Practical Performance of the 2015 American Thyroid Association Guidelines for Predicting Tumor Recurrence in Patients with Papillary Thyroid Cancer in South Korea

Thyroid ◽  
2017 ◽  
Vol 27 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Seul Gi Lee ◽  
Woo Kyung Lee ◽  
Hye Sun Lee ◽  
Jieun Moon ◽  
Cho Rok Lee ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
South Korea ◽  
Papillary Thyroid Cancer ◽  
Tumor Recurrence ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Practical Performance

scholarly journals Annual Hazard Rate of Recurrence in Middle Eastern Papillary Thyroid Cancer over a Long-Term Follow-Up

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3624
Author(s):  
Abdul K. Siraj ◽  
Sandeep Kumar Parvathareddy ◽  
Zeeshan Qadri ◽  
Khawar Siddiqui ◽  
Saif S. Al-Sobhi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Hazard Rate ◽  
Tumor Recurrence ◽  
Cox Regression ◽  
Middle Eastern ◽  
Treatment Strategies ◽  
Recurrence Risk ◽  
Papillary Thyroid ◽  
Cox Regression Analysis

Predicting the pattern of recurrence in papillary thyroid cancer (PTC) is necessary to establish optimal surveillance and treatment strategies. We analyzed changes in hazard rate (HR) for tumor recurrence over time in 1201 unselected Middle Eastern PTC patients. The changes in risk were further analyzed according to clinical variables predictive of early (≤5 years) and late (>5 years) recurrence using Cox regression analysis to identify patient populations that remain at risk. Tumor recurrence was noted in 18.4% (221/1201) patients. The annualized hazard of PTC recurrence was highest during the first 5 years (2.8%), peaking between 1 and 2 years (3.7%), with a second smaller peak between 13 and 14 years (3.2%). Patients receiving radioactive iodine (RAI) therapy had lower recurrence hazard compared to those who did not (1.5% vs. 2.7%, p = 0.0001). Importantly, this difference was significant even in intermediate-risk PTC patients (0.7% vs. 2.3%; p = 0.0001). Interestingly, patients aged ≥55 years and having lymph node metastasis were at persistent risk for late recurrence. In conclusion, we confirmed the validity of the double-peaked time-varying pattern for recurrence risk in Middle Eastern PTC patients and our findings could help in formulating individualized treatment and surveillance plans.

scholarly journals Blood prognostic predictors of treatment response for patients with papillary thyroid cancer

2020 ◽  
Vol 40 (10) ◽  
Author(s):  
Xiangxiang Liu ◽  
Zhongke Huang ◽  
Xianghui He ◽  
Xiangqian Zheng ◽  
Qiang Jia ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Poor Prognosis ◽  
Response To Therapy ◽  
Prognostic Indicators ◽  
High Morbidity ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Distribution Width ◽  
Prognosis Group

Abstract Background: Papillary thyroid cancer (PTC) is a very common malignant disease with high morbidity. We needed some pretreatment indicators to help us predict prognosis and guide treatment. We conducted a study about some pretreatment prognostic indicators. Methods: This clinical study recruited 705 postoperative PTC patients (211 males, 494 females). Clinical data before radioactive iodine (RAI) treatment were collected. Patients’ response to therapy were classified into two categories: ‘Good Prognosis Group’ (GPG) and ‘Poor Prognosis Group’ (PPG), according to ‘2015 American Thyroid Association Guidelines’. Differences of indicators between different prognosis groups were compared. Odds ratios (ORs) were calculated by univariate/multiple binary logistic regression models. Difference of body mass index (BMI) changes before and after RAI treatment between different prognosis groups was also compared. Results: A total of 546 (77.45%) belonged to GPG, and 159 (22.55%) belonged to PPG. Platelet (PLT), neutrophil (NEUT), PLT subgroups, and combination of red blood cell distribution width (RDW) and BMI (COR-BMI) were different between two prognosis groups. The significance of the difference between the two groups of BMI disappeared after the Bonferroni correction. PLT and PLT subgroups had detrimental effects on the risk of PPG; T stage had a positive effect on the risk of PPG. PLT subgroup showed a detrimental effect on the risk of PPG when we included additional covariates. Conclusions: We found that lower pretreatment PLT levels may indicate a poor prognosis for PTC. The relationship between platelet-derived growth factor (PDGF) and radiation sensitivity may be the key to this association.

