Preferential Use of Total Thyroidectomy without Prophylactic Central Lymph Node Dissection for Early-Stage Papillary Thyroid Cancer: Oncologic Outcomes in an Integrated Health Plan

Said, Meena; Fujimoto, Michelle; Franken, Cara; Woo, Sunee; Vuong, Brooke; Haigh, Philip I.

doi:10.7812/tpp/15-251

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…In cases of the greatest severity with the worst prognosis, methods as surgery, radiotherapy and chemotherapy may not be sufficient to successfully treat PDHC (20). Previous studies have investigated the pathogenesis, therapeutic strategies and drug development associated with PDHC (16,21). The present results showed that dTAT NP-NIS inhibits cell growth and induces cellular apoptosis in TPC-1 cells.…”

Section: Discussionmentioning

confidence: 57%

“…However, it has been hypothesized that due to obstructions to NIS positioning and reductions in NIS protein expression levels, iodine uptake capacities for certain patients with thyroid cancer are reduced or depleted entirely, which may influence the efficacy of I-131 treatment and worsen prognosis (15). By improving functional position expression levels of NIS, iodine uptake capacities of thyroid cancer tissues may be increased (16). Thus, in the present study we investigated whether the cell penetrating peptide of NIS affects the efficacy of I-131 radiotherapy in human thyroid cancer cells.…”

Section: Introductionmentioning

confidence: 99%

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Cell penetrating peptide of sodium-iodide symporter effect on the I-131 radiotherapy on thyroid cancer

Fan

Liang

Liu

et al. 2017

Experimental and Therapeutic Medicine

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The aim of the present study was to clarify whether the cell penetrating peptide of sodium-iodide symporter (NIS) has an effect on the I-131 radiotherapy of thyroid cancer. Firstly, we combined the HIV-1 TAT peptide (a cell penetrating peptide, dTAT) and established a nanoparticle vector (dTAT NP) to study the delivery efficiency of this cell-penetrating strategy for tumor-targeted gene delivery. dTAT NP was transfected into cultured TPC-1 cells as a model to study the effects of I-131 radiotherapy on thyroid cancer. Reverse transcription-quantitative polymerase chain reaction and western blotting results showed that the mRNA and protein expression levels of NIS in the transfected TPC-1 cells were substantially higher than in the negative control cells. MTT and flow cytometric analyses demonstrated that the cell growth and apoptosis rates of the TPC-1 cells were significantly inhibited and activated, respectively, by treatment with dTAT NP. The results of DAPI staining showed that treatment with dTAT NP visibly increased the nuclear apoptosis rate of the TPC-1 cells. The effect of dTAT NP on TPC-1 cells was associated with the promotion of caspase-3 and downregulation of the PI3K/Akt signaling pathway. In summary, the present data provide a pre-clinical proof-of-concept for a novel gene delivery system that efficiently delivers NIS to the targeted cancer cells and presents a satisfactory efficacy. This approach may offer an effective strategy for improving thyroid cancer gene therapy.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Cell penetrating peptide of sodium-iodide symporter effect on the I-131 radiotherapy on thyroid cancer

Fan

Liang

Liu

et al. 2017

Experimental and Therapeutic Medicine

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“…Regarding prophylactic CND, the AAES guidelines point out that in the absence of clinically US-evident LNM, there are no conclusive data showing that aggressive prophylactic extirpation of LN with microscopic metastatic disease improves PTC outcomes (since microscopic metastasis is usually resected in prophylactic CND [ 2 , 20 , 21 ]).…”

Section: Discussionmentioning

confidence: 99%

Drawing as a Way of Knowing: How a Mapping Model Assists Preoperative Evaluation of Patients with Thyroid Carcinoma

