scholarly journals Association between Tumor Size and Bilateral Involvement in Papillary Thyroid Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Suna Erkilic ◽  
Fatih Celenk ◽  
Zehra Bozdag
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
Papillary Thyroid ◽  
Tertiary Care Medical Center ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. Tumor multifocality and bilaterality of papillary thyroid carcinoma (PTC) are important factors when selecting the most appropriate surgical procedure. The aim of this study was to assess the bilaterality rate in PTC and the relationship between the tumor size and bilaterality.Materials and Methods. Thyroidectomy specimens with a diagnosis of PTC were retrospectively reviewed in the Pathology Department of a tertiary care medical center. Specimens were divided into three groups according to the size of the primary and contralateral tumor foci. Tumors less than or equal to 1 cm in each lobe were included in group 1. Group 2 consisted of tumors greater than 1 cm in one lobe and less than 1 cm in the other lobe. Tumors greater than 1 cm in each lobe were included in group 3.Results. We identified 868 total thyroidectomy specimens with a diagnosis of PTC between 2001 and 2011. Of these cases, both thyroid lobes were involved in 262 cases (32%). There were 109 (42%), 121 (46%), and 32 cases (12%) in group 1, group 2, and group 3, respectively.Conclusion. Bilaterality is frequent in PTC and is not related to tumor size. Accordingly, the high frequency of bilateral disease in PTC should be kept in mind when determining the extent of the surgical procedure.

scholarly journals Mutation in Genes Encoding Key Functional Groups Additively Increase Mortality in Patients with BRAFV600E-Mutant Advanced Papillary Thyroid Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5846
Author(s):  
Eyun Song ◽  
Meihua Jin ◽  
Ahreum Jang ◽  
Min Ji Jeon ◽  
Dong Eun Song ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Functional Groups ◽  
Papillary Thyroid ◽  
Primary Tumors ◽  
Targeted Next Generation Sequencing ◽  
Genes Encoding ◽  
Group 3 ◽  
Mutation Group ◽  
Group 2

The prognosis of BRAFV600E-mutant papillary thyroid carcinoma (PTC) ranges from indolent to highly aggressive courses. To better define the genetic diversity of this subtype, we evaluated the survival according to the presence of an additional mutation in genes encoding functional groups (FGs) in BRAFV600E-mutant advanced PTC patients. Targeted next-generation sequencing was performed in primary tumors of 50 BRAFV600E-mutant PTCs with distant metastasis or aggressive variants. The mutation in genes encoding FGs included alterations in histone methyltransferases, SWI/SNF subunit, and the PI3K/AKT/mTOR pathway. The primary outcome was overall survival (OS). Fifteen patients only had the BRAFV600E-mutation (group 1), 22 had BRAFV600E and mutation other than FGs (group 2), and 13 had BRAFV600E and FG mutation (group 3). OS was significantly lower in patients with FG mutations (p = 0.001) than those without, and group 3 patients had the worst survival (p = 0.004). OS significantly varied among none, one, or two FG mutation sites (p = 0.005). Presence of FG mutation was independently associated with increased mortality (hazard ratio 11.65, 95% confidence interval 1.39–97.58, p = 0.024). Coexistence of mutations in BRAFV600E and genes encoding FGs was associated with high mortality. Identification of FG mutation in BRAFV600E-mutant PTCs may be valuable in risk stratifying this subtype.

In Situ Preservation of Parathyroid Gland With Vasculature for Papillary Thyroid Carcinoma Is Associated With Higher PTH Levels After Total Thyroidectomy

2021 ◽  
pp. 014556132110398
Author(s):  
Chuanchang Yin ◽  
Bin Song ◽  
Weihong Zheng ◽  
Xingrui Li ◽  
Huichuan Zhao ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Parathyroid Gland ◽  
Papillary Thyroid ◽  
Postoperative Serum ◽  
Group 2 ◽  
Thyroid Parenchyma ◽  
Group 1

Purpose: To evaluate the impact of parathyroid gland vasculature preservation in-situ technique (PGVPIST) on postoperative parathyroid hormone (PTH) and calcium plasma levels in thyroid patients undergoing total thyroidectomy for papillary thyroid carcinoma (PTC). Study Design: Retrospective cohort study. Methods: Patients with PTC who underwent total thyroidectomy by either the conventional technique (group 1, January 2019 to January 2020) or PGVPIST (group 2, January 2020 to January 2021) were compared. Postoperative blood calcium levels and PTH levels were assessed in these groups. Results: Totally 149 patients with consecutive PTC underwent total thyroidectomy, including 60 patients in group 1 and 89 patients in group 2. Postoperative serum calcium levels in group 1 were insignificantly lower than in group 2 at day 1 (2.18 ± 0.02 vs 2.15 ± 0.01 mmol/L) and day 30 (2.27 ± 0.02 vs 2.38 ± 0.11) after surgery. But postoperative serum PTH levels in group 1 were significantly lower than that in group 2 at day 1 (23.68 ± 2.54 vs 31.46 ± 2.11 pg/mL) and day 30 (45.63 ± 3.21 vs 55.65 ± 2.89 pg/mL) after surgery. Conclusion: Parathyroid gland vasculature preservation in-situ technique for PTC is associated with higher PTH level after total thyroidectomy. The parathyroid gland vasculature mostly strongly adheres with adjacent thyroid parenchyma. Therefore, deferred processing of tiny thyroid parenchyma of parathyroid gland vessels is essential to prevent devascularization.

