scholarly journals Analysis of Clinical Outcome of Patients with Poorly Differentiated Thyroid Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Katsuhiro Tanaka ◽  
Hiroshi Sonoo ◽  
Wataru Saito ◽  
Yusuke Ohta ◽  
Toshiro Shimo ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Survival Rates ◽  
Differentiated Thyroid Carcinoma ◽  
Free Survival ◽  
Distant Relapse ◽  
Component Type ◽  
Poor Differentiation ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Cause Specific Survival

Background. We retrospectively analyzed whether poor differentiation is the independent prognostic factor for thyroid carcinoma or not. Methods. The subjects were 29 patients with PDTC who were treated between April 1996 and March 2006 to compare with those of well-differentiated papillary carcinoma patients (). Results. The relapse free (RFS), distant relapse-free survival and cause-specific survival, rates were significantly lower in patients with PDTC (, , and ). After classification into focal (<10%) and diffuse type (over 10%) of PDTC, there were no significant differences in RFS and cause-specific survival due to component type or proportion of poorly differentiated component. On multivariate analysis, poor differentiation (, RR = 4.456, 95% CI; 1.953–10.167) and extrathyroidal infiltration (, RR = 2.898, 95% CI; 1.278–6.572) showed a significant impact on DFS, and poor differentiation (, RR = 9.343, 1.314–66.453) and age (, RR = 1.306, 1.103–1.547) significantly impacted cause-specific survival. Conclusion. Poor differentiation was an independent factor for survival. Distant relapse was significantly more common among PDTC patients, and systemic therapy might be warranted.

Clinicopathological Profiling of Lung Carcinoids with a Ki67 Index > 20%

2018 ◽  
Vol 108 (2) ◽  
pp. 109-120 ◽  
Author(s):  
Atsuko Kasajima ◽  
Björn Konukiewitz ◽  
Naomi Oka ◽  
Hiroyoshi Suzuki ◽  
Akira Sakurada ◽  
...  
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Japanese Patients ◽  
Clinicopathological Parameters ◽  
Neuroendocrine Neoplasms ◽  
Free Survival ◽  
Tumor Group ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Disease Free

The clinicopathological features of lung neuroendocrine neoplasms (NEN) with a high proliferative index at the border area between atypical carcinoid and neuroendocrine carcinoma have not been investigated so far. The aim of this study was, therefore, to search for lung NENs which are well differentiated but show Ki67 values that overlap with those of poorly differentiated (PD)-NENs. Resected lung NENs from 244 Japanese patients were reviewed, and Ki67 indices were assessed in all tumors. The data were then correlated to clinicopathological parameters and patient outcome. Among 59 (24%) well-differentiated (WD)-NENs and 185 (76%) lung PD-NENs, 7 were defined as WD-NENs with Ki67 indices > 20%. The Ki67 indices of these tumors (mean 29%, range 24–36) were significantly lower than those of PD-NENs (mean 74%, range 34–99). All WD-NENs with Ki67 > 20% lacked abnormal p53 and loss of retinoblastoma 1 (Rb1) expression. In contrast, many PD-NENs expressed p53 (48%) and showed loss of Rb1 (86%). The 2- and 5-year disease-free survival rates in WD-NEN patients with Ki67 > 20% were lower than those of WD-NEN patients with Ki67 ≤20% (p < 0.01 for disease-free and overall survival). No statistical differences were detected between outcome of WD-NEN patients with Ki67 > 20% and those of PD-NEN. It is concluded that WD-NEN patients with Ki67 > 20% share the morphological and immunohistochemical features of WD-NEN patients with Ki67 ≤20%, but they have a worse prognosis, suggesting that this tumor group requires particular attention in future classifications and probably new therapeutic regimes.

scholarly journals Oncocytic variant of poorly differentiated thyroid carcinoma: “Is diagnosis possible by fine-needle aspiration?”

CytoJournal ◽  
2016 ◽  
Vol 13 ◽  
pp. 23 ◽  
Author(s):  
Mine Onenerk ◽  
Sule Canberk ◽  
Pembegul Gunes ◽  
Murat Erkan ◽  
Gamze Z. Kilicoglu
Keyword(s):  
Thyroid Carcinoma ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Rare Entity ◽  
Fine Needle ◽  
Poorly Differentiated Thyroid Carcinoma ◽  
Oncocytic Variant ◽  
Poorly Differentiated ◽  
Characteristic Features ◽  
Well Differentiated

Poorly differentiated thyroid carcinoma (PDTC) is a very rare entity, and the diagnosis can be made on histopathology specimens. However, recognition of characteristic features of PDTC is significant on fine-needle aspirations (FNAs) to differentiate this entity from well-differentiated and anaplastic thyroid carcinomas. Here, we present an FNA case concordant with “oncocytic variant of PDTC” and discuss whether definitive diagnosis can be given on FNAs to assess the prognosis in clinically inoperable patients.

scholarly journals Poorly Differentiated Thyroid Carcinoma: Single Centre Experience and Review of the Literature

2021 ◽  
Vol 10 (22) ◽  
pp. 5258
Author(s):  
Maria Bellini ◽  
Marco Biffoni ◽  
Renato Patrone ◽  
Maria Borcea ◽  
Maria Costanzo ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Correct Diagnosis ◽  
Morphological Characteristics ◽  
Differentiated Thyroid Carcinoma ◽  
Single Centre ◽  
Poorly Differentiated Thyroid Carcinoma ◽  
Single Centre Experience ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Insular Carcinoma

There is controversy in the literature regarding a distinct subset of thyroid carcinoma whose histologically classification falls between well-differentiated and anaplastic carcinomas, previously identified as ‘poorly differentiated thyroid carcinoma’ (PDTC), or ‘insular carcinoma’, in view of the peculiar morphological characteristics of the cell groupings. The correct diagnosis and treatment of this entity have important prognostic and therapeutic significance. In this review, we describe the epidemiology, diagnosis, and management of PDTC and report our single centre experience to add to the limited evidence existing in the literature.