Biffoni,

Grani,

Melcarne

et al. 2024

JCM

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Background: Effective pre-surgical planning is crucial for achieving successful outcomes in endocrine surgery: it is essential to provide patients with a personalized plan to minimize operative and postoperative risks. Methods: Preoperative lymph node (LN) mapping is a structured high-resolution ultrasonography examination performed in the presence of two endocrinologists and the operating surgeon before intervention to produce a reliable “anatomical guide”. Our aim was to propose a preoperative complete model that is non-invasive, avoids overdiagnosis of thyroid microcarcinomas, and reduces medical expenses. Results: The use of ‘preoperative echography mapping’ has been shown to be successful, particularly in patients with suspected or confirmed neoplastic malignancy. Regarding prognosis, positive outcomes have been observed both post-surgery and in terms of recurrence rates. We collected data on parameters such as biological sex, age, BMI, and results from cytologic tests performed with needle aspiration, and examined whether these parameters predict tumor malignancy or aggressiveness, calculated using a multivariate analysis (MVA). Conclusions: A standard multidisciplinary approach for evaluating neck lymph nodes pre-operation has proven to be an improved diagnostic and preoperative tool.

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“…However, there were 12 patients (35.3%) who developed transient hypocalcemia that improved within few weeks after surgery. Islam et al [37] in their study reported a rate of 32% of hypocalcemia after thyroidectomy. In another study by Sousa et al [38], the incidence of temporary hypocalcemia was 40.8%.…”

Section: Discussionmentioning

confidence: 99%

“…Postthyroidectomy hypocalcemia is a complex phenomenon that may happens due to many factors even with preservation of the parathyroid glands e. g. surgical trauma to parathyroid glands, and parathyroid devascularization specially that parathyroid glands share the blood supply with thyroid. This blood supply is delicate and easy to be disrupted [37,41].…”

Section: Discussionmentioning

confidence: 99%

Total Thyroidectomy Without Prophylactic Central Cervical Lymph Node Dissection: Is It Oncologically Safe in Patients with Early-Stage Papillary Thyroid Carcinoma

El-Bakary¹

2017

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Abstract:Background: The necessity and the benefits of prophylactic central cervical lymph node dissection (PCLND) in clinically node negative patients with early-stage papillary thyroid carcinoma (PTC) remain controversial. Objective: to evaluate the safety of total thyroidectomy without PCLND in clinically node-negative early-stage PTC. Patients & Methods: 34 patients with T1 or T2 & N0 PTC were included in the study and submitted to total thyroidectomy without PCLND. Postoperatively, all patients received TSH suppression therapy & radio-active iodine (RAI) ablation. Any suspicious local neck recurrence during the follow up was confirmed cytologically and treated by RAI ablation. Results: The mean age was 42.1 years. 55.9% of patients were less than 45 years and 44.1% were 45 years old or more. Male to female ratio was 10:24. T1 was found in 14 cases & T2 in 20 cases. Total thyroidectomy was successfully done for all the cases. Central cervical lymph nodes sampling was done in 5 cases. Excised lymph nodes were found in 8 specimens; 5 cases with lymph node sampling (14.7%) and 3 cases (8.8%) with accidental lymph node excision during thyroidectomy. only 6 of these 8 patients (17.6%) showed positive metastasis (pN1). No recurrent laryngeal nerve injury was reported. In 12 patients (35.3%), temporary hypocalcemia was encountered. The mean follow up period was 34.6 months. There were 2 recurrences (5.9%); 1 in the central & 1 in the lateral neck compartment. All recurrences were treated by RAI ablation. No distant metastasis or mortality was reported. Conclusion: total thyroidectomy without PCLND in clinically node-negative early stage PTC is an excellent treatment option that gives adequate loco-regional control of the disease with low rate of surgical complications. Close follow up for longer periods is needed.

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Preferential Use of Total Thyroidectomy without Prophylactic Central Lymph Node Dissection for Early-Stage Papillary Thyroid Cancer: Oncologic Outcomes in an Integrated Health Plan

Cited by 9 publications

References 29 publications

Cell penetrating peptide of sodium-iodide symporter effect on the I-131 radiotherapy on thyroid cancer

Cell penetrating peptide of sodium-iodide symporter effect on the I-131 radiotherapy on thyroid cancer

Drawing as a Way of Knowing: How a Mapping Model Assists Preoperative Evaluation of Patients with Thyroid Carcinoma

Total Thyroidectomy Without Prophylactic Central Cervical Lymph Node Dissection: Is It Oncologically Safe in Patients with Early-Stage Papillary Thyroid Carcinoma

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