Macroscopic extranodal invasion is a risk factor for tumor recurrence in papillary thyroid cancer

2001 ◽  
Vol 164 (1) ◽  
pp. 85-89 ◽  
Author(s):  
Kazuhiko Asanuma ◽  
Ritsu Kusama ◽  
Masayuki Maruyama ◽  
Minoru Fujimori ◽  
Jun Amano
Keyword(s):  
Risk Factor ◽  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Tumor Recurrence ◽  
Papillary Thyroid

scholarly journals The Clinical Significance of Lymph Node Ratio and Ki-67 Expression in Papillary Thyroid Cancer

2021 ◽  
Author(s):  
Helene Lindfors ◽  
Catharina Ihre Lundgren ◽  
Jan Zedenius ◽  
C. Christofer Juhlin ◽  
Ivan Shabo
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Tumor Recurrence ◽  
Lymph Node Ratio ◽  
Papillary Thyroid ◽  
Ki 67 ◽  
Node Ratio ◽  
N Stage

Abstract Background The N stage in papillary thyroid cancer (PTC) is an important prognostic factor based on anatomical localization of cervical lymph nodes (LNs) only and not the extent of lymphatic metastasis. In this retrospective study, the clinical significance of lymph node ratio (LNR) and tumor cell proliferation in relation to the conventional classification of PTC was explored. Methods Patients diagnosed with PTC at the Karolinska University Hospital in Stockholm, Sweden, during the years 2009–2011 were included. The LNR, defined as the number of metastatic LNs divided by the total number of LNs investigated, and the Ki-67 index were analyzed in relation to clinical data. Results The median number of LN removed was 16 with the following N stage distribution: N0 (26%), N1a (45%), and N1b (29%). A Ki-67 index of ≥3% was significantly correlated with the presence of metastases and tumor recurrence with a sensitivity of 50% and specificity of 80% (p = 0.015). Lymph node ratio ≥21% was related to tumor recurrence with sensitivity of 89% and specificity of 70% (p = 0.006). Patients with LN metastases in the lateral cervical compartment only had significantly lower LNR (14.5%) compared to those with both central and lateral cervical metastases (39.5%) (p = 0.004) and exhibited no tumor recurrence. Increased Ki-67 index was significantly related to LNR ≥21% (p = 0.023) but was not associated with N stage. Conclusions The Ki-67 proliferation index and LNR may better reflect the malignant behavior of PTC compared to the anatomical classification of LN metastases solely.

scholarly journals Stratification of papillary thyroid cancer relapse risk based on the results of molecular genetic studies

2020 ◽  
Vol 10 (1) ◽  
pp. 93-100 ◽  
Author(s):  
S. A. Lukyanov ◽  
S. V. Sergiyko ◽  
S. E. Titov ◽  
I. V. Reshetov ◽  
Yu. A. Veryaskina ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Braf Mutation ◽  
Clinical Manifestations ◽  
Microrna Expression ◽  
Preoperative Treatment ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Study Objective ◽  
Risk Of Relapse

Introduction. Post-transcriptional mechanisms play a crucial role in the biological course and clinical manifestations of papillary thyroid cancer (PTC). Recent studies show that an increased content of oncogenic or reduced content of oncosuppressive microRNAs increases the aggressiveness of the tumor and correlates with an unfavorable prognosis of treatment, which allows them to be used in personalizing the treatment tactics of patients with PTC. The study objective is to compare the level of expression of 12 PTC-specific microRNAs and the frequency of V600E mutation of the BRAF gene in patients with different risk of relapse. Materials and methods. The study included 175 patients with PTC. For quantitative analysis of microRNA expression, a reverse transcription reaction followed by a real-time polymerase chain reaction in formalin-fixed paraffin blocks was used. Correlations between 12 microRNA expression and BRAF mutation with different clinical and anatomical features of PTC the risk of relapse according to the American Thyroid Association Risk Stratification System (2009) were analyzed. Results. We demonstrated that miR-146b, miR-221, miR-144, miR-451a, and miR-7 expression correlated with features such as extrathyroid tumor growth, larger size, multifocus, lymph node metastasis, and the presence of distant metastases of the PTC. Most importantly, miR-221, miR-144, miR-451a, and miR-7 expression correlated with risk levels, suggesting their potential significance in stratifying the risk of relapsing PTC. The dependence of the clinical behavior of PTC on the BRAF mutation has not been established.Conclusion. The result of the study will contribute to the individual choice of preoperative treatment tactics for patients with PTC. 

