Changing trends of incidence and prognosis of thyroid carcinoma

2019 ◽  
Vol 58 (02) ◽  
pp. 86-92 ◽  
Author(s):  
Jamshid Farahati ◽  
Uwe Mäder ◽  
Elena Gilman ◽  
Rainer Görges ◽  
Ines Maric ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Distant Metastases ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
Population Based ◽  
Management Algorithm ◽  
Node Involvement ◽  
T1 And T2 ◽  
Lower Franconia

Abstract Aim to evaluate the time trend of epidemiology of follicular cell derived thyroid cancer (TC) based on data from a well documented cancer registry. Methods Population based data on TC from Lower Franconia (LF), Germany, within 1981 and 2015 were analysed to estimate the regional epidemiology of TC. The incidence was assessed in 5-year-intervals for gender, histology, and tumor stage. Results Incidence of TC solely attributable to papillary TC (PTC) doubled mainly in T1- and T2-stages within the evaluation period from 4.5 to 8.7/100.000/y in females and 1.7 to 4.1/100.000/y in males. There was no significant change of follicular TC (FTC), whereas anaplastic TC (ATC) decreased in the same interval. The number of lymph-node metastases and T3-cases increased, while the frequency of T4-stage and distant metastases decreased. Increased incidences of T1- and T2-stages suggest an over-diagnosis. In contrast, increasing number of tumors at T3-stage and with lymph node involvement contradict the over-diagnosis as the only reason for rising incidence. Declining of T4-stages in spite of increasing of T3-stages and N1-cases indicates the value of timely detection and treatment of TC. In accordance, reduced incidence of advanced cancers with M1-stage and ATC cases promote our current management of TC. Conclusion Timely diagnosis and adequate risk-adopted treatment of thyroid cancer reduce the frequency of high-risk cases with distant metastases and the possible protracted dedifferentiation of TC to anaplastic features. Our analyses support the management algorithm in thyroid cancer according to the recent guidelines of German Nuclear Medicine Society.

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

scholarly journals The Role of BiP and the IRE1α–XBP1 Axis in Rhabdomyosarcoma Pathology

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4927
Author(s):  
Mahmoud Aghaei ◽  
Ahmad Nasimian ◽  
Marveh Rahmati ◽  
Philip Kawalec ◽  
Filip Machaj ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Lymph Node ◽  
Tumor Development ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
P Value ◽  
Adult Disease ◽  
Specific Tumor ◽  
Node Involvement ◽  
The Unfolded Protein Response

Background: Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in children, and is associated with a poor prognosis in patients presenting with recurrent or metastatic disease. The unfolded protein response (UPR) plays pivotal roles in tumor development and resistance to therapy, including RMS. Methods: In this study, we used immunohistochemistry and a tissue microarray (TMA) on human RMS and normal skeletal muscle to evaluate the expression of key UPR proteins (GRP78/BiP, IRE1α and cytosolic/nuclear XBP1 (spliced XBP1-sXBP1)) in the four main RMS subtypes: alveolar (ARMS), embryonal (ERMS), pleomorphic (PRMS) and sclerosing/spindle cell (SRMS) RMS. We also investigated the correlation of these proteins with the risk of RMS and several clinicopathological indices, such as lymph node involvement, distant metastasis, tumor stage and tumor scores. Results: Our results revealed that the expression of BiP, sXBP1, and IRE1α, but not cytosolic XBP1, are significantly associated with RMS (BiP and sXBP1 p-value = 0.0001, IRE1 p-value = 0.001) in all of the studied types of RMS tumors (n = 192) compared to normal skeletal muscle tissues (n = 16). In addition, significant correlations of BiP with the lymph node score (p = 0.05), and of IRE1α (p value = 0.004), cytosolic XBP1 (p = 0.001) and sXBP1 (p value = 0.001) with the stage score were observed. At the subtype level, BiP and sXBP1 expression were significantly associated with all subtypes of RMS, whereas IRE1α was associated with ARMS, PRMS and ERMS, and cytosolic XBP1 expression was associated with ARMS and SRMS. Importantly, the expression levels of IRE1α and sXBP1 were more pronounced in ARMS than in any of the other subtypes. The results also showed correlations of BiP with the lymph node score in ARMS (p value = 0.05), and of sXBP1 with the tumor score in PRMS (p value = 0.002). Conclusions: In summary, this study demonstrates that the overall UPR is upregulated and, more specifically, that the IRE1/sXBP1 axis is active in RMS. The subtype and stage-specific dependency on the UPR machinery in RMS may open new avenues for the development of novel targeted therapeutic strategies and the identification of specific tumor markers in this rare but deadly childhood and young-adult disease.

