scholarly journals Gastric Cancer: 10-Year Survival after Surgery

2021 ◽  
Vol 12 (3) ◽  
pp. 020-032
Author(s):  
Kshivets Oleg
Keyword(s):  
Neural Networks ◽  
Lymph Node ◽  
Blood Cell ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Rank Test ◽  
Node Dissection ◽  
Cell Ratio ◽  
Log Rank Test ◽  
Cell Circuit

Methods: We analyzed data of 796 consecutive GCP (age=57.1±9.4 years; tumor size=5.4±3.1 cm) radically operated (R0) and monitored in 1975-2021 (m=556, f=240; distal gastrectomies-G=461, proximal G=165, total G=170, D2 lymph node dissection=551; combined G with resection of 1-7 adjacent organs (pancreas, liver, diaphragm, esophagus, colon transversum, splenectomy, small intestine, kidney, adrenal gland, etc.)=245; D3-4 lymph node dissection=245; only surgery-S=623, adjuvant chemoimmunotherapy-AT=173: 5FU+thymalin/taktivin; T1=237, T2=220, T3=182, T4=157; N0=435, N1=109, N2=252, M0=796; G1=222, G2=164, G3=410; early GC=164, invasive GC=632; Variables selected for 10YS study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Survival curves were estimated by the Kaplan-Meier method. Differences in curves between groups of GCP were evaluated using a log-rank test. Multivariate Cox modeling, discriminant analysis, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence. Results: Overall life span (LS) was 2130.8±2304.3 days and cumulative 5-year survival (5YS) reached 58.4%, 10 years – 52.4%, 20 years – 40.4%. 316 GCP lived more than 5 years (LS=4316.1±2292.9 days), 169 GCP – more than 10 years (LS=5919.5±2020 days). 294 GCP died because of GC (LS=640.6±347.1 days). AT significantly improved 10YS (62.3% vs. 50.5%) (P=0.0228 by log-rank test) for GCP. Cox modeling displayed that 10YS of LCP significantly depended on: phase transition (PT) early-invasive GC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, AT, blood cell circuit, prothrombin index, hemorrhage time, residual nitrogen, age, sex, procedure type (P=0.000-0.039). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 10YS and healthy cells/CC (rank=1), PT early-invasive GC (rank=2), PT N0—N12(rank=3), erythrocytes/CC (4), thrombocytes/CC (5), monocytes/CC (6), segmented neutrophils/CC (7), eosinophils/CC (8), leucocytes/CC (9), lymphocytes/CC (10), stick neutrophils/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). Conclusions: 10-Year survival of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) GC characteristics; 9) anthropometric data; 10) surgery type. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection of GC; 2) availability of experienced abdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunotherapy for GCP with unfavorable prognosis.

scholarly journals Non-small cell lung cancer: 10-year survival after surgery

2021 ◽  
Vol 12 (2) ◽  
pp. 246-260
Author(s):  
Oleg Kshivets
Keyword(s):  
Lung Cancer ◽  
Neural Networks ◽  
Lymph Node ◽  
Small Cell ◽  
Rank Test ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Cell Ratio ◽  
Log Rank Test ◽  
Cell Circuit

Objective: 10-Year survival (10YS) after radical surgery for non-small cell lung cancer (LC) pa­tients (LCP) (T1-4N0-2M0) was analyzed. Methods: We analyzed data of 768 consecutive LCP (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated (R0) and monitored in 1985-2021 (m=660, f=108; upper lobectomies=277, lower lobectomies=177, middle lobectomies=18, bilobectomies=42, pneumonectomies=254, mediastinal lymph node dissection=768; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=193; only surgery-S=618, adjuvant chemoimmunoradiotherapy-AT=150: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=320, T2=255, T3=133, T4=60; N0=516, N1=131, N2=121, M0=768; G1=194, G2=243, G3=331; squamous=417, adenocarcinoma=301, large cell=50; early LC=214, invasive LC=554; right LC=412, left LC=356; central=290; peripheral=478. Variables selected for 10YS study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Survival curves were estimated by the Kaplan-Meier method. Differences in curves between groups of LCP were evaluated using a log-rank test. Multivariate Cox modeling, analysis, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence. Results: Overall life span (LS) was 2244.9±1750.3 days and cumulative 5-year survival (5YS) reached 72.9%, 10 years – 64.3%, 20 years – 43.1%. 502 LCP lived more than 5 years (LS=3128.7±1536.8 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). AT significantly improved 10YS (52.4% vs. 27.7%) (P=0.00002 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 10YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time, weight, color index (P=0.000-0.039). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 10YS and PT early-invasive LC (rank=1), thrombocytes/CC (rank=2), PT N0—N12(rank=3), segmented neutrophils/CC (4), healthy cells/CC (5), lymphocytes/CC (6), erythrocytes/CC (7), stick neutrophils/CC (8), eosinophils/CC (9), leucocytes/CC (10), monocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). Conclusions: 10-Year survival of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) anthropometric data; 10) surgery type. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.

