Thyroid Lobectomy as an Initial Treatment Option on 1-4 cm Papillary Cancer

113 Background: Surgery has been the standard treatment for operable squamous esophageal cancer. However, radiation therapy/chemoradiotherapy (RT/CRT) or endoscopic resection (ER) could be an alternative treatment option for stage 0-IA (TNM 7th edition) squamous esophageal cancer, because these treatments are less invasive and can preserve the organ. To evaluate the efficacy of surgery, RT/CRT and EC for stage 0-1A squamous esophageal cancer in clinical practice, we reviewed our experience. Methods: From March 2007 to December 2010, 92 patients with stage 0-IA squamous esophageal cancer were treated in our institute. Overall survival, relapse-free survival, and relapse pattern were evaluated according to the initial treatment modality. Results: Of 92 patients (pts), 76 were male and 16 were women. Median age was 65.5 years old. Tis/T1a/T1b:4/36/52. Median follow up time was 29.1(4.7-55.5) months. As an initial treatment, 9 pts received surgery, 27 pts received RT/CRT and 56 pts received ER. Among the pts underwent ER, one patient underwent esophagectomy and 13 pts were received CRT based on the pathological evaluation for the risk of the lymph node metastasis. Two-year relapse free survival and overall survival of surgery, RT/CRT and ER was 77.8%/100%, 68.6%/100% and 89.8%/95.7%, respectively. After completion of initial therapy, local failures (residual or recurrent disease), regional lymph node relapse and distant metastasis and 1 undetermined relapse were observed in 6, 3 and 5 pts, respectively. Eight out of the 15 pts with recurrence could be disease free after salvage therapy. While 4 pts died during the follow up period, all pts died from other diseases and no pts died from esophageal cancer. Overall esophageal preservation rate was 89.1% (82/92). Conclusions: Although longer follow-up was needed, this study showed that non-surgical treatments (RT/CRT or ER) for stage 0-1A squamous esophageal cancer could be an alternative treatment option and could provide a chance of organ preservation. [Table: see text]

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Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Arquivos Brasileiros de Oftalmologia ◽

10.5935/0004-2749.20160118 ◽

2016 ◽

Vol 79 (6) ◽

Cited By ~ 2

Author(s):

Ana Lúcia Freitas ◽

Michele Ushida ◽

Izabela Almeida ◽

Diego T. Dias ◽

Syril Dorairaj ◽

...

Keyword(s):

Treatment Option ◽

Initial Treatment ◽

Open Angle Glaucoma ◽

Open Angle ◽

Selective Laser Trabeculoplasty ◽

Laser Trabeculoplasty

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Partial splenectomy followed by total splenectomy in thalassemia

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v10i3.33521 ◽

2017 ◽

Vol 10 (3) ◽

pp. 173

Author(s):

Abu Saleh Md. Oli Ullah ◽

Bhupal Chandra Barman ◽

Md. Ruhul Amin

Keyword(s):

Treatment Option ◽

Alternative Treatment ◽

Initial Treatment ◽

Prophylactic Antibiotic ◽

Partial Splenectomy ◽

Thalassemic Patient ◽

Alternative Treatment Option ◽

Total Splenectomy

<p class="Abstract">Total splenectomy is the usual operative practice for children with thalassemia requiring splenectomy. But wherever possible, the surgical community should carefully consider partial splenectomy as an alternative treatment option that may offer few important benefits to the patient with the same indication. Here, we are reporting a case where a thalassemic boy enjoyed six years free from overwhelming post-splenectomy infection after partial splenectomy without any vaccination or prophylactic antibiotic before eventual total splenectomy. So, partial splenectopmy may be considered as a preferable initial treatment option for the thalassemic patient with splenomegally requiring splenectomy.</p>

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Minimally Invasive Radiofrequency Ablation for Large Thyroid Toxic Adenoma

Acta Medica Bulgarica ◽

10.2478/amb-2019-0031 ◽

2019 ◽

Vol 46 (3) ◽

pp. 50-52

Author(s):

