Papillary Thyroid Cancer Treated at the Mayo Clinic, 1946 Through 1970: Initial Manifestations, Pathologic Findings, Therapy, and Outcome

McConahey, William M.; Hay, Ian D.; Woolner, Lewis B.; Heerden, Jon A. van; Taylor, William F.

doi:10.1016/s0025-6196(12)62641-x

Cited by 518 publications

(367 citation statements)

References 40 publications

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“…Our findings revealed that low risk group had better prognosis than intermediate and high risk. This result was similar to many publish studies (McConahey et al, 1986;Gemsenjager et al, 2001;Falvo et al, 2005;Lang et al, 2006).…”

Section: Discussionsupporting

confidence: 92%

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Thamnirat

Utamakul²,

Chamroonrat³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Purpose: The study aim was to assess factors that impact on the outcome of radioiodine therapy in patients diagnosed with differentiated thyroid carcinoma (DTC). Materials and Methods: We performed a retrospective cohort study on 256 patients with DTC who underwent thyroidectomy and received radioiodine therapy during December 2003 to January 2012. All patients were followed up for at least 1 year. They were considered diseasefree by the criteria of the revised American Thyroid Association Management Guideline for Patients with Thyroid nodules and DTC (ATA guideline 2009). Results: On Cox univariate analysis, factors associated with disease-free status were age<45, stage I tumor, low risk group by histopathology, unifocal tumor involvement, stimulated serum Tg level at 1st dose of radioiodine therapy and no distant metastasis from 1st post-treatment WBS (post RxWBS). On multivariate analysis, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy < 30 ng/mL were the significant prognostic factors that increased disease-free rate by 1.73 times and 2.60 times, respectively (P-value <0.05). Conclusions: Factors affecting the outcome of radioiodine therapy in our study were age, stage, risk of recurrence by histopathology, unifocal tumor involvement and 1st postRxWBS findings. From these factors, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy were independent prognostic factors that substantial increase the disease-free rate.

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Section: Discussionsupporting

confidence: 92%

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Thamnirat

Utamakul²,

Chamroonrat³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Although most of the patients in our study received treatment that included nearly total thyroidectomy with lymph node dissection, post-operative 131I treatment and one-fifth of these patients received external radiotherapy, 7% of the patients still died of thyroid cancer. The ratio of papillary thyroid cancer with ETE and the mortality rate of patients with ETE in our study was close to that in the series from Mayo Clinic [14] and Mazzaferri et a1. [11].…”

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confidence: 90%

Prognostic Variables of Papillary Thyroid Carcinomas with Local Invasion.

et al. 1999

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“…Lymphatic metastases develop in 30%-90% of PTC patients, depending not only on the actual pathological stage of the disease but also on which diagnostic modalities are employed to assess the potential metastases [18][19][20]. Several reports have emphasized that although lymphatic metastasis does not affect overall survival in PTC patients, cervical LND can improve locoregional control [3][4][5]18]. Therefore, the control of regional metastasis in PTC is a major prognostic factor.…”

Section: Discussionmentioning

confidence: 99%

“…Cervical LN metastasis is the most significant prognostic factor for locoregional recurrences in patients with PTC [3][4][5]. However, cervical LN metastasis in such patients does not necessarily have an adverse affect on overall survival [2,6,7].…”

Section: Methodsmentioning

confidence: 99%

Is Level IIb Lymph Node Dissection Always Necessary in N1b Papillary Thyroid Carcinoma Patients?

et al. 2007

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Introduction Papillary thyroid carcinoma (PTC) patients show a high rate of cervical lymphatic metastasis. However, there are no universal binding guidelines for the extent of lateral cervical lymph node dissection (LND) in such cases. In particular, the need for LND above the spinal accessory nerve (SAN) remains controversial. The present study examined whether level IIb lymph node (LN) dissection is always necessary in PTC patients with lateral cervical LN metastasis. Materials and Methods The study prospectively examined 167 PTC patients with lateral cervical LN metastasis who underwent modified radical neck dissection (MRND) in our institution from November 2005 to March 2007. The MRND was bilateral in 24 cases. All patients underwent level II, III, IV, and V LND. Levels IIa and IIb LNs were individually dissected in all cases. All LND was performed using strict leveling criteria by a single operating team. The patterns of lymphatic metastasis and potential risk factors for level IIb LN involvement were evaluated. Results The most common site of metastasis was level III (80.6% of cases), followed by level IV (74.9%) and II (55.5%). The metastasis rates in level IIa and IIb were 55.5% and 6.8%, respectively; all level IIb LN metastasis was accompanied by level IIa metastasis (p = 0.001). In addition, level IIb LN metastasis was found to be associated with the aggressiveness of lymphatic metastasis (i.e., the total number of metastatic LNs) (p \ 0.0001).Conclusions A level IIb LND should be performed when there is clinical or radiological evidence of lymphatic metastasis. In the absence of such evidence, the findings suggest that level IIb LND is not necessary in N1b PTC patients when there is no level IIa LN metastasis, or when the metastasis is not aggressive.Of all thyroid malignancies, papillary thyroid carcinoma (PTC) has the highest risk of cervical lymph node (LN) metastasis [1,2]. Cervical LN metastasis is the most significant prognostic factor for locoregional recurrences in patients with PTC [3][4][5]. However, cervical LN metastasis in such patients does not necessarily have an adverse affect on overall survival [2,6,7].Debate continues regarding the appropriate extent of surgery for cervical LN metastasis in PTC. Surgery can extend from selective dissection (i.e., ''berry picking'') to extensive neck dissection. Most investigators agree that prophylactic neck dissection is not necessary in pathologically negative neck nodes (N0). However, for pathologically positive neck nodes, some clinicians recommend radical neck dissection (RND), whereas others recommend selective dissection with limitations [8][9][10][11].The shoulder syndrome is a major postoperative sequela of RND [12]. Postoperative spinal accessory nerve (SAN) dysfunction can result from direct pressure or traction during surgery. Even when the SAN is

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Papillary Thyroid Cancer Treated at the Mayo Clinic, 1946 Through 1970: Initial Manifestations, Pathologic Findings, Therapy, and Outcome

Cited by 518 publications

References 40 publications

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Prognostic Variables of Papillary Thyroid Carcinomas with Local Invasion.

Is Level IIb Lymph Node Dissection Always Necessary in N1b Papillary Thyroid Carcinoma Patients?

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