Correlation of BMI with tumor stage in early breast cancer patients (pts): Pooled analysis of the German SUCCESS A, B, and C trials.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1602-1602
Author(s):  
Carola Anna Melcher ◽  
Uta Ortmann ◽  
Christoph Scholz ◽  
Thomas Zwingers ◽  
Andreas Schneeweiss ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
Primary Breast Cancer ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
Phase Iii ◽  
Tumor Characteristics ◽  
Node Involvement ◽  
Disease Free

1602 Background: Independent from known prognostic factors, e.g., tumor size and nodal status, obesity is a risk factor for poor disease free, distant disease free, and overall survival in breast cancer. The aim of this analysis was to examine the correlation of the body mass index (BMI) with tumor characteristics in early breast cancer. Methods: We analyzed the data of 7,997 pts with early, node positive or high risk node negative primary breast cancer treated with adjuvant taxan-based chemotherapy within the German multicenter phase III SUCCESS A, B, or C trials. The pts’ tumor stage at primary diagnosis was classified according to the UICC tumor-node-metastasis (TNM) classification. Additionally, the tumor’s hormone-receptor status and HER2/neu status were determined. Before enrollment into the study each patient was grouped according to the WHO global database on BMI. Contingency table methods were used to analyze the correlation of BMI and tumor characteristics. Results: Among the 7,997 pts 100 (1.3%) pts were underweight, 3,556 (44.5%) pts were normal weight, 2,569 (32.1%) pts were overweight and 1,772 (22.2%) were obese. Of all pts 4,508 pts (56.4%) suffered from a pT2-4 tumor, 4830 (60.4%) showed lymph node involvement (pN1-3) and 7509 (93.9%) had G2-3 tumors. 5839 pts (73.0%) showed positivity for ER or PR and 935 (11.7%) for HER2/neu. Overweight and obese pts had significantly larger tumors compared to pts with normal BMI (p<0.0001; p<0.0001). Furthermore, overweight and obesity were associated with a significantly higher rate of lymph node involvement (p=0.0001; p=0.0003) respectively. In contrast neither grading, tumor histology, ER/PR-status nor HER2/neu-overexpression were correlated with BMI. Conclusions: These data are the first to show in a large number of pts that both obese and overweight women suffering from primary breast cancer have significantly larger tumors and more often positive axillary lymph nodes. As there are no differences in tumor biology, the advanced tumor stage might be due to more difficult and delayed detection of breast cancer and lymph node lesions in these women.

scholarly journals Quality of Life and Anxiety in Adolescents with Differentiated Thyroid Cancer

2012 ◽  
Vol 97 (10) ◽  
pp. E1933-E1937 ◽  
Author(s):  
Asaf Oren ◽  
Melissa Anne Benoit ◽  
Anne Murphy ◽  
Fiona Schulte ◽  
Jill Hamilton
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Lymph Node ◽  
Differentiated Thyroid Cancer ◽  
Lymph Node Involvement ◽  
Autoimmune Hypothyroidism ◽  
Control Subjects ◽  
Node Involvement ◽  
Anxiety Levels