Thyroid Ultrasound: More Sensitive than Radioactive Iodine Imaging in Detecting Recurrence of Papillary Thyroid Cancer in Two Pediatric Patients

2018 ◽  
Vol 90 (1) ◽  
pp. 66-72
Author(s):  
Brittany K. Wise-Oringer ◽  
Marina Goldis ◽  
Molly O. Regelmann ◽  
Michelle Klein ◽  
Josef Machac ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Pediatric Patients ◽  
Radioactive Iodine ◽  
Imaging Modality ◽  
Thyroid Stimulating Hormone ◽  
Whole Body ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin

Background: Papillary thyroid cancer (PTC) is an uncommon pediatric disease with an excellent prognosis. In follow-up surveillance, neck ultrasound (US), basal and thyroid-stimulating hormone-stimulated serum thyroglobulin (Tg) levels, and diagnostic whole-body radioactive iodine scans (DxWBS) have been traditionally used in both adults and children for the detection of recurrence or metastases of PTC. Methods: Two pediatric patients with metastatic PTC were followed after standard ablative treatment with routine neck US and serum Tg levels, as well as periodic DxWBS. Results: Neck US identified recurrent and metastatic PTC which DxWBS failed to detect. Conclusion: Neck US was superior to DxWBS in the detection of recurrent PTC in these 2 pediatric patients. These findings are consistent with the 2015 American Thyroid Association (ATA) Guidelines that neck US is an ideal imaging modality in pediatric patients for the surveillance of PTC local recurrence or lymph node metastases.

Impact of the American Thyroid Association guidelines on the Australian surgical management of papillary thyroid cancer

2018 ◽  
Vol 88 (11) ◽  
pp. 1102-1103 ◽  
Author(s):  
Dane Cole-Clark ◽  
Philip J. Townend ◽  
Anton Engelsman ◽  
Man-Shun Wong ◽  
Mark Sywak ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Surgical Management ◽  
American Thyroid Association ◽  
Papillary Thyroid

scholarly journals Preoperative significance of thyroglobulin, thyroid stimulating hormone and thyroglobulin antibody in differentiated papillary thyroid carcinoma

2019 ◽  
Vol 6 (12) ◽  
pp. 4229
Author(s):  
Tarek M. Rageh ◽  
Asmaa G. Abdou ◽  
Enas A. Elkhouly ◽  
Dalia H. Abou El- Ela ◽  
Mohamed A. Zidan
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Tumor Recurrence ◽  
Thyroid Stimulating Hormone ◽  
Lymph Node Status ◽  
Papillary Thyroid ◽  
Neck Ultrasound ◽  
Significant Difference ◽  
Benign Thyroid ◽  
Stimulating Hormone

Background: The objective of the study was to compare the levels of preoperative thyroglobulin (TG), thyroid stimulating hormone level (TSH), FT3, FT4 and TG Ab among 50 malignant and 50 benign thyroid swellings. Papillary thyroid cancer (PTC) is the most common malignancy in thyroid gland. TG antibodies (Ab) occur in around 20% of patients with papillary thyroid cancer (PTC), and the presence of TG Ab complicates the follow-up of these patients because TG-Ab interferes with the assay of serum TG7.Methods: A prospective and retrospective study conducted on 100 patients with thyroid nodule diagnosed by neck ultrasound and confirmed by histopathological evaluation in Faculty of Medicine, Menoufia University Hospital, Egypt, during January 2017 to July 2019. History taking, levels of TG, TSH free T3, free T4 and TG Ab, neck ultrasound or CT and pathological evaluation were done.Results: There were statistically significant differences between malignant and benign thyroid swellings regarding, TG level, TSH and T4 level. Also, there was statistically significant difference between the level of TG and tumor recurrence (p=0.01). While, there was no statistical significance between focality, staging, lymph node status, capsular invasion, lymphovascular embolization, and evidence of hashimoto thyroiditis and the level of TG.Conclusions: Preoperative serum TG concentration is a useful marker for predicting the presence of initial distant metastasis of PTC and tumor recurrence. TSH level considered an important prognostic factor for papillary thyroid cancer patients.