Lymph node metastases of gastric cancer and blood cell circuit.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16024-e16024
Author(s):  
Oleg Kshivets
Keyword(s):  
Gastric Cancer ◽  
Neural Networks ◽  
Lymph Node ◽  
Blood Cell ◽  
Lymph Node Metastases ◽  
Tumor Size ◽  
Equation Modeling ◽  
Bootstrap Simulation ◽  
Node Metastases ◽  
Cell Circuit

e16024 Background: Significance of blood cell circuit in terms of detection of gastric cancer (GC) patients (GCP) with lymph node metastases was investigated. Methods: We analyzed data of 793 consecutive GCP (age = 57±9.4 years; tumor size = 5.4±3.1 cm) radically operated (R0) and monitored in 1975-2021 (m = 555, f = 238; distal gastrectomies = 460, proximal gastrectomies = 163, total gastrectomies = 170, combined gastrectomies with resection of pancreas, liver, diaphragm, colon transversum, esophagus, duodenum, splenectomy, small intestine, kidney, adrenal gland = 244; D2-lymphadenectomy = 513, D3-4 = 280; T1 = 235, T2 = 220, T3 = 182, T4 = 156; N0 = 433, N1 = 109, N2 = 251; G1 = 222, G2 = 162, G3 = 409; early GC = 162, invasive = 631; only surgery = 621, adjuvant chemoimmunotherapy-AT = 172 (5-FU+thymalin/taktivin). Variables selected for study were input levels of blood cell circuit, sex, age, TNMG. Differences between groups were evaluated using discriminant analysis, clustering, nonlinear estimation, structural equation modeling, Monte Carlo, bootstrap simulation and neural networks computing. Results: It was revealed that separation of GCP with lymph node metastases (n = 360) from GCP without metastases (n = 433) significantly depended on: eosinophils (%, abs, total), thrombocytes (abs, total), ESS, Hb, erythrocytes (abs), residual nitrogen, protein, cell ratio factors (CRF) (ratio between cancer cells- CC and blood cells subpopulations), T, G, tumor size, histology, tumor growth, blood group, procedures type (P = 0.043-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of lymph node metastases and CRF: thrombocytes/CC (rank = 1), healthy cells/CC (2), erythrocytes/CC (3), monocytes/CC (4), segmented neutrophils/CC (5), lymphocytes/CC (6), leucocytes/CC (7), eosinophils/CC (8), stick neutrophils/CC (9). Correct classification N0—N12 was 99.9% by neural networks computing (area under ROC curve = 1.0; error = 0.0). Conclusions: Lymph node metastases of gastric cancer significantly depended on blood cell circuit.

An Evaluation of Frozen Section and Lymph Node Dissection Results for Mucinous Ovarian Tumors

2018 ◽  
Vol 28 (1) ◽  
pp. 92-98 ◽  
Author(s):  
Marisa R. Moroney ◽  
Miriam D. Post ◽  
Amber A. Berning ◽  
Jeanelle Sheeder ◽  
Bradley R. Corr
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Node Dissection ◽  
Cross Sectional ◽  
Mucinous Histology ◽  
Final Pathology ◽  
Mucinous Ovarian Tumors

