Functional radical cervical dissection for differentiated thyroid cancer: the experience of a single center

Tulin, Adrian; Aleçu, Lucian; Poiană, Cătălina; Tomescu, Luminiţa; Slavu, Iulian; Tulin, Raluca; Pițuru, Silviu; Orlov, Cristina; Jecan, Cristian Radu; Cristian, Balalau; Stoian, Anca Pantea; Hainăroşie, Răzvan; Nițipir, Cornelia

doi:10.22543/7674.52.p278283

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…The hypothesis that weight gain is a positive prognostic and predictive factor is not new either, with the same concept demonstrated in relation to chemotherapy. This was demonstrated for some other tumors as well [14][15][16].…”

Section: Discussionmentioning

confidence: 60%

Possible Influence of Weight Gain and Creatinine Levels in Predicting Response to Nivolumab: A Multicenter Analysis

et al. 2020

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Literature suggests that high body mass index can be correlated with better response to immune checkpoint inhibitors. On the other hand, sarcopenia seems to be a negative predictive marker. The present analysis is a retrospective, multicenter trial that included patients with metastatic melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma treated with nivolumab between 2018 and 2020. Patients were stratified by creatinine levels both at treatment initiation and at first follow-up (at three months) and by BMI for the same intervals, as recorded in the patients’ charts. Creatinine was considered a surrogate marker for sarcopenia. IBM SPSS version 20 was used for statistical analysis. A total of 57 (n = 57) patients were included in the trial. Overall response rate (ORR) for the entire population was 38.59% (p = 0.02). Patients with BMI lower than 25 had an ORR of 28.5% (p = 0.003), whereas patients with BMI higher than 25 had an ORR of 42.3% (p = 0.002). Patients who gained weight during treatment had a lower probability of having progressive disease (OR = 0.4 [95% CI; 0.4–1.2]), as did patients with creatinine higher than 0.9 (OR = 0.39 [95% CI: 0.13–1.14]). No superiority was found in progression-free survival (PFS) when patients were dichotomized for BMI = 25 or BMI = 18.5. Mean PFS in the BMI under 18.5 group was 10.2 months [95% CI: 5.8–23.1], versus 11.2 for BMI over 18.5 [95% CI: 5.3–25.3], p < 0.03. Mean PFS for the BMI under 25 was 11.2 months [95% CI: 7.2–20.1], vs. 13.3 months [95% CI: 6.4–22] for the BMI over 25, p < 0.001. There were also differences in PFS in the patients with baseline creatinine over 0.9 when compared with under 0.9 values. Mean PFS in the first group was 19.78 months [95% CI: 16.23–22.9] vs. 16.1 [95% CI: 12.2–20.3], p < 0.001. Patients treated with nivolumab who have weight gain during treatment have a better PFS than the ones who do not. Creatinine levels of over 0.9 at treatment initiation also have positive predictive value.

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Section: Discussionmentioning

confidence: 60%

Possible Influence of Weight Gain and Creatinine Levels in Predicting Response to Nivolumab: A Multicenter Analysis

et al. 2020

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“…Whenever necessary, evaluation of other specialties was requested (such as thoracic surgery, pneumology, cardiology, radiotherapy and palliative care) and all decisions for further treatment were taken in the multidisciplinary board [14,15].…”

Section: Discussionmentioning

confidence: 99%

The Importance of Dose Intensity When Administering Cytotoxic Chemotherapy in NSCLC—A Matter as Actual Now as in the Past

et al. 2020

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Lung cancer, as the leading cause of death in oncology is one of the most challenging diseases nowadays. Even after the implementation of checkpoint inhibitors and targeted therapy as a standard of therapy for metastatic disease, the chemotherapy backbone remains essential in the treatment of these patients. This study aimed to evaluate how administration particularities in chemotherapy and toxicity management can influence the outcome. We conducted a retrospective single-institution study, at Elias University Emergency Hospital, Bucharest, Romania, between 2014 and 2018, in a heterogeneous patient population with metastatic non-small cell lung cancer that received combination chemotherapy. The inclusion criteria for this trial were—histological proof of non-small cell lung cancer (NSCLC), stage IV disease, ECOG (Eastern Cooperative Oncology Group) performance status of a maximum of two, treatment with cytotoxic chemotherapy for at least four courses (patients with fewer courses were excluded). All patients received combination chemotherapy. The main focus was on the effect of dose reduction and treatment delay on overall survival and progression-free survival. A total of 129 patients were enrolled. The response rate in the studied population was 69% and 62.8% had no toxicity greater than grade 2. Chemotherapy regimens used had the following distribution—paclitaxel + carboplatin 41.9%, paclitaxel + carboplatin + bevacizumab 12.4%, pemetrexed + carboplatin 12.4%, gemcitabine + carboplatin 26.4% and other regimens 7%. Mean PFS (Progression Free Survival) was 9.1 months and the mean OS (Overall Survival) was 14 months. OS was not significantly different in the treatment delay group versus the no delay one, p < 0.25 but dose- reduction significantly impacted OS, p < 0.03. Administration particularities, like febrile neutropenia prophylaxis, treatment of chemotherapy-related anemia, respecting the details of chemostability and preparation rules and emesis prophylaxis, were considered reasons for the good outcome. Details regarding cytotoxic chemotherapy administration remain of paramount importance for a good outcome and the benefit for survival they convey is crucial. Sometimes the benefit the patient derives from these details is comparable to the one newer therapies convey.

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“…The latter plays an important but not definitive diagnostic role because of the false-negative results due to low sensitivity and specificity. [ 1 ] The sensitivity of ultrasound and CT is low because most LNs are small and located deep in the neck tissue or behind the breastbone, preventing adequate visualization. The reported sensitivity of these two techniques is 51–67% and 62–66%, respectively [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…TC is classified into subtypes according to the degree of cellular differentiation: well differentiated, including papillary and follicular TCs, and poorly differentiated including medullary and anaplastic TCs. The anaplastic TC has a worse short-term prognosis [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Radical neck dissection with advancement flap in advanced papillary thyroid cancer: a therapeutic option

Ribadeneira

García

Basantes

2020

Journal of Surgical Case Reports

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Papillary thyroid cancer (TC) is the most common TC subtype with a global incidence of 80–90% and an annual rate of increase of 5% in the last ten years. Papillary TC has the peculiar tendency to spread to the central and lateral lymph nodes (LNs) of the neck, and recurrence occurs in 60–75% of cases. The most affected site is the central compartment. Total thyroidectomy with radical dissection achieved the best results for differentiated TC with LN involvement, with a complication rate of 6%. Classic radical dissection is an effective surgical approach when performed by experienced surgeons in cases in which there is a good knowledge of local anatomy, decreasing recurrence and improving survival.

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Functional radical cervical dissection for differentiated thyroid cancer: the experience of a single center

Cited by 3 publications

References 17 publications

Possible Influence of Weight Gain and Creatinine Levels in Predicting Response to Nivolumab: A Multicenter Analysis

Possible Influence of Weight Gain and Creatinine Levels in Predicting Response to Nivolumab: A Multicenter Analysis

The Importance of Dose Intensity When Administering Cytotoxic Chemotherapy in NSCLC—A Matter as Actual Now as in the Past

Radical neck dissection with advancement flap in advanced papillary thyroid cancer: a therapeutic option

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