Prognostic factors for recurrence of locally advanced differentiated thyroid cancer

Kim, Boyoung; Choi, Ji Eun; Lee, Eun-Kyu; Son, Young‐Ik; Baek, Chung‐Hwan; Kim, Sun Woo; Chung, Man Ki

doi:10.1002/jso.24740

Cited by 20 publications

(15 citation statements)

References 22 publications

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“…In the 8th edition of the tumour-node-metastasis classification, the microscopic ETE was no longer considered as criterion for the definition of T3 disease, while gross extrathyroidal extension as an unfavourable prognostic factor was underlined [25]. Gross ETE which develops from microscopic ETE can result in local invasion to important organs or tissues such as the trachea, RLN, oesophagus, or even the carotid artery, which further complicates surgery and worsens the prognosis of thyroid cancer [26]. Thus, individualised treatment plans should be determined based not only on the biological characteristics of PTMC, but also on its location in the thyroid lobe.…”

Section: Discussionmentioning

confidence: 99%

Immediate Surgery Might Be a Better Option for Subcapsular Thyroid Microcarcinomas

Jiang

Lü

2019

International Journal of Endocrinology

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For high-risk papillary thyroid microcarcinomas (PTMCs), immediate surgery is recommended. This study aimed to evaluate the location of PTMCs in the thyroid lobe and determine whether location is associated with an aggressive biology and the necessity of immediate surgery. This retrospective study included 288 patients who underwent initial surgery for PTMC. Clinical data were extracted. Subcapsular thyroid microcarcinomas (STMs) and nonsubcapsular thyroid microcarcinomas (NSTMs), distinguished by ultrasound, were compared in terms of tumour size, extrathyroidal extension, cervical lymph node metastasis, and multifocality. The preoperative ultrasound features predictive of recurrent laryngeal nerve (RLN) involvement were assessed. There were no statistical differences in tumour size (P = 0.985), multifocality (P = 0.866), lymph node metastases to the central compartment (P = 0.154), or lateral lymph node metastases (P = 0.929) between STM and NSTM groups. Macroscopic extrathyroidal extension was exclusively found in the STM group. For assessing RLN involvement, the sensitivity, specificity, and positive predictive value of the presence of an abnormal thyroid capsule margin between the STM and the presumed RLN course, assessed on preoperative ultrasonography images, were 100%, 43.3%, and 43.3%, respectively. Immediate surgery appears to be a better option than conservative treatment for these high-risk STM patients.

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Section: Discussionmentioning

confidence: 99%

Immediate Surgery Might Be a Better Option for Subcapsular Thyroid Microcarcinomas

Jiang

Lü

2019

International Journal of Endocrinology

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“…A recent retrospective analysis by Kim et al found 29.4% of patients with classical type PTC between 1-4 cm had contralateral cancers at the time of surgery. Importantly, patients who underwent only hemithyroidectomy were excluded from the study, and the authors do not state how many, if any, of these patients would have been eligible for hemithyroidectomy under the ATA guidelines (78). Notably, many of the features denoted as high risk by the ATA are strongly associated with multifocality (77,(79)(80)(81); suggesting that these patients would have undergone total thyroidectomy under the current guidelines.…”

Section: Extent Of Surgery For Differentiated Tumorsmentioning

confidence: 99%

Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers

et al. 2018

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Despite the development of novel diagnostic, surgical, and chemotherapeutic approaches to differentiated thyroid cancers (DTCs), the diagnosis and management of these tumors remains controversial. The most recent American Thyroid Association (ATA) guidelines, released in 2015, reflect a recent shift towards less aggressive management for patients with DTCs. However, many clinicians have expressed concern that more conservative management will put patients at risk for disease recurrence and metastasis. In particular, the management of indeterminate nodules on fine needle aspiration (with special attention to genetic and epigenetic markers of malignancy), the extent of surgery for known differentiated cancers, the role of adjuvant radioactive iodine (RAI) therapy, and novel targeted treatments with tyrosine kinase inhibitors (TKIs) represent current areas of uncertainty and opportunities for future research. In this review, we examine the current state of the art in these areas, and address some of the questions that remain.

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“…2 Surgical resection is the primary management SCC of the aerodigestive tract, potentially with concurrent chemo-radiation therapy depending on the extent of the disease. 3 A modern advance in robotic oncologic surgical techniques of the head and neck, trans-oral robotic surgery (TORS), has been developed using the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA) and demonstrated use in resection of orophangyeal and laryngeal SCC with promising results on functional preservation. 4 The da Vinci system relies on conventional optical imaging using a high resolution monitor, but studies have aimed to expand the optical imaging capabilities utilized.…”

Section: Introductionmentioning

confidence: 99%

Cancer detection using hyperspectral imaging and evaluation of the superficial tumor margin variance with depth

Halicek¹,

Fabelo

Ortega

et al. 2019

Medical Imaging 2019: Image-Guided Procedures, Robotic Interventions, and Modeling

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Head and neck squamous cell carcinoma (SCCa) is primarily managed by surgical resection. Recurrence rates after surgery can be as high as 55% if residual cancer is present. In this study, hyperspectral imaging (HSI) is evaluated for detection of SCCa in ex-vivo surgical specimens.Several methods are investigated, including convolutional neural networks (CNNs) and a spectralspatial variant of support vector machines. Quantitative results demonstrate that additional processing and unsupervised filtering can improve CNN results to achieve optimal performance. Classifying regions that include specular glare, the average AUC is increased from 0.73 [0.71, 0.75 (95% confidence interval)] to 0.81 [0.80, 0.83] through an unsupervised filtering and majority voting method described. The wavelengths of light used in HSI can penetrate different depths into biological tissue, while the cancer margin may change with depth and create uncertainty in the ground-truth. Through serial histological sectioning, the variance in cancer-margin with depth is also investigated and paired with qualitative classification heat maps using the methods proposed for the testing group SCC patients.

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Prognostic factors for recurrence of locally advanced differentiated thyroid cancer

Cited by 20 publications

References 22 publications

Immediate Surgery Might Be a Better Option for Subcapsular Thyroid Microcarcinomas

Immediate Surgery Might Be a Better Option for Subcapsular Thyroid Microcarcinomas

Current controversies and future directions in the diagnosis and management of differentiated thyroid cancers

Cancer detection using hyperspectral imaging and evaluation of the superficial tumor margin variance with depth

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