ObjectivesIntraoperative frozen section has greater than 90% accuracy for ovarian tumors; however, mucinous histology has been shown to be associated with increased frozen section inaccuracy. Recent data demonstrate that primary ovarian mucinous carcinomas have no lymph node involvement, even when extraovarian disease is present, and therefore may not require lymph node dissection. Our primary objective is to evaluate the accuracy of identifying mucinous histology on frozen section.Methods/MaterialsA cross-sectional review of mucinous ovarian tumors in surgical patients at one institution from 2006 to 2016 was performed. Cases reporting a mucinous ovarian tumor on frozen section or final pathology were identified. Frozen section results were compared with final diagnosis to calculate concordance rates. Analyses with χ2 and t tests were performed to identify variables associated with pathology discordance.ResultsA total of 126 mucinous ovarian tumors were identified. Of these, 106 were reported as mucinous on frozen section and 103 (97.2%) were concordant on final pathology. Discordant cases included 2 serous and 1 clear cell tumor. Among the 103 mucinous tumors, classification as malignant, borderline, or benign was concordant in 74 (71.8%) of 103 cases, whereas 22 (21.4%) of 103 were discordant and 7 (6.8%) were deferred to final pathology. Lymph node dissection was performed in 33 cases; the only case with lymph node metastasis was a gastrointestinal mucinous adenocarcinoma. Discordance between frozen section and final pathology was associated with larger tumor size and diagnosis other than benign: discordant cases had a mean tumor size of 21.7 cm compared with 14.4 cm for concordant cases (P < 0.001), and 93.5% of discordant cases were borderline or malignant, compared with 30.5% of concordant cases (P < 0.001).ConclusionsIntraoperative identification of mucinous histology by frozen section is reliable with a concordance rate to final pathology of 97.2%. No lymph node metastases were present in any malignant or borderline primary ovarian cases.

scholarly journals [Table 5.5.a.1] Tumor size and treatment (rate of resectability) [Figure 5.5.a.2] Cumulative survival of the patients after pancreatectomy for TS1 cancer according to residual tumors [Figure 5.5.a.3] Cumulative survival of the patients with TS1 cancer according to extent of lymph node dissection [Figure 5.5.a.4] Combined resection of portal vein and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head [Figure 5.5.a.5] Combined resection of peripancreatic plexus and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head [Figure 5.5.a.6] Combined resection of peripancreatic plexus when there is no plexus infiltration and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head [Figure 5.5.a.7] Combined resection of artery and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head [Figure 5.5.a.8] Combined resection of portal vein and cumulative survival of the patients after pancreatectomy for TS2 (2.1-4.0 cm) cancer of UICC Stage IIa or IIb in the pancreatic head [Figure 5.5.a.9] Combined resection of peripancreatic plexus and cumulative survival of the patients after pancreatectomy for TS2 (2.1-4.0 cm) cancer of UICC Stage IIa or IIb in the pancreatic head

Suizo ◽  
2007 ◽  
Vol 22 (1) ◽  
pp. e239-e247
Keyword(s):  
Lymph Node ◽  
Portal Vein ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Pancreatic Head ◽  
Uicc Stage ◽  
Node Dissection ◽  
Treatment Rate ◽  
Cumulative Survival ◽  
Combined Resection

Clinico-epidemiologic characteristics and patterns of care in Merkel cell carcinoma: Data from a single-institution series.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21049-e21049
Author(s):  
Michael Del Rosario ◽  
Eric Anderson ◽  
Yani Lu ◽  
Stephanie Farrell ◽  
Steven C. Plaxe ◽  
...  
Keyword(s):  
Lymph Node ◽  
Statistical Analysis ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Merkel Cell Carcinoma ◽  
Tumor Size ◽  
Primary Tumor ◽  
Merkel Cell ◽  
Node Dissection ◽  
Primary Tumor Size

e21049 Background: Merkel cell carcinoma (MCC) is associated with increased sun exposure. There is an average of 348 days of sunshine per year in our geographic area. Methods: With the IRB approval, we performed a retrospective chart review of all consecutive MCC patients seen at our institution between 2006-2017. Clinico-epidemiologic data such as age, gender, race, stage, tumor size, stage at presentation, and disease course were collected. Therapy and survival were analyzed. Using the surveillance, epidemiology, and end results program (SEER), we identified 4,256 patients with MCC from the years 2006-2013. We compared our data with the SEER findings . Statistical analysis: Chi-square and Fishers’ exact tests were used to assess the significance of associations in large and small populations, respectively. Survival analyses were performed using the Cox proportional hazards. Results: We identified 40 patients with MCC (n = 40) with a median age of 77. Compared to SEER data, our population was entirely Caucasian (100% vs. 95%; p = 0.11) and male predominant (75% vs. 63%; p = 0.11). The patients in our cohort were diagnosed more often with TNM stage I (50% vs. 39%; p = 0.00003) and found to have more often a primary tumor size < 2cm (58% vs. 34%; p < 0.01). Our patients were more frequently treated with lymph node dissection (70% vs. 63%, p = 0.002) and radiation therapy (60% vs. 50%; p = 0.24). Conclusions: Compared to the general population, MCC patients treated at our institution had similar mean age at diagnosis, gender and racial distribution and radiation treatment frequency (all p-values > 0.05). However, our patient population was significantly more likely to be diagnosed at stage I disease, have a primary tumor size less than 2 cm and receive lymph node dissection. Final statistical analysis, including survival analysis, and significance are to be discussed.

