The Treatment of Well-Differentiated Thyroid Carcinoma

Paschke, Ralf; Lincke, Thomas; Kreißl, Michael C.; Dralle, Henning; Faßnacht, Martin

doi:10.3238/arztebl.2015.0452

Cited by 38 publications

(33 citation statements)

References 28 publications

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“…The clinically relevant features that define the classical type of WDTC with a low risk of aggressiveness are pT1a solitary or multiple, N0/Nx, pT1b N0/Nx, pT2 N0/Nx, pT3>4 cm N0/Nx, tumor diameter below 4 cm and intrathyroid, R0 or R1 resection, and M0. The features connected with a high risk of WDTC are pT4 and M1 or R2 resection 12. However, on the basis of our own observation and subsequent postsurgical follow-up, this risk stratification does not always correspond with clinical outcome.…”

Section: Introductionmentioning

confidence: 71%

<p>Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review</p>

Kaliszewski

2019

CMAR

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Introduction: The classical type of well-differentiated thyroid cancer (WDTC) is the most common endocrine tumor with generally excellent prognosis. WDTC of the WHO stage 1 classification metastasizing to the vertebral column is not often seen for this neoplasm. Here, I present a case series of 14 individuals with aggressive classical type of WDTC. Methods: To identify the most aggressive cases of classical type WDTC, I reviewed the medical records of 4,327 patients consecutively admitted and surgically treated in a single institution for thyroid pathology in the years 2008–2016. Demographic, pathological and outcome data were collected and reviewed. Results: During the study period, 14 (4.02%) patients with aggressive forms of the classical type of WDTC were reviewed: 10 (2.87%) cases with papillary thyroid cancer (PTC) and 4 (1.14%) with follicular thyroid cancer (FTC). The median age at diagnosis was 61 years (31–84 years). Aggressive features such as extrathyroid extension 11/14 (78.57%), positive surgical margins 11/14 (78,57%), lymph node metastases 7/14 (50%), multifocality 6/14 (42.85%), regional tissue infiltration 11/14 (78.57%) and distant metastases 4/14 (28.57%) were observed. Long-term follow-up (median 40 months) demonstrated a high rate of locoregional recurrence in 12/14 (85.71%) individuals. Pulmonary and other distant metastases were observed in 4/14 (28.57%) patients, with mortality in 3/14 (21.42%) individuals. Conclusion: In patients with classical type of WDTC characterized by excellent prognosis, extremely aggressive entities might be observed, making WDTC in some cases an unpredictable tumor.

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Section: Introductionmentioning

confidence: 71%

<p>Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review</p>

Kaliszewski

2019

CMAR

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“…Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer and accounts for approximately 80- 85% of malignant neoplasms of the thyroid gland. It has a 10-year survival rate 93% in the United States, which is relatively favorable compared to that of malignant tumors [ 1 ]. The major factors underlying the prognosis of PTC include patient age, gender, tumor size, histological findings, extrathyroidal extension, clinical lymph node metastasis and remote metastasis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of the BRAF mutation in papillary thyroid carcinoma and chronic lymphocytic thyroiditis

Kim

Bae

2018

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundThe purpose of this study was to examine the possible prognostics and clinicopathologic characteristics underlying the BRAFV600E mutation and papillary thyroid carcinoma (PTC) coexisting or in absence of chronic lymphocytic thyroiditis (CLT).MethodsThis study was conducted on 172 patients who had undergone total thyroidectomy or unilateral total thyroidectomy for PTC; the patients were then examined for the BRAFV600E mutation using specimens obtained after their surgery from January 2013 to August 2015.ResultsBRAF mutations were found in 130 of 172 patients (75.6%). CLT was present in 27.9% of patients (48/172). The incidence of the BRAFV600E mutation was significantly increased in the group with no CLT (P = 0.001). The findings of the multivariate analysis pertaining to the coexistence of CLT and PTC showed no significant correlation other than the BRAFV600E mutation. No significant difference was noted in the clinicopathologic factors between the two groups based on the coexistence of CLT in univariate and multivariate analyses.ConclusionsThe BRAFV600E mutation is less frequent in PTC coexisting with CLT presumably because CLT and the BRAFV600E mutation operate independently in the formation and progression of thyroid cancer.

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“…These two drugs were recently applied in the treatment of these tumors, where they have shown that they prolong progression free-survival, but not the overall survival. 35 In general, all the anti-VEGF drugs that were applied in recent clinical trials, have limited therapeutic success in TC, due to low response rate 36 and adverse effects in various tissues and organs 37 . That is why it is necessary to conduct more investigations, which should be focused on molecular studies that could result in a novel antiangiogenesis therapy as an effective treatment for thyroid tumors.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Role of Vascular Endothelial Growth Factor-A Expression in Thyroid Carcinomas

Vela-Gaxha¹,

Shahini²,

Manxhuka-Kërliu³

2019

Folia Medica

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Background: Thyroid carcinomas are the most common endocrine tumors – they account for 95% of all endocrine tumors. Thyroid carcinomas are more vascular than normal thyroid tissue. For the tumor to grow and subsequently metastasize it is crucial that it induces angiogenesis. This requires a change in the balance between certain angiogenic factors such as the vascular endothelial growth factor-A (VEGF-A) and the inhibitors of angiogenesis. The aim of this study was to evaluate the role of VEGF-A expression in thyroid carcinomas. Materials and methods: The present prospective study included 80 cases, of which 60 were patients with thyroid cancer including papillary, follicular, medullary and anaplastic carcinoma, and 20 patients (controls) with benign thyroid tissue (thyroid goiter). All cases were examined using the immunohistochemical staining for VEGF-A. Results: VEGF-A expression in thyroid carcinoma was significantly higher than in benign thyroid tissues (p<0.001). VEGF-A expression values in thyroid carcinoma did not associate with tumor necrosis degree (p=1.000). Furthermore, VEGF-A expression values in thyroid carcinoma were not associated with other prognostic factors such as tumor hemorrhage, angioinvasion, atypical mitosis, and lymphatic invasion. Conclusion: Our data showed that the VEGF-A expression is upregulated in thyroid cancers compared with benign thyroid tissue. Therefore, it would be useful to perform IHC staining for VEGF-A expression as a valuable diagnostic tool in TC.

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The Treatment of Well-Differentiated Thyroid Carcinoma

Cited by 38 publications

References 28 publications

<p>Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review</p>

<p>Does every classical type of well-differentiated thyroid cancer have excellent prognosis? A case series and literature review</p>

Clinical implications of the BRAF mutation in papillary thyroid carcinoma and chronic lymphocytic thyroiditis

The Prognostic Role of Vascular Endothelial Growth Factor-A Expression in Thyroid Carcinomas

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