M. Belitova ◽

S. Ivanov ◽

Ts. Marinov ◽

T. Popov ◽

R. Pandev

Keyword(s):

Radiofrequency Ablation ◽

Treatment Option ◽

Multinodular Goiter ◽

Thyroid Nodules ◽

Percutaneous Treatment ◽

Thyroid Stimulating Hormone ◽

Treatment Modalities ◽

Toxic Adenoma ◽

Effective Treatment Option ◽

Thyroid Lobectomy

Abstract Background: Most thyroid nodules are benign and do not need intervention. Toxic adenoma and toxic multinodular goiter (MNG) are common causes of hyperthyroidism, second in prevalence only to Graves’ disease. Toxic adenoma and MNG are the result of focal or diffuse hyperplasia of thyroid follicular cells whose functional capacity is independent from regulation by the thyroid stimulating hormone (TSH). When conservative treatment modalities fail to ensure an euthyroid state, surgical intervention is required, typically surgical left or right thyroid lobectomy. Radiofrequency ablation (RFA) is a new percutaneous treatment option that results in thermal tissue necrosis and fibrosis. As a result of this process, the thyroid nodules shrink. Case presentation: We describe a case of a young woman with a large toxic thyroid adenoma who refused surgery. She was admitted to a one-day surgery unit and underwent radiofrequency ablation under total intravenous anesthesia. Using “moving shot technique” the procedure went uneventfully and the toxic adenoma displayed a significant volume reduction with resolution of the hyperthyroid symptoms. The patient also reported a significant improvement of her neck symptoms (from 7/10 to 1/10 on a Visual Analogue Scale). Conclusions: Radiofrequency ablation is a new, well tolerated, safe and effective treatment option in selected patients with benign thyroid nodules, toxic adenomas of the thyroid gland and multinodular goiter. To the best of our knowledge, this is the first time such treatment modality is used in Bulgaria.

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Development of machine learning-based clinical decision support system for hepatocellular carcinoma

Scientific Reports ◽

10.1038/s41598-020-71796-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Gwang Hyeon Choi ◽

Jihye Yun ◽

Jonggi Choi ◽

Danbi Lee ◽

Ju Hyun Shim ◽

...

Keyword(s):

Machine Learning ◽

Hepatocellular Carcinoma ◽

Decision Support ◽

Decision Support System ◽

Treatment Option ◽

Clinical Decision Support ◽

Support System ◽

Initial Treatment ◽

Clinical Decision Support System ◽

Clinical Decision

Abstract There is a significant discrepancy between the actual choice for initial treatment option for hepatocellular carcinoma (HCC) and recommendations from the currently used BCLC staging system. We develop a machine learning-based clinical decision support system (CDSS) for recommending initial treatment option in HCC and predicting overall survival (OS). From hospital records of 1,021 consecutive patients with HCC treated at a single centre in Korea between January 2010 and October 2010, we collected information on 61 pretreatment variables, initial treatment, and survival status. Twenty pretreatment key variables were finally selected. We developed the CDSS from the derivation set (N = 813) using random forest method and validated it in the validation set (N = 208). Among the 1,021 patients (mean age: 56.9 years), 81.8% were male and 77.0% had positive hepatitis B BCLC stages 0, A, B, C, and D were observed in 13.4%, 26.0%, 18.0%, 36.6%, and 6.3% of patients, respectively. The six multi-step classifier model was developed for treatment decision in a hierarchical manner, and showed good performance with 81.0% of accuracy for radiofrequency ablation (RFA) or resection versus not, 88.4% for RFA versus resection, and 76.8% for TACE or not. We also developed seven survival prediction models for each treatment option. Our newly developed HCC-CDSS model showed good performance in terms of treatment recommendation and OS prediction and may be used as a guidance in deciding the initial treatment option for HCC.