Factors Predictive of Tumor-Positive Nonsentinel Lymph Nodes After Tumor-Positive Sentinel Lymph Node Dissection for Melanoma

2004 ◽  
Vol 22 (18) ◽  
pp. 3677-3684 ◽  
Author(s):  
Jonathan H. Lee ◽  
Richard Essner ◽  
Hitoe Torisu-Itakura ◽  
Leslie Wanek ◽  
Hejing Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Risk Group ◽  
Wald Test ◽  
Positive Sentinel Lymph Node ◽  
High Risk Group ◽  
Node Dissection ◽  
Nodal Disease ◽  
Univariate Analyses

Purpose Approximately 20% of sentinel node (SN) positive melanoma patients have additional non-SN (NSN) metastasis. The rationale for this study was to identify the factors associated with additional nodal disease, as a method to determine which patients may most benefit from completion lymph node dissection (CLND). Patients and Methods During 1990 to 2002, 1,599 patients have undergone SN biopsy at our institute. 19.5% underwent CLND for tumor-positive SN. One hundred ninety-one of these patients had clinicopathologic information available for review. Univariate analyses used χ2 test, Wilcoxson rank sum test, and χ2 test for trend. Multivariate analyses used logistic regression and Wald test. Results Forty-six (24%) patients had tumor-positive NSN. Univariate analyses showed that primary thickness (Breslow and Clark), primary site, SN tumor size, and number of tumor-positive SNs were significantly associated with tumor-positive NSN. Multivariate analysis (167 patients), confirmed that Breslow and SN tumor size were independently predictive. Sex, histology, ulceration, mitotic index, and SN basin location were not predictive. Risk stratification by the number of prognostic factors present (Breslow ≥ 3 mm and SN tumor size ≥ 2 mm) showed that probability of finding tumor-positive NSN was 12.3% in the low-risk group (0 factors), 30.9% in the intermediate-risk group (1 factor), and 41.9% in the high-risk group (2 factors). Conclusion Thicker primary and larger SN tumor size are factors that correlate best with tumor-positive NSN. Although none of these factors are absolutely predictive of residual nodal disease, these factors must be strongly considered if the SN contains metastasis, as they provide enhanced risk assessment for NSN tumor-positivity.

scholarly journals An Approach to Macroscopic Central Lymph Nodes Detected during Surgery in Patients with Thyroid Micropapillary Carcinoma: Should We Resort to Dissection?

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Osman Kurukahvecioglu ◽  
Kursat Dikmen ◽  
Hasan Bostanci ◽  
Murat Akin ◽  
Ferit Taneri
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Node Dissection ◽  
Micropapillary Carcinoma ◽  
Central Lymph Node ◽  
Lymphocytic Thyroiditis ◽  
Central Lymph Node Dissection ◽  
Central Lymph

Background. High-resolution ultrasonography and the ability to perform fine-needle aspiration biopsy even for nodules smaller than three millimeters have considerably increased the detection rate of thyroid micropapillary carcinoma (TMPC). Despite favorable prognosis, the prevalence of cervical lymph node metastases in patients with TMPC is approximately 30%. Aim. In this study, we aimed to determine the central lymph node metastasis rate and its relation to the characteristics of the tumor. Methods. One hundred nine patients who underwent surgery due to TMPC between December 2009 and January 2014 were analyzed retrospectively. Patients were divided into two groups according to whether they underwent lymph node dissection and the two groups were then compared with respect to tumor size and multicentricity, age, and presence of lymphocytic thyroiditis. Results. There were no statistically significant differences between the two groups of patients in terms of tumor size, tumor multicentricity, age, and presence of lymphocytic thyroiditis. When the patient group that received lymph node dissection was further analyzed, it was found that patients with lymphocytic thyroiditis had a significantly lower number of metastatic lymph nodes. Conclusion. Central lymph node dissection in TMPC patients with macroscopic lymph node detected intraoperatively would ensure accurate staging without an increase in morbidity.

