disease (pT3 and pT4) was significantly higher in the patients above 55 years old than in those below 55 years old (p=0.013). No significant differences were found for this parameter in series with cutoff point 45 years old. A significantly higher risk of locally advanced disease T3+T4 (OR=4.87) and presence of LNM (N1) (OR=3.78) was observed in ≥45 years old group (p=0.021 and p<0.0001, respectively). More expressive results were found for the patients ≥55 years old group, where the risk of locally advanced disease (T3+T4) was higher (OR=5.21) and LNM presence was OR=4.76 (p<0.001 and p<0.0001, respectively). None of the patients below 55 years old showed distant metastasis, but 19 patients above 55 years old showed M1 (p<0.0001). In older patients group (≥55 years old) we observed deaths related thyroid cancer in 11 individuals.Conclusions: The age cut off of 55 years old for risk stratification proposed by the 8th Edition of AJCC effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

scholarly journals The age threshold of the 8th edition AJCC classification is useful for indicating patients with aggressive papillary thyroid cancer in clinical practice

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Krzysztof Kaliszewski ◽  
Dorota Diakowska ◽  
Łukasz Nowak ◽  
Beata Wojtczak ◽  
Jerzy Rudnicki
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Papillary Thyroid Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Papillary Thyroid ◽  
Locally Advanced Disease ◽  
In Series ◽  
8Th Edition

Abstract Background Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification is to increase the age cut off for risk stratification in PTC from 45 to 55 years. However, whether this cut off is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC. Methods We retrospectively analyzed the clinicopathological features and overall survival rate of patients with PTC admitted to and surgically treated at a single surgical center. The study protocol was divided into two series. In each series all patients (n = 523) were divided in 2 groups according to age cut off. In the first series (cut off 45) patients < 45 (n = 193) vs. ≥45 (n = 330) were compared, and in the second series (cut off 55) patients < 55 (n = 306) vs. ≥55 (n = 217) were compared. Results The rate of the prevalence of locally advanced disease (pT3 and pT4) was significantly higher in the patients above 55 years old than in those below 55 years old (p = 0.013). No significant differences were found for this parameter in series with cut off point 45 years old. A significantly higher risk of locally advanced disease T3 + T4 (OR = 4.87) and presence of LNM (N1) (OR = 3.78) was observed in ≥45 years old group (p = 0.021 and p < 0.0001, respectively). More expressive results were found for the patients ≥55 years old group, where the risk of locally advanced disease (T3 + T4) was higher (OR = 5.21) and LNM presence was OR = 4.76 (p < 0.001 and p < 0.0001, respectively). None of the patients below 55 years old showed distant metastasis, but 19 patients above 55 years old showed M1 (p < 0.0001). In older patients group (≥55 years old) we observed deaths related thyroid cancer in 11 individuals. Conclusions The age cut off of 55 years old for risk stratification proposed by the 8th Edition of AJCC effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

scholarly journals Breast Cancer Surgery at a Cancer Center in Janakpurdham: An Initial Experience

2020 ◽  
Vol 42 (1) ◽  
pp. 72
Author(s):  
Pamesh Jha ◽  
Anshu K Thakur ◽  
Sanjay Gupta ◽  
Richa Mishra ◽  
Yogendra P Singh
Keyword(s):  
Breast Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Cancer Center ◽  
Locally Advanced Disease ◽  
Cancer Hospital

Introduction Breast cancer is the second commonest cancer in Nepalese women. In most of the low income countries including Nepal, breast cancer is commonly diagnosed at late stage. The Binaytara Foundation Cancer Center (BTFCC), a 25 bed cancer hospital was established in Province 2, the most densely populated province, of Nepal in December 2018. We describe our experience of breast cancer surgery at the cancer hospital. MethodsSurgical service was started from April 2019 after establishing an equipped operating room and post-operative and ICU wards. Total 51 surgeries were performed for both benign and malignant diseases by the end of 2019. The commonest surgery was breast surgery in 18 patients. Retrospective analysis of all six patients who were operated for breast cancer at the cancer center was done. ResultSix female patients of this province were operated for breast cancer during this period. Age ranged from 40 to 56 years. Four patients were presented with locally advanced disease. Two patients received neo-adjuvant chemotherapy and two were subjected for upfront surgery. Modified radical mastectomy was done in four patients. For one patient with suspected hereditary localized breast cancer and one with Paget’s disease of the breast with non invasive ductal carcinoma, simple mastectomy was performed. Postoperative period was uneventful except one case with seroma formation. Other than one Paget’s disease of the breast, all were triple nipple breast cancer. ConclusionBreast cancer surgery is one of the important modality of treatment even for locally advanced disease in resource limited settings.

Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Independent Predictor ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Small Sample ◽  
Locally Advanced Disease ◽  
Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

scholarly journals Can 3T multiparametric magnetic resonance imaging accurately detect prostate cancer extracapsular extension?

2013 ◽  
Vol 7 (11-12) ◽  
pp. 699 ◽  
Author(s):  
Yannick Cerantola ◽  
Massimo Valerio ◽  
Aida Kawkabani Marchini ◽  
Jean-Yves Meuwly ◽  
Patrice Jichlinski
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Resonance Imaging ◽  
Extracapsular Extension ◽  
Predictive Values ◽  
Locally Advanced Disease ◽  
Multiparametric Magnetic Resonance Imaging

Background: Accurate staging is essential to determine the correct management of patients diagnosed with prostate cancer. We assess the accuracy of 3T multiparametric magnetic resonance imaging (MRI) with endorectal coil (3TemMRI) in detecting prostate cancer local extension.Methods: We retrospectively reviewed charts from January 2008 to July 2012 from all patients undergoing radical prostatectomy. Patients were only included if 3TemMRI and radical prostatectomywere performed at our institution. Based on the presence of extracapsular extension (ECE) at 3TemMRI, prostate cancer was dichotomized into locally advanced or organ-confined disease. The accuracy of 3TemMRI local staging was then evaluated using definitive pathology as a reference.Results: Overall, 177 radical prostatectomies were performed within the timeframe. After applying exclusion criteria, 60 patients were included in the final analysis. The mean patient age was 67 ± 7 (standard deviation) years. Mean prostate-specific antigen value was 12.7 ± 12.7 ng/L. Based on preoperative characteristics, we considered 38 of the 60 patients (63%) patients high risk. 3TemMRI identified an organ-confined tumour in 46 patients and locally advanced disease in 14 patients. When correlated to final pathology, 3TemMRI specificity, sensitivity, negative and positive predictive values, and accuracy in detecting locally advanced prostate cancer were 90%, 35%, 57%, 79% and 62%, respectively.Interpretation: This study shows that the use of preoperative 3TemMRI can be used to identify organ-confined prostate cancer when locally advanced disease is suspected.

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