Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

Asimakopoulos, Panagiotis; Nixon, Iain J.; Shaha, Ashok R.

doi:10.1016/j.clon.2017.01.001

Cited by 23 publications

(10 citation statements)

References 42 publications

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“…Papillary thyroid carcinoma (PTC) is the most common pathological type of this cancer, accounting for ~80% of all cases between 1980 and 2005 in the USA (4). Although thyroidectomy combined with radioactive iodine treatment and chemotherapy has achieved good clinical outcomes, recurrence and metastasis are the main causes of mortality in patients with thyroid cancer (5,6). It is common for PTC to metastasize to the lymph nodes (LNs) of the neck, occurring in up to 50% of cases (7,8).…”

Section: Introductionmentioning

confidence: 99%

Upregulation of sphingosine kinase 1 is associated with recurrence and poor prognosis in papillary thyroid carcinoma

Zhang

Bai

et al. 2019

Oncol Lett

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Sphingosine kinase 1 (SPHK1), an ATP-dependent protein, has previously been demonstrated to be upregulated in several types of human cancer and to play an important role in tumor development and progression. However, the role of SPHK1 in predicting long-term prognosis in patients with papillary thyroid carcinoma (PTC) remains unclear. The purpose of the present study was to assess the significance of SPHK1 expression and its associations with clinicopathological characteristics and prognostic outcome in patients with PTC. Immunohistochemistry staining was retrospectively performed to investigate the expression levels of SPHK1 in 92 PTC tumors. Statistical analyses revealed that high levels of SPHK1 expression were associated with tumor size, lymph node metastasis and the Tumor-Node-Metastasis stage. The disease-free survival (DFS) time of patients that exhibited high levels of SPHK1 expression was shorter, whereas patients with lower levels of SPHK1 expression survived longer. Furthermore, multivariate analysis suggested that upregulated SPHK1 was an independent prognostic factor for predicting DFS of patients with PTC. The results of the Cell Counting Kit-8 and invasion assays demonstrated that SPHK1 overexpression significantly enhanced the proliferation and invasion of a PTC cell line, consistent with clinical findings. The results from the present study provide evidence that elevated expression levels of SPHK1 may be involved in the development and progression of PTC, indicating that this protein may act as a potential prognostic marker for patients with this disease.

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Section: Introductionmentioning

confidence: 99%

Upregulation of sphingosine kinase 1 is associated with recurrence and poor prognosis in papillary thyroid carcinoma

Zhang

Bai

et al. 2019

Oncol Lett

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“…A variety of therapeutic options is available for thyroid cancer [ 6 ], but surgery still remains the predominant treatment [ 7 ]. Radical surgery is the most important form of therapy for undifferentiated thyroid cancer [ 8 ], and surgical treatment of significant nodal disease in well differentiated thyroid cancer is widely accepted to be associated with improved outcomes in terms of survival and recurrence rates [ 9 ]. Nonetheless, extensive surgery in this specific context carries a high risk of therapy-related morbidity like phrenic nerve palsy, brachial plexus palsy, cranial nerve injury, chyle leak, and pneumothorax [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer

Schob

Meyer

Dieckow

et al. 2017

IJMS

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Pre-surgical diffusion weighted imaging (DWI) is increasingly important in the context of thyroid cancer for identification of the optimal treatment strategy. It has exemplarily been shown that DWI at 3T can distinguish undifferentiated from well-differentiated thyroid carcinoma, which has decisive implications for the magnitude of surgery. This study used DWI histogram analysis of whole tumor apparent diffusion coefficient (ADC) maps. The primary aim was to discriminate thyroid carcinomas which had already gained the capacity to metastasize lymphatically from those not yet being able to spread via the lymphatic system. The secondary aim was to reflect prognostically important tumor-biological features like cellularity and proliferative activity with ADC histogram analysis. Fifteen patients with follicular-cell derived thyroid cancer were enrolled. Lymph node status, extent of infiltration of surrounding tissue, and Ki-67 and p53 expression were assessed in these patients. DWI was obtained in a 3T system using b values of 0, 400, and 800 s/mm2. Whole tumor ADC volumes were analyzed using a histogram-based approach. Several ADC parameters showed significant correlations with immunohistopathological parameters. Most importantly, ADC histogram skewness and ADC histogram kurtosis were able to differentiate between nodal negative and nodal positive thyroid carcinoma. Conclusions: histogram analysis of whole ADC tumor volumes has the potential to provide valuable information on tumor biology in thyroid carcinoma. However, further studies are warranted.