Pain Outcomes in Patients Undergoing CT-Guided Celiac Plexus Neurolysis for Intractable Abdominal Visceral Pain

2016 ◽  
Vol 34 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Mark R. Edelstein ◽  
Ryan T. Gabriel ◽  
Jeffrey D. Elbich ◽  
Luke G. Wolfe ◽  
Malcolm K. Sydnor
Keyword(s):  
Pain Relief ◽  
Visceral Pain ◽  
Medical Center ◽  
Tertiary Care ◽  
Celiac Plexus ◽  
Ct Guided ◽  
Tertiary Care Medical Center ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of this study was to assess outcomes in patients who have undergone celiac plexus neurolysis (CPN) as treatment for refractory abdominal visceral pain at a tertiary care medical center. This study involved retrospective analysis of all patients who had undergone computed tomography (CT)-guided CPN over a 7-year period, as identified in the medical record. Cases were categorized into 1 of 3 groups—group 1: patients getting at least moderate improvement in pain but with improvements subsiding within 2 days; group 2: patients with some sustained pain relief but still requiring heavy doses of narcotics; group 3: patients with major or complete sustained reduction in pain where the narcotic dose was able to be reduced. One hundred thirty-eight cases were identified, 51 of which had no or insufficient follow-up, leaving 87 cases for analysis. Of the 87 cases, 31 (36%) were categorized as group 1, 21 (24%) as group 2, and 35 (40%) as group 3. There were no statistical differences in outcomes based on patient age, gender, time since diagnosis, or type of cancer. Documented postoperative complications were diarrhea (11 cases) and 1 case each of obtundation, hypotension, and presyncopal event. We conclude that patients undergoing CT-guided CPN for abdominal visceral pain achieve moderate or major short-term pain relief in a majority of cases. The procedure is safe with minimal complications.

scholarly journals Is BRAFV600E mutation a marker for central nodal metastasis in small papillary thyroid carcinoma?

2014 ◽  
Vol 21 (2) ◽  
pp. 285-295 ◽  
Author(s):  
Brian Hung-Hin Lang ◽  
Young Jun Chai ◽  
Benjamin J Cowling ◽  
Hye Sook Min ◽  
Kyu Eun Lee ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Protective Factor ◽  
Independent Predictor ◽  
Nodal Metastasis ◽  
Prediction Score ◽  
Papillary Thyroid ◽  
Male Sex ◽  
Central Nodal Metastasis

Utilizing BRAFV600E mutation as a marker may reduce unnecessary prophylactic central neck dissection (pCND) in clinically nodal negative (cN0) neck for small (≤2 cm) classical papillary thyroid carcinoma (PTC). We aimed to assess whether BRAF is a significant independent predictor of occult central nodal metastasis (CNM) and its contribution to the overall prediction after adjusting for other significant preoperative clinical factors in small PTC. Primary tumor tissue (paraffin-embedded) from 845 patients with small classical cN0 PTC who underwent pCND was tested for BRAF mutation. Clinicopathologic factors were compared between those with and without BRAF. BRAF was evaluated to see if it was an independent factor for CNM. Prediction scores were generated using logistic regression models and their predictability was measured by the area under the ROC curve (AUC). The prevalence of BRAF was 628/845 (74.3%) while the rate of CNM was 285/845 (33.7%). Male sex (odds ratio (OR): 2.68, 95% CI: 1.71–4.20), large tumor size (OR: 2.68, 95% CI: 1.80–4.00), multifocality (OR: 1.49, 95% CI: 1.07–2.09), lymphovascular permeation (OR: 10.40, 95% CI: 5.18–20.88), and BRAF (OR: 1.65, 95% CI: 1.10–2.46) were significant independent predictors of CNM, while coexisting Hashimoto's thyroiditis (OR: 0.56, 95% CI: 0.40–0.80) was an independent protective factor. The AUC for prediction score based on tumor size and male sex was similar to that of prediction score based on tumor size, male sex, and BRAF status (0.68 vs 0.69, P=0.60). Although BRAF was an independent predictor of CNM, knowing its status did not substantially improve the overall prediction. A simpler prediction score based on male sex and tumor size might be sufficient.