Abstract Context: Adolescents with differentiated thyroid cancer (DTC) require lifelong monitoring with a high possibility of reoperation or radioactive iodine. Although adult DTC survivors have similar or slightly worse quality of life (QOL), this has not been evaluated in the pediatric population. Objective: Our objective was to compare QOL and anxiety in adolescents with DTC to patients with acquired autoimmune hypothyroidism. Design, Setting, and Patients: In this cross-sectional pilot study, three validated questionnaires were administered to 16 adolescents with DTC and 16 controls for assessment of QOL and anxiety levels. These included teen and parent PedsQL, Multidimensional Anxiety Scale for Children, and Coddington Life Events Scales for Adolescents. The contribution of age, time since diagnosis, and biochemical variables were compared with the outcome measures. Results: There were 16 DTC patients (seven males); 13 had papillary carcinoma, one had follicular carcinoma, and two had mixed type. At diagnosis, five DTC patients had lymph node involvement and two had lung metastases, although at time of assessment, only one DTC patient had lymph node involvement. DTC patients were older than control subjects (P = 0.004) and had lower TSH levels than control subjects at time of assessment (P = 0.013). QOL and anxiety levels did not differ between DTC patients compared with control subjects and with previously reported scores in a healthy cohort. QOL and anxiety level parameters were not influenced by age, time since diagnosis, or free T4 levels measured at the time of assessment. Conclusions: Adolescents with DTC have similar QOL and anxiety levels compared with autoimmune hypothyroidism patients and with a healthy normative population.

scholarly journals Impact of 18F-FDG PET/CT on the staging of patients with non-small cell lung cancer

2020 ◽  
Vol 8 (6) ◽  
pp. 2023
Author(s):  
Ngo Minh Xuan ◽  
Huynh Quang Huy
Keyword(s):  
Lymph Node ◽  
Tumor Size ◽  
Distant Metastases ◽  
Large Cell ◽  
Lymph Node Involvement ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Node Involvement ◽  
Group 3

Background: Non-small cell lung cancer (NSCLC) accounts for approximately 80% of new diagnoses of pulmonary carcinoma. This study investigated the correlation between 18 F-fluorodeoxyglucose uptake in computerized tomography integrated positron emission tomography and tumor size, lymph node metastasis, and distant metastasis in patients with NSCLC.Methods: The records of 318 NSCLC patients (220 male, 98 females; mean age 60.94 years) were evaluated retrospectively.Results: 278 cases were adenocarcinomas; 28 squamous cell carcinomas; and 12 large cell carcinoma. When the cases were categorized according to tumor size (group 1, ≤3 cm; group 2, >3 and ≤5 cm; group 3, >5 cm), the maximum standardized uptake value (SUVmax) was significantly lower in groups 1 and 2 compared with group 3 (p<0,001 for each). Considering all cases, tumor SUVmax was not correlated with age, gender or histopathological type. Lymph node metastases were seen in 250 cases: 80.2% of these were adenocarcinomas, 71.4% squamous cell carcinomas, and 58.3% large cell carcinomas. Neither lymph node involvement nor distant metastases were correlated with tumor SUVmax, although lymph node size was positively correlated with lymph node SUVmax (r=0.758; p<0.001).Conclusions: SUVmax was significantly associated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases. 

scholarly journals Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 83
Author(s):  
Zsuzsanna Iyizoba-Ebozue ◽  
Louise J. Murray ◽  
Moses Arunsingh ◽  
Karen E. Dyker ◽  
Sriram Vaidyanathan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Concurrent Chemotherapy ◽  
Oropharyngeal Carcinoma ◽  
Retropharyngeal Lymph Node ◽  
Significant Difference ◽  
Node Involvement ◽  
Fdg Pet Ct ◽  
The Impact

The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, p = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, p = 0.011), with no significant difference in local control (81.6% vs. 87.7%, p = 0.154) or regional control (80.7% vs. 85.4%, p = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.

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