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“…A growing body of literature indicates that the benefit-to-risk ratio is necessary to accurately identify patients who are ideal candidates for the therapy. RAI-131 can avoid unnecessary treatment, cost, and adverse effects at the same time [ 5 , 17 , 20 , 21 ]. Evidence surrounding the use of RAI-131 in patients with intermediate-risk DTC is less robust and there is no consensus regarding the benefit-to-risk ratio [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Surgery and Radioactive Iodine Therapeutic Strategy for Patients Greater Than 60 Years of Age with Differentiated Thyroid Cancer

Tang

Jiang

Zhang

et al. 2022

Journal of Healthcare Engineering

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Purpose: The purpose of the current study was to determine whether older patients with differentiated thyroid cancer (DTC) who received surgical treatment had a better cause-specific survival (CSS) than patients who were recommended surgery, but declined, and whether patients who underwent postoperative RAI-131 therapy had an impact on CSS based on TNM staging and number of lymph node metastases for all total or near-total thyroidectomy patients. Patients and Methods: This retrospective, population-based study analyzed the clinical data of 162 DTC patients from signal institution in China and 26,487 cases from the Surveillance, Epidemiology, and End Results (SEER) program registry. The patients were divided into two groups (underwent surgery and surgery recommended, but not performed) in the SEER cohort. Furthermore, patients were grouped as follows: T4; N1b; M1; T1-3N0-1a; specific number of lymph node metastases; and total or near-total thyroidectomy. Results: The 120-month cause-specific survival (CSS) rate of women and men showed a gradual declining trend from 60–64 to ≥80 years of age in the group that underwent surgery. The CSS rate of women and men showed a marked downward and irregular trend with an increase in age in the recommended, but no surgery group in the SEER cohort. Univariate analysis indicated that the surgery group had a higher 120-month CSS in women in most stages and men, compared with the no surgery group in the SEER cohort. The analysis of the SEER cohort showed that RAI-131 therapy was associated with an improved 80-month CSS in T4/N1b/M1 women ( P < 0.0183 ) and men ( P < 0.0011 ). However, there were no CSS differences between the RAI-131 therapy and the no-RAI-131 group for the patients with T4/N1b/M1 (AJCC 7th) thyroid cancer in the Chinese cohort. There was no CSS difference in women or men between the T1-3N0 and T1-3N1a patients in the SEER cohort. And similar findings were observed in T1-3N1a patients in the Chinese cohort. There was no statistical difference between the two subgroups. Conclusions: Surgical treatment should be recommended for elderly DTC patients because surgery can lead to a better CSS. High-risk patients achieve a higher benefit-to-risk ratio with RAI-131 therapy. To avoid the adverse effects associated with RAI-131 therapy, a multidisciplinary discussion should be arranged for intermediate- and low-risk patients.

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Differentiated and Medullary Thyroid Cancer: Surgical Management of Cervical Lymph Nodes

Cited by 23 publications

References 42 publications

Upregulation of sphingosine kinase 1 is associated with recurrence and poor prognosis in papillary thyroid carcinoma

Upregulation of sphingosine kinase 1 is associated with recurrence and poor prognosis in papillary thyroid carcinoma

Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer

Surgery and Radioactive Iodine Therapeutic Strategy for Patients Greater Than 60 Years of Age with Differentiated Thyroid Cancer

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