Thyroid Cancer Treatment Choice: A Pilot Study of a Tool to Facilitate Conversations with Patients with Papillary Microcarcinomas Considering Treatment Options

Summary:Aim: For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected?. Is there a difference concerning the surgical radicalism and the outcome?. Does the perioperative morbidity increase with the higher radicalism of the procedure?. Patients, methods: Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following radioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. Results: 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas <1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas <1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Conclusion: Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the socalled papillary microcarcinomas (old term) has to be respected within the current guidelines.

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The Genomic Landscape of Thyroid Cancer Tumourigenesis and Implications for Immunotherapy

Cells ◽

10.3390/cells10051082 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1082

Author(s):

Amandeep Singh ◽

Jeehoon Ham ◽

Joseph William Po ◽

Navin Niles ◽

Tara Roberts ◽

...

Keyword(s):

Thyroid Cancer ◽

Mapk Pathway ◽

Treatment Options ◽

Metastatic Potential ◽

Pi3k Pathway ◽

Mitogen Activated Protein Kinase ◽

Sequencing Data ◽

Genetic Aberrations ◽

Progression Model ◽

Mitogen Activated Protein

Thyroid cancer is the most prevalent endocrine malignancy that comprises mostly indolent differentiated cancers (DTCs) and less frequently aggressive poorly differentiated (PDTC) or anaplastic cancers (ATCs) with high mortality. Utilisation of next-generation sequencing (NGS) and advanced sequencing data analysis can aid in understanding the multi-step progression model in the development of thyroid cancers and their metastatic potential at a molecular level, promoting a targeted approach to further research and development of targeted treatment options including immunotherapy, especially for the aggressive variants. Tumour initiation and progression in thyroid cancer occurs through constitutional activation of the mitogen-activated protein kinase (MAPK) pathway through mutations in BRAF, RAS, mutations in the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) pathway and/or receptor tyrosine kinase fusions/translocations, and other genetic aberrations acquired in a stepwise manner. This review provides a summary of the recent genetic aberrations implicated in the development and progression of thyroid cancer and implications for immunotherapy.

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Multigene profiling to identify alternative treatment options for glioblastoma: a pilot study

Journal of Clinical Pathology ◽

10.1136/jclinpath-2014-202173 ◽

2014 ◽

Vol 67 (7) ◽

pp. 550-555 ◽

Cited By ~ 15

Author(s):

Tania Tabone ◽

Hazem J Abuhusain ◽

Anna K Nowak ◽

Wendy N Erber ◽

Kerrie L McDonald ◽

...

Keyword(s):

Pilot Study ◽

Alternative Treatment ◽

Treatment Options

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Participation of Asian-American Women in Cancer Treatment Research: A Pilot Study

JNCI Monographs ◽

10.1093/jncimonographs/lgi046 ◽

2005 ◽

Vol 2005 (35) ◽

pp. 102-105 ◽

Cited By ~ 23

Author(s):

T. T. Nguyen

Keyword(s):

Pilot Study ◽

Cancer Treatment ◽

Asian American ◽

Asian American Women ◽

American Women ◽

Treatment Research

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Concern Grows Over Prostate Cancer Treatment Options

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/86.12.897 ◽

1994 ◽

Vol 86 (12) ◽

pp. 897-898 ◽

Cited By ~ 2

Author(s):

T. Parkins

Keyword(s):

Prostate Cancer ◽

Cancer Treatment ◽

Treatment Options ◽

Prostate Cancer Treatment

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Six month follow-up after 111In-DTPA-octreotide therapy in patients with progressive radioiodine non-responsive thyroid cancer: a pilot study

Nuclear Medicine Communications ◽

10.1097/01.mnm.0000130244.14444.5e ◽

2004 ◽

Vol 25 (7) ◽

pp. 683-690 ◽

Cited By ~ 14

Author(s):

Marcel P.M. Stokkel ◽

Robbert B.T. Verkooijen ◽

Hanneke Bouwsma ◽

Jan W.A. Smit

Keyword(s):

Thyroid Cancer ◽

Pilot Study ◽

Octreotide Therapy

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AB3-loaded and tumor-targeted unimolecular micelles for medullary thyroid cancer treatment

Journal of Materials Chemistry B ◽

10.1039/c6tb02530g ◽

2017 ◽

Vol 5 (1) ◽

pp. 151-159 ◽

Cited By ~ 16

Author(s):

Renata Jaskula-Sztul ◽

Guojun Chen ◽

Ajitha Dammalapati ◽

April Harrison ◽

Weiping Tang ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Treatment ◽

Targeted Delivery ◽

Medullary Thyroid Cancer ◽

Medullary Thyroid

Multifunctional unimolecular micelles conjugated with KE108, a superior MTC-targeting ligand, were developed for targeted delivery of AB3 to treat MTC.

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