Optimization of Plerixafor Utilization Based on Peripheral Blood CD34+ Count for Autologous Peripheral Blood Stem-Cell Collection

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 41-41
Author(s):  
Gaurav K. Gupta ◽  
Sera Perreault ◽  
Stuart Seropian ◽  
Christopher A. Tormey ◽  
Jeanne E. Hendrickson
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Tertiary Care ◽  
Peripheral Blood Cd34 ◽  
Tertiary Care Medical Center ◽  
Group 2 ◽  
Group 1

Introduction: Peripheral CD34+ cells may be mobilized using filgrastim (G-CSF) alone or in combination with chemotherapy. However, some patients also require plerixafor, an inhibitor of C-X-C chemokine receptor type-4, for adequate mobilization. Given its cost, judicious utilization of plerixafor is warranted. Material and Methods: A retrospective analysis of autologous stem-cell mobilization was performed at a tertiary-care medical center in adult patients with multiple myeloma and lymphoma; here we will focus on the utility of repeat plerixafor dosing. Patients were mobilized at the treating physician's discretion with filgrastim plus plerixafor or chemotherapy plus filgrastim plus plerixafor. Collections were initiated once peripheral CD34+ counts reached 20/µL (or 10/µL if chemotherapy mobilized); plerixafor was administered if these counts were not reached after 4 or 8 days, respectively, of filgrastim treatment. Results: Patients with multiple myeloma (86) or lymphoma (30) were evaluated. One hundred five were mobilized by filgrastim plus plerixafor and 11 by chemotherapy plus filgrastim plus plerixafor. No patient that received plerixafor with a CD34+ count <5/µL after chemotherapy mobilized the next day. The end collection goal was achieved in 86 (81.9%) of the filgrastim plus plerixafor group and 7 (63.6%) of the chemotherapy plus filgrastim plus plerixafor group. Patients given at least one dose of plerixafor were divided into groups based on collection goal, peripheral blood CD34+ cell count after 1 dose and the first day collection yield: Group 1) Goal of 3x10^6/kg and CD34+ count ≥ 30 cell/µL vs < 30 cell/µL; Group 2) Goal of 6x10^6/kg and ≥ 50% of collection goal after 1 day of collection vs CD34+ count < 50 cell/µL or < 50% of collection goal. Forty of 42 (95%) patients in Group 1 with a CD34+ count ≥ 30 cell/µL achieved their end collection goal after one plerixafor dose. Eighteen of 19 (95%) patients in Group 1 with a CD34+ count <30 cell/µL received a second dose of plerixafor and 8 (44.4%) achieved their end collection goal. Twenty-eight of 32 (87.5%) patients in Group 2 with ≥ 50% of collection goal achieved on the first day of collection reached their end collection goal after one plerixafor dose. Nine of 12 (75%) patients in Group 2 with a CD34+ count of < 50 cells/µL or <50% collection goal received an additional dose of plerixafor and 6 (66.7%) achieved their end collection goal. Conclusion: Based on these data, we have developed the following repeat plerixafor dosing algorithm: 1) for a collection goal is 3x10^6/kg, administer a second dose of plerixafor if the CD34+ count on the first day of collection is < 30 cell/µL, and 2) for a collection goal of 6x10^6/kg, administer a second dose of plerixafor if the CD34+ count on the first day of collection is < 50 cell/µL or if the first day of collection yields <50% of the end goal. This algorithm optimizes pharmacy, apheresis and stem cell processing resources. Disclosures No relevant conflicts of interest to declare.

scholarly journals Postpartum Morbidity Associated With Advanced HIV Disease

2006 ◽  
Vol 2006 ◽  
pp. 1-5 ◽  
Author(s):  
Judette Louis ◽  
Mudathiru A. Buhari ◽  
Dianne Allen ◽  
Bernard Gonik ◽  
Theodore B. Jones
Keyword(s):  
Cesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Wound Complication ◽  
Hiv Disease ◽  
Increased Risk ◽  
Group 3 ◽  
Group 2 ◽  
Advanced Hiv Disease ◽  
Group 1

Objective. To investigate the postpartum morbidity and postpartum management of febrile morbidity associated with advanced HIV infection. Methods. A case control study of HIV infected women at a tertiary care center during January 2000–June 2005 was performed. Postpartum morbidity was defined as endometritis, blood transfusion, wound complication, readmission, infectious morbidity, or unexpected surgery. Results. Women in Group 1 had AIDS (N=33), Group 2 were relatively immunocompetent HIV infected women (N=115), and Group 3 were uninfected women (N=152). Group 1 was more likely to have a postpartum morbidity (32.3 versus 19.3 and 13.2%,P=.03) and to have postpartum imaging 18.8 versus 7.9 and 2.6%,P=.002. After controlling for potential confounders, cesarean delivery (OR 6.2, 95%CI 2.1–505.5) but not advanced HIV disease was associated with an increased risk of postpartum morbidity. Conclusion. Cesarean delivery and not advanced HIV disease increases the risk of postpartum morbidity in women with AIDS.

scholarly journals Investigation of the prognosis of patients with papillary thyroid carcinoma by tumor size

2012 ◽  
Vol 59 (6) ◽  
pp. 457-464 ◽  
Author(s):  
Yasuhiro Ito ◽  
Mitsuhiro Fukushima ◽  
Minoru Kihara ◽  
Yuuki Takamura ◽  
Kaoru Kobayashi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Size ◽  
Papillary Thyroid
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