Utility of lymph node dissection for clinical node negative upper tract urothelial cell carcinoma: A multicenter study.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 474-474
Author(s):  
Zachary Hamilton ◽  
Miki Haifler ◽  
Laura-Maria Krabbe ◽  
Timothy N Clinton ◽  
Daniel Han ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Survival Benefit ◽  
Urothelial Cell ◽  
Urothelial Cell Carcinoma ◽  
Node Dissection ◽  
Node Negative ◽  
Upper Tract

474 Background: Upper tract urothelial cell carcinoma (UTUC) is an uncommon malignancy with disparate outcomes. Although use of lymph node dissection (LND) for urothelial cell carcinoma of the bladder has survival benefit even in setting of negative nodal status, therapeutic benefit of LND in the setting of clinical node negative disease for UTUC is unclear. We evaluated survival outcomes for UTUC after LND. Methods: Multicenter retrospective analysis of UTUC patients undergoing nephroureterectomy (NU) for clinical node negative, non-metastatic disease from 2001-2016 (cTis/1-T3N0M0). The cohort was divided based on pathologic lymph node status (pNx, pN0, and pN+). Primary outcome was overall survival (OS). Secondary outcome was recurrence free survival (RFS). Cox regression (CR), logistic regression (LR) and Kaplan−Meier (KMA) analyses were utilized. Results: 191 patients were analyzed (mean age 71.1 years, mean follow up 30.4 months, 27% ureteral location). LND was performed in 40.8% (78) and pN+ was noted in 11.0% (21). Mean number of nodes removed for pN0 = 6.6 and pN+ = 3.9 (p = 0.22). On CR for worsened all-cause mortality, significance was noted for ≥pT2 (OR 1.9, p = 0.031), recurrence (OR 2.3, p = 0.003), and pN+ (OR 2.8, p = 0.004). On KMA, 5 year OS stratified by pathologic node status and nuclear grade (grade 1-2 = LG; grade 3-4 = HG) noted negative survival effect associated with pN+ and HG disease (pN0 LG 85.7%, pN0 HG 41.2%, pNx LG 58.1%, pNx HG 51.1%, pN+ HG 10.7%, log-rank p < 0.001). No patient with pN+ had LG disease. On LR HG disease was predicted only by increasing clinical tumor size (OR 1.3, p = 0.032). No significant difference in complications was noted between the groups (p = 0.1). Conclusions: In clinical node negative disease, LND for UTUC did not have survival benefit; however, LND for UTUC provided prognostic information without significantly increasing risk of complications. Finding of pN+ disease was associated with worsened prognosis. LND may be omitted in LG disease yet should be considered in patients with HG disease and increasing tumor size. Further investigation is requisite.

scholarly journals Factors associated with postoperative hypocalcemia following surgery for thyroid cancer in childhood

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Marco Ghionzoli ◽  
Alessia Bertocchini ◽  
Beatrice Sanna ◽  
Carlotta Plessi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Thyroid Surgery ◽  
Tumor Size ◽  
Pediatric Population ◽  
Follicular Carcinoma ◽  
Node Dissection ◽  
Sample Collection ◽  
Postoperative Hypocalcemia ◽  
Factors Associated

Background: Postoperative hypocalcemia is a frequent complication after thyroid surgery. Hypoparathyroidism may develop as transient (TtHP), with normalization within six months from surgery, or permanent (PtHP) if the patient requires replacement therapy. The present study analyzes rates and factors associated with the development of TtHP or PtHP following thyroid surgery in a pediatric population. Procedure: A retrospective multicenter study analyzing 363 patients was carried out. We recorded gender, age, tumor size, type of surgery, lymph node dissection, histology. Calcium levels were acquired daily for 72 hours after discharge. Subsequent sample collection was customized on the patient’s hypocalcemia severity. Results: We analyzed 363 patients aged ≤18 years (mean age 14.2 years) who underwent thyroid surgery clustered into age groups (≤15 or >15). Patients mean follow-up was 5.8 years (1-11yrs). At histology 310 (85%) were papillary carcinoma, 32 (9%) were follicular carcinoma, 6 (2%) presented diffuse sclerosing variant of papillary thyroid carcinoma whilst 15 (4%) had familial medullary carcinoma. TtHP developed in 36 (9,9%), PtHP in 20 (5.5%) cases. TtHP was more frequent in younger patients (p=0,009). Both PtHP and TtHP were increased in case of larger tumors (≥2 cm) (p=0,001). All TtHP and PtHP were in TT group. PtHP rate was increased if lymph node dissection was carried out (p<0.001). Conclusions: The risk of hypoparathyroidism is related to younger age, tumor size, TT and lymph node dissection therefore surgeons should tailor surgery as much as possible to avert such complication.

Sign in / Sign up

Export Citation Format

Share Document