scholarly journals Exploratory Analysis to Predict Optimal Tumor Burden for Starting Lenvatinib in Patients With Radioiodine-Refractory Differentiated Thyroid Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Chiaki Suzuki ◽  
Naomi Kiyota ◽  
Yoshinori Imamura ◽  
Hideaki Goto ◽  
Hirotaka Suto ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Linear Correlation ◽  
Differentiated Thyroid Cancer ◽  
Tumor Burden ◽  
Post Treatment ◽  
Optimal Timing ◽  
Tumor Diameter ◽  
Strong Linear Correlation ◽  
Optimal Tumor

BackgroundWe previously reported that a high tumor burden is a prognostic factor based on an analysis of 26 patients with radioactive iodine-refractory differentiated thyroid cancer (RR-DTC) who were treated with lenvatinib. However, the optimal tumor burden for starting lenvatinib still remains to be defined. The aim of this retrospective study was to further explore in the same patient cohort the optimal timing for the start of lenvatinib by focusing on the pre- and post-treatment tumor burden.MethodsThe 26 patients were treated with lenvatinib from 2012 to 2017. We explored the optimal timing for the start of lenvatinib by comparing the characteristics of long-term responders who were defined as patients with progression-free survival ≥ 30 months and non-long-term responders.ResultsLong-term responders had a smaller post-treatment tumor burden at maximum shrinkage than non-long-term responders. Further, post-treatment tumor burden had a strong linear correlation with baseline tumor burden. We created an estimation formula for baseline tumor burden related to prognosis, using these regression lines. Patients with a sum of diameters of target lesions < 60 mm or maximum tumor diameter < 34 mm at baseline were estimated to have significantly better survival outcomes.ConclusionsWe found a strong linear correlation between pre- and post-treatment tumor burden. Our results suggested a cut-off value for baseline tumor burden for long-term prognosis among patients treated with lenvatinib.

scholarly journals Preoperative Serum Thyroglobulin and Its Correlation with the Burden and Extent of Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 625
Author(s):  
Hosu Kim ◽  
So Young Park ◽  
Jun-Ho Choe ◽  
Jee Soo Kim ◽  
Soo Yeon Hahn ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Primary Tumor ◽  
Differentiated Thyroid Cancer ◽  
Medical Center ◽  
Distant Metastases ◽  
Predictive Biomarker ◽  
Tumor Burden ◽  
Serum Thyroglobulin ◽  
Preoperative Serum ◽  
Clinical Records

Lymph node metastasis (LNM) in differentiated thyroid cancer (DTC) is usually detected with preoperative ultrasonography; however, this has limited sensitivity for small metastases, and there is currently no predictive biomarker that can help to inform the extent of surgery required. We evaluated whether preoperative serum thyroglobulin levels can predict tumor burden and extent. We retrospectively reviewed the clinical records of 4029 DTC cases diagnosed and treated at a Samsung Medical Center between 1994 and 2016. We reviewed primary tumor size, number and location of LNM, and presence of distant metastases to reveal relationships between tumor burden and extent and preoperative serum thyroglobulin levels. We found a linear association between increasing preoperative thyroglobulin levels, the size of the primary tumor, and the number of LNM (r = 0.34, p < 0.001, r = 0.20, p < 0.001, respectively). Tumor extent also increased with each decile of increasing preoperative thyroglobulin level (r = 0.18, p < 0.001). Preoperative thyroglobulin levels of 13.15 ng/mL, 30.05 ng/mL, and 62.9 ng/mL were associated with the presence of ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis, respectively. Our results suggest that preoperative measurement of serum thyroglobulin may help to predict LNM and help to tailor surgery.

Long-Term Follow-Up of Patients With Differentiated Thyroid Cancer Who had Negative 131I Whole-Body Scan at First Evaluation After Treatment

2013 ◽  
Vol 38 (10) ◽  
pp. 765-769 ◽  
Author(s):  
Luciana Souza Cruz Caminha ◽  
Denise Prado Momesso ◽  
Fernanda Vaisman ◽  
Rossana Corbo ◽  
Mario Vaisman
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Long Term Follow Up

scholarly journals Fly wing evolution explained by a neutral model with mutational pleiotropy

2020 ◽  
Author(s):  
Daohan Jiang ◽  
Jianzhi Zhang
Keyword(s):  
Linear Correlation ◽  
Evolutionary Biology ◽  
Stabilizing Selection ◽  
Evolutionary Divergence ◽  
Phenotypic Evolution ◽  
Central Question ◽  
Evolutionary Patterns ◽  
Strong Linear Correlation ◽  
Mutational Variance