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Under Most Circumstances, Thyroid Lobectomy Is Appropriate for Low-Risk Patients With Papillary Cancer of the Thyroid

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.127.4.461 ◽

2001 ◽

Vol 127 (4) ◽

pp. 461 ◽

Cited By ~ 1

Author(s):

Frederic P. Ogren

Keyword(s):

Low Risk ◽

Papillary Cancer ◽

Thyroid Lobectomy ◽

Risk Patients

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The Role of Total Thyroidectomy in the Initial Treatment of Well-differentiated Follicular-cell-derived Thyroid Carcinomas

European Endocrinology ◽

10.17925/ee.2010.06.00.73 ◽

2010 ◽

Vol 06 ◽

pp. 73

Author(s):

Alessandro Antonelli ◽

Pablo Miccoli ◽

Gabriele Materazzi ◽

Michele Minuto ◽

Poupak Fallahi ◽

...

Keyword(s):

Thyroid Cancer ◽

Total Thyroidectomy ◽

Initial Treatment ◽

Radioactive Iodine ◽

Primary Tumour ◽

Low Risk ◽

Follicular Cell ◽

Thyroid Carcinomas ◽

Thyroid Lobectomy ◽

Risk Patients

The incidence of thyroid cancer has been increasing over the past 30 years. The follicular-cell-derived thyroid carcinomas (DTC) – papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC) – are most common (79 and 13%, respectively). Initial treatment of DTC involves resection of the primary tumour. Post-operative therapy consists of radioactive iodine ablation for most patients, followed by thyroid-stimulating hormone (TSH) suppression with thyroxine. An ongoing controversy in the surgical treatment of DTC is the extent of thyroid gland resection. Consensus guidelines recommend total or near-total thyroidectomy in high-risk DTC (PTC tumour >1–2cm, any tumour, node, metastasis [TNM] stage III and IV [extrathyroidal spread], any N1 [regional metastasis] or M1 [distant metastasis], any patient 㹅 years and <16 years of age, aggressive histological subtypes) rather than thyroid lobectomy as the initial procedure of choice, given its advantages of treating potential multicentric disease, facilitating maximal uptake of adjuvant radioactive iodine and facilitating post-treatment follow-up by monitoring serum thyroglobulin levels and neck ultrasonography. Low-risk patients are currently treated by thyroid lobectomy or total (or near-total) thyroidectomy; in fact, conflicting views persist for low-risk patients who have differentiated thyroid cancer. The main arguments for lobectomy in low-risk PTC patients are that there is no clear evidence that total thyroidectomy may affect the survival of patients with low-risk PTC, and that total thyroidectomy increases the risk of recurrent laryngeal nerve injury and hypoparathyroidism even in the hands of an experienced endocrine surgeon.

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Pseudocyst of the auricle : management options

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401683 ◽

2012 ◽

Vol 01 (04) ◽

pp. 181-185

Author(s):

Atul M Bage ◽

Nutan N Bage ◽

Anand Karthikeyan D. ◽

Keyword(s):

Triamcinolone Acetonide ◽

Treatment Option ◽

Successful Treatment ◽

Initial Treatment ◽

Intralesional Injection ◽

Serous Fluid ◽

Management Options ◽

High Propensity ◽

Promising Treatment

Abstract Background & Aims : Pseudocyst of auricle otherwise called as auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following surgery or trauma. Successful treatment of seromas remain a challenge because this disease has a high propensity for recurrence. The aim was to study the role of triamcinolone in reducing recurrence of pseudocyst of the auricle. Materials and methods : A total of 50 patients with pseudocyst of auricle were randomized into two groups. They were followed up to a year for recurrence. The technique of intra-lesional injection of triamcinolone acetonide after aspirating the fluid was followed in one group as against aspiration and tight bandaging in another group. Results : Out of seroma patients who underwent aspiration and bandaging, 90.91 % had recurrence as against only 25.64% recurrence in patients who underwent aspiration and Inj. Triamcinolone infiltration. Out of seroma patients who underwent aspiration and bandaging 54.55% had recurrence within 1 month of initial treatment and 27 .27% of them had a second recurrence within 3 months. Conclusion : Intralesional injection of triamcinolone is a promising treatment option for management of auricular seroma. It prevents the recurrence also.

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