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 Surgical management of papillary thyroid cancer: review of current evidence and consensus

2019 ◽  
Vol 37 (4) ◽  
pp. 18 ◽  
Author(s):  
Umesh Jayarajah ◽  
Kavinda Nagodavithane ◽  
Oshan Basnayake ◽  
Sanjeewa Seneviratne
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Surgical Management ◽  
Current Evidence ◽  
Papillary Thyroid ◽  
Cancer Review

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.

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.

scholarly journals 391P Incremental value of preoperative CT in the surgical management of papillary thyroid cancer

2016 ◽  
Vol 27 ◽  
pp. ix121
Author(s):  
A. Mahajan ◽  
R. Vaish ◽  
N. Sable ◽  
S. Arya ◽  
S.V. Kane ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Surgical Management ◽  
Papillary Thyroid ◽  
Incremental Value ◽  
Preoperative Ct

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

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