Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel; Pessoa, Cencita H. C. N.; Cruz, Manuel Domingos Gonçalves da; Dias, Fernando Luiz; Corbo, Rossana; Vaisman, Mário; Tuttle, R. Michael

doi:10.1155/2013/398194

Cited by 58 publications

(54 citation statements)

References 15 publications

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“…Similar findings were reported by Memorial Sloan Kettering in a matched pair analysis [20]. Single institutions would provide increasingly compelling evidence that more aggressive therapy was not associated with improved outcome [21][22][23][24]. These findings were supported by updated national database studies, which also concluded that a more aggressive approach could not be supported in low-risk groups [25].…”

Section: Prace Poglądowesupporting

confidence: 64%

Wysoko zróżnicowany rak tarczycy — czy nie leczysz swoich pacjentów zbyt intensywnie?

Nixon

2016

Endokrynologia Polska

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Over the last 50 years there has been a move towards more aggressive therapy for well-differentiated thyroid cancer. In recent times, however, international guidelines have shown some trend back towards a more conservative approach to treating low-risk patients. This review explores how the state of the art in well-differentiated thyroid cancer research has evolved in tandem with improvements in riskstratification. A focus on the surgical approach to the primary thyroid tumour and the regional lymphatics in addition to the interplay between surgical decision making and the use of radioactive iodine are presented to allow the reader to determine whether they are now overtreating patients with well-differentiated thyroid cancer. StreszczenieW ciągu ostatnich 50 lat nastąpiła zmiana w leczeniu wysoko zróżnicowanego raka tarczycy na rzecz bardziej agresywnej terapii. Jednakże, całkiem niedawno, międzynarodowe wytyczne wskazały trend w kierunku powrotu ku bardziej konserwatywnemu podejściu w leczeniu pacjentów niskiego ryzyka. W niniejszym artykule opisano jak najnowsze badania na temat wysoko zróżnicowanego raka tarczycy ewoluują równocześnie z ulepszeniami w stratyfikacji ryzyka. Podejście chirurgiczne do raka pierwotnego tarczycy oraz regionalnych węzłów chłonnych przedstawiono wraz ze wzajemnymi zależnościami operacyjnego procesu decyzyjnego i wykorzystaniem radiojodu, aby umożliwić czytelnikowi ustalenie, czy zbyt intensywnie leczy pacjentów z wysoko zróżnicowanym rakiem tarczycy.

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Section: Prace Poglądowesupporting

confidence: 64%

Wysoko zróżnicowany rak tarczycy — czy nie leczysz swoich pacjentów zbyt intensywnie?

Nixon

2016

Endokrynologia Polska

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“…The major reasons included the following: low complication rate associated with TT (as reported by several authors) [27][28][29], risk of relapse after hemithyroidectomy [5,7], risk of an occult malignancy [30] that makes follow-up complex, and/or greater difficulty in performing the revision surgery after thyroid lobectomy. Several recent studies have emphasized various advantages of hemithyroidectomy [31,32] in selected cases of malignancy [33,34]. Further observations may reinforce the support of HT such as voice and swallowing disorders that have been evaluated in association with TT [35,36].…”

Section: Discussionmentioning

confidence: 88%

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Scerrino¹,

Raspanti²,

Attard³

et al. 2017

Langenbecks Arch Surg

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Purpose Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. Methods A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre-and postoperative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy. Results One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery. Conclusions CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.

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“…Traditionally, the initial treatment of PTC has included a total thyroidectomy, often with radioactive iodine remnant ablation (2). However, a more risk adapted management approach has been followed at many centers (3,4) and is now being endorsed in both the National Comprehensive Cancer Center and the American Thyroid Association guidelines (5,6).…”

mentioning

confidence: 99%

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Moreira

Hatzoglou

et al. 2015

Thyroid

Self Cite

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Background: Initial management recommendations of papillary thyroid carcinoma (PTC) are very dependent on preoperative studies designed to evaluate the presence of PTC with aggressive features. The purpose of this study was to evaluate whether diffusion-weighted magnetic resonance imaging (DW-MRI) before surgery can be used as a tool to stratify tumor aggressiveness in patients with PTC. Methods: In this prospective study, 28 patients with PTC underwent DW-MRI studies on a three Tesla MR scanner prior to thyroidectomy. Due to image quality, 21 patients were finally suitable for further analysis. Apparent diffusion coefficients (ADCs) of normal thyroid tissues and PTCs for 21 patients were calculated. Tumor aggressiveness was defined by surgical histopathology. The Mann-Whitney U test was used to compare the difference in ADCs among groups of normal thyroid tissues and PTCs with and without features of tumor aggressiveness. Receiver operating characteristic (ROC) analysis was performed to assess the discriminative specificity, sensitivity, and accuracy of and determine the cutoff value for the ADC in stratifying PTCs with tumor aggressiveness. Results: There was no significant difference in ADC values between normal thyroid tissues and PTCs. However, ADC values of PTCs with extrathyroidal extension (ETE; 1.53 -0.25 · 10 -3 mm 2 /s) were significantly lower than corresponding values from PTCs without ETE (2.37 -0.67 · 10 -3 mm 2 /s; p < 0.005). ADC values identified 3 papillary carcinoma patients with extrathyroidal extension that would have otherwise been candidates for observation based on ultrasound evaluations. The cutoff value of ADC to discriminate PTCs with and without ETE was determined at 1.85 · 10 -3 mm 2 /s with a sensitivity of 85%, specificity of 85%, and ROC curve area of 0.85. Conclusion: ADC value derived from DW-MRI before surgery has the potential to stratify ETE in patients with PTCs.

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Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

Cited by 58 publications

References 15 publications

Wysoko zróżnicowany rak tarczycy — czy nie leczysz swoich pacjentów zbyt intensywnie?

Wysoko zróżnicowany rak tarczycy — czy nie leczysz swoich pacjentów zbyt intensywnie?

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

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