Elevated serum thyroglobulin levels at the time of ablative radioactive iodine therapy indicate a worse prognosis in thyroid cancer: an Australian retrospective cohort study

2016 ◽  
Vol 130 (S4) ◽  
pp. S50-S53 ◽  
Author(s):  
T J Matthews ◽  
E Chua ◽  
A Gargya ◽  
J Clark ◽  
K Gao ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Differentiated Thyroid Carcinoma ◽  
Radioactive Iodine Therapy ◽  
Serum Thyroglobulin ◽  
Free Survival ◽  
Thyroglobulin Level ◽  
Well Differentiated

AbstractBackground:Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival.Methods:A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis.Results:Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35–15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47–16.55).Conclusion:An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.

scholarly journals Comprehensive Literature Review: Recent Advances in Diagnosing and Managing Patients with Poorly Differentiated Thyroid Carcinoma

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jack Hannallah ◽  
Jessica Rose ◽  
Marlon A. Guerrero
Keyword(s):  
Treatment Approach ◽  
Survival Rates ◽  
Multimodality Treatment ◽  
Differentiated Thyroid Carcinoma ◽  
Poor Survival ◽  
Thyroid Carcinomas ◽  
Comprehensive Literature Review ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Therapeutic Tools

Poorly differentiated thyroid carcinomas are a rare form of thyroid carcinomas; they display an intermediate behavior between well-differentiated and anaplastic thyroid carcinomas. PDTCs are more aggressive than the well-differentiated, but less aggressive than the undifferentiated or anaplastic, forms. No clinical features can accurately diagnose poorly differentiated thyroid carcinomas. Thus, the results of histocytology, immunohistochemistry, and molecular genetics tests aid in diagnosis. Given the aggressiveness of poorly differentiated thyroid carcinomas and the poor survival rates in patients who undergo surgery alone, a multimodality treatment approach is required. We conducted a comprehensive review of the current diagnostic and therapeutic tools in the management of patients with poorly differentiated thyroid carcinomas.

scholarly journals Efficacy of perioperative chemotherapy for synovial sarcoma: a retrospective analysis of a Nationwide database in Japan

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gang Xu ◽  
Hisaki Aiba ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Synovial Sarcoma ◽  
Survival Rates ◽  
Surgical Margin ◽  
Oncologic Outcomes ◽  
Wide Resection ◽  
Perioperative Chemotherapy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Relapse

Abstract Background Synovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of perioperative chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan. Methods This study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. Moreover, the effects of perioperative chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive chemotherapy were compared (cx + and cx-). Results Multivariate analysis revealed significant correlations of age (over 40, hazard ratio [HR] = 0.61, p = 0.043), margin status (marginal resection, HR = 0.18, p < 0.001 and intralesional resection, HR = 0.30, p = 0.013 versus wide resection) with overall survival; surgical margin type (marginal resection, HR = 0.14, p = 0.001 and intralesional resection, HR = 0.09, p = 0.035 versus wide resection) with local recurrence; and postoperative local recurrence (HR = 0.30, p = 0.027) and surgical margin (marginal resection, HR = 0.31, p = 0.023 versus wide resection) with distant relapse-free survival. Before propensity score matching, perioperative chemotherapy was mainly administered for young patients and patients with deeper tumor locations, larger tumors, more advanced-stage disease, and trunk location. The 3-year overall survival, local control, and distant relapse-free survival rates were 79.8%/89.3% (HR = 0.64, p = 0.114), 89.6%/93.0% (HR = 0.37, p = 0.171) and 71.4%/84.5% (HR = 0.60, p = 0.089) in the cx+/cx- groups, respectively. After propensity score matching, 152 patients were selected such that the patient demographics were nearly identical in both groups. The 3-year overall survival, local control, and distant relapse-free survival rates were 71.5%/86.0% (HR = 0.48, p = 0.055), 92.5%/93.3% (HR = 0.51, p = 0.436) and 68.4%/83.9% (HR = 0.47, p = 0.046) in the cx+/cx- groups, respectively. Conclusion This large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of perioperative chemotherapy for survival outcomes in synovial sarcoma patients was not proven in this Japanese database analysis.

scholarly journals Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia De Falco ◽  
Giuseppe Santangelo ◽  
Fabrizio Chirico ◽  
Angelo Cangiano ◽  
Maria Giulia Sommella ◽  
...  
Keyword(s):  
Literature Review ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Parathyroid Carcinoma ◽  
Malignant Tumors ◽  
Gamma Probe ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
First Case ◽  
Well Differentiated

Abstract Background Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. Case presentation We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. Conclusions Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.

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