ADDITIONAL SURGERY FOR OCCULT RISK FACTORS AFTER LOBECTOMY IN SOLITARY THYROID NODULES IS PREDICTED BY CYTOPATHOLOGY CLASSIFICATION AND TUMOR SIZE

2020 ◽  
Vol 26 (7) ◽  
pp. 754-760
Author(s):  
Andrew Flagg ◽  
Lisa Rooper ◽  
Sheila Sheth ◽  
Mohammad Shaear ◽  
Prasanna Santhanam ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Thyroid Nodules ◽  
Multivariable Analysis ◽  
Extrathyroidal Extension ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Extrathyroidal Invasion ◽  
Additional Surgery

Objective: Clinical practice for differentiated thyroid cancer is moving towards lobectomy rather than total thyroidectomy in patients at low risk of recurrence. However, recurrence risk assessment depends on post-operative findings, while the surgical decision is based on preoperative factors. We determined the preoperative predictors of occult higher-risk pathology and rates of completion thyroidectomy among surgical candidates with nonbenign thyroid nodules 10 to 40 mm and no evidence of extrathyroidal extension or metastasis on preoperative evaluation. Methods: Thyroid surgery cases at a single institution from 2005–2015 were reviewed to identify those meeting American Thyroid Association (ATA) criteria for lobectomy. ATA-based risk stratification from postoperative surgical pathology was compared to preoperative cytopathology, ultrasound, and clinical findings. Results: Of 1,995 thyroid surgeries performed for nonbenign thyroid nodules 10 to 40 mm, 349 met ATA criteria for lobectomy. Occult high-risk features such as tall cell variant, gross extrathyroidal invasion, or vascular invasion were found in 36 cases (10.7%), while intraoperative lymphadenopathy led to surgical upstaging in 13 (3.7%). Intermediate risk features such as moderate lymphadenopathy or minimal extrathyroidal extension were present in an additional 44 cases. Occult risk features were present twice as often in Bethesda class 6 cases (35%) as in lower categories (12 to 17%). In multivariable analysis, Bethesda class and nodule size, but not age, race, sex, or ultrasound features, were significant predictors of occult higher-risk pathology. Conclusion: Most solitary thyroid nodules less than 4 cm and with cytology findings including atypia of undetermined significance through suspicious for papillary thyroid cancer would be sufficiently treated by lobectomy. Abbreviations: ATA = American Thyroid Association; CND = central neck dissection; DTC = differentiated thyroid cancer; ETE = extrathyroidal extension; FNA = fine needle aspiration; FTC/HCC = follicular thyroid carcinoma/Hurthle cell carcinoma; NIFTP = noninvasive follicular thyroid neoplasm with papillary-like nuclear features; OR = odds ratio; PTC = papillary thyroid cancer; US = ultrasound

scholarly journals Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Cancers ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 26 ◽  
Author(s):  
Yossi Geron ◽  
Carlos Benbassat ◽  
Miriam Shteinshneider ◽  
Shlomit Koren ◽  
Keren Or ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
Recurrent Disease ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Term Outcome ◽  
Aggressive Approach ◽  
Long Term Outcome

Background: The extent of surgery for differentiated thyroid cancer (DTC) remains a controversial issue. Since a less aggressive approach is becoming more predominant, we aim here to study the short- and long-term outcomes of DTC patients after hemithyroidectomy. Methods: From a total of 1252 consecutive papillary thyroid cancer (PTC) patients, 109 treated with hemithyroidectomy and 50 with total thyroidectomy but no I131 were included. Persistent or recurrent disease was defined based on histopathology, imaging studies, and thyroglobulin levels. Results: Our hemithyroidectomy cohort included females (84.4%), microcarcinomas (81.9%), TNM stage I (95.4%), and a low American Thyroid Association (ATA) recurrence risk (94.5%). At one-year post-treatment, 3.7% had persistent disease (all female, median age 55 years, tumor size 7.5 mm). Recurrent disease was detected in 7.5% of those with excellent response at 1-year. With a follow-up of 8.6 years (1–48), all 109 patients were disease free at last visit, including the 11 patients (10.1%) who received additional treatment. Also, when comparing the hemi- and total thyroidectomy groups no significant differences were found in the rate of persistent and recurrent disease, overall mortality, and disease status at last visit. Conclusions: For properly selected low-risk PTC patients, hemithyroidectomy is a safe treatment option with a favorable long-term outcome.

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