ABSTRACTTo what extent the speed of mutational production of phenotypic variation determines the rate of long-term phenotypic evolution is a central question in evolutionary biology. In a recent study, Houle et al. addressed this question by studying the mutational variation, microevolution, and macroevolution of locations of vein intersections on fly wings, reporting very slow phenotypic evolution relative to the rates of mutational input, high phylogenetic signals of these traits, and a strong, linear correlation between the mutational variance of a trait and its rate of evolution. Houle et al. examined multiple models of phenotypic evolution but found none consistent with all these observations. Here we demonstrate that the purported linear correlation between mutational variance and evolutionary divergence is an artifact. More importantly, patterns of fly wing evolution are explainable by a simple model in which the wing traits are neutral or neutral within a range of phenotypic values but their evolutionary rates are reduced because most mutations affecting these traits are purged owing to their pleiotropic effects on other traits that are under stabilizing selection. We conclude that the evolutionary patterns of fly wing morphologies are explainable under the existing theoretical framework of phenotypic evolution.

scholarly journals Lymph node characteristics of 6279 N1 differentiated thyroid cancer patients

2020 ◽  
Vol 9 (3) ◽  
pp. 201-210 ◽  
Author(s):  
C Sui ◽  
Q He ◽  
R Du ◽  
D Zhang ◽  
F Li ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Regression Models ◽  
Differentiated Thyroid Cancer ◽  
Nodular Goiter ◽  
Clinicopathological Characteristics ◽  
Tumor Diameter ◽  
Linear Regression Models ◽  
Neck Metastasis

Purpose This study examined the clinicopathological characteristics of 6279 N1 differentiated thyroid cancer (DTC) patients who underwent operations in our center. Methods This was a retrospective longitudinal analysis. We categorized the DTC patients on the basis of various lymph node (LN) characteristics. Logistic regression models and multiple linear regression models were used for the correlation analysis. Results A total of 3693 (58.8%) N1a patients and 2586 (41.2%) N1b patients were included. Patients with N1b disease had larger metastatic foci (0.5 vs 0.15 cm), a greater number of metastatic LNs (5 vs 2), a greater number of dissected LNs (25 vs 7), and a smaller lymph node ratio (NR, number of positive LNs/number of sampled LNs) (23.1% vs 28.6%) than patients in stage N1a. Comparing the clinicopathological features, we found that male, increased tumor size, multifocality, and thyroiditis increased the risk of stage N1b disease (P < 0.05). Sex, multifocality, capsular infiltration, and tumor size were associated with the size of the metastatic LNs (P < 0.05). Sex, capsular infiltration, and nodular goiter were associated with the NR (P < 0.05). Female sex, tumor located in inferior lobe, maximal tumor diameter (MTD) < 1 cm, and nodular goiter were independent predictors for skip metastases (P < 0.05). MTD > 1 cm, central neck metastasis and age were independent predictors for bilateral lateral neck metastasis (BLNM) (P < 0.05). Conclusion The LN characteristics of stage N1a and N1b disease were associated with significantly different features, such as sex, tumor size, multifocality, capsular infiltration, and nodular goiter.

scholarly journals Thyroid Lobectomy for Low to Intermediate Risk Differentiated Thyroid Cancer

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3282
Author(s):  
Dana M. Hartl ◽  
Joanne Guerlain ◽  
Ingrid Breuskin ◽  
Julien Hadoux ◽  
Eric Baudin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Postoperative Morbidity ◽  
Intermediate Risk ◽  
Thyroid Lobectomy ◽  
Pros And Cons ◽  
Short And Long Term ◽  
Extensive Surgery

Many recent publications and guidelines have promoted a “more is less” approach in terms of treatment for low to intermediate risk differentiated thyroid cancer (DTC), which comprise the vast majority of thyroid cancers: less extensive surgery, less radioactive iodine, less or no thyroid hormone suppression, and less frequent or stringent follow-up. Following this approach, thyroid lobectomy has been proposed as a means of decreasing short- and long-term postoperative morbidity while maintaining an excellent prognosis for tumors meeting specific macroscopic and microscopic criteria. This article will examine the pros and cons of thyroid lobectomy for low to intermediate risk cancers and discuss, in detail, criteria for patient selection and oncological outcomes.

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