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van Kinschot CMJ, Oudijk L, van Noord C, Korevaar TIM, van Nederveen FH, Peeters RP, van Kemenade FJ, Visser WE. Predictors of treatment response in lymphogenic metastasized papillary thyroid cancer: a histopathological study. Eur J Endocrinol 2024; 190:374-381. [PMID: 38652802 DOI: 10.1093/ejendo/lvae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Lymph node metastases in papillary thyroid cancer (PTC) increase the risk for persistent and recurrent disease. Data on the predictive value of histopathological features of lymph node metastases, however, are inconsistent. The aim of this study was to evaluate the prognostic significance of known and new histopathological features of lymph node metastases in a well-defined cohort of PTC patients with clinically evident lymph node metastases. METHODS A total of 1042 lymph node metastases, derived from 129 PTC patients, were reexamined according to a predefined protocol and evaluated for diameter, extranodal extension, cystic changes, necrosis, calcifications, and the proportion of the lymph node taken up by tumor cells. Predictors for a failure to achieve a complete biochemical and structural response to treatment were determined. RESULTS The presence of more than 5 lymph node metastases was the only independent predictor for a failure to achieve a complete response to treatment (odds ratio [OR] 3.39 [95% CI, 1.57-7.33], P < .05). Diameter nor any of the other evaluated lymph node features were significantly associated with the response to treatment. CONCLUSIONS Detailed reexamination of lymph nodes revealed that only the presence of more than 5 lymph node metastases was an independent predictor of failure to achieve a complete response to treatment. No predictive value was found for other histopathological features, including the diameter of the lymph node metastases. These findings have the potential to improve risk stratification in patients with PTC and clinically evident lymph node metastases.
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Affiliation(s)
- Caroline M J van Kinschot
- Department of Internal Medicine, Maasstad Hospital, 3079 DZ Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Lindsey Oudijk
- Academic Center for Thyroid Diseases, Department of Pathology, Erasmus Medical Center, 3079 DZ Rotterdam, The Netherlands
| | - Charlotte van Noord
- Department of Internal Medicine, Maasstad Hospital, 3079 DZ Rotterdam, The Netherlands
| | - Tim I M Korevaar
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | | | - Robin P Peeters
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Folkert J van Kemenade
- Academic Center for Thyroid Diseases, Department of Pathology, Erasmus Medical Center, 3079 DZ Rotterdam, The Netherlands
| | - W Edward Visser
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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Kim H, Kwon H, Moon BI. Predictors of Recurrence in Patients with Papillary Thyroid Carcinoma: Does Male Sex Matter? Cancers (Basel) 2022; 14:cancers14081896. [PMID: 35454803 PMCID: PMC9030936 DOI: 10.3390/cancers14081896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 02/04/2023] Open
Abstract
Male patients with papillary thyroid carcinoma (PTC) usually have aggressive clinicopathological features, including large tumor size and lymph node metastasis; however, it is unclear whether male sex increases the risk of recurrence. Here, we evaluated the effect of sex on disease-free survival (DFS) of patients with PTC. Between 2009 and 2016, 1252 patients who underwent total thyroidectomy for PTC were enrolled; 157 (12.5%) were male and 1095 (87.5%) were female. With a mean follow-up of 6.6 years, five-year DFS rates were comparable between male and female patients (94.9% vs. 96.9%; p = 0.616) after adjusting for potential confounders. Multivariate Cox regression analysis also demonstrated that male sex was not an independent risk factor for recurrence (HR 1.982, 95% CI 0.831−4.726). Subgroup analyses further indicated that both male and female sex—in terms of their associations with five-year DFS—were comparable with other variables, including age < 55 years (94.5% vs. 97.3%; p = 0.520) and tumor size > 1 cm (91.9% vs. 97.0%; p = 0.243). In conclusion, male sex was not associated with the risk of recurrence in patients with PTC. Male patients do not always require aggressive treatment and follow-up approaches.
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Filauro M, Missale F, Marchi F, Iandelli A, Carobbio ALC, Mazzola F, Parrinello G, Barabino E, Cittadini G, Farina D, Piazza C, Peretti G. Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology. Eur Arch Otorhinolaryngol 2020; 278:2943-2952. [PMID: 33084951 PMCID: PMC8266699 DOI: 10.1007/s00405-020-06421-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022]
Abstract
Objective The first-line therapeutic approach for oral cavity squamous cell carcinoma (OCSCC) is complete surgical resection. Preoperative assessment of depth of invasion (cDOI) is crucial to plan the surgery. Magnetic resonance (MR) and intraoral ultrasonography (IOUS) have been shown to be useful tools for assessment of DOI. The present analysis investigates the accuracy of MR and IOUS in evaluating DOI in OCSCC compared to histological evaluation (pDOI). Materials and methods Forty-nine previously untreated patients with cT1-T3 OCSCC were reviewed. Nine patients were staged with MR alone, 10 with IOUS alone, and 30 with both MR and IOUS. Results Mean difference between cDOIMR and pDOI values of 0.2 mm (95% CI − 1.0–1.3 mm) and between cDOIIOUS and pDOI of 0.3 mm (95% CI − 1.0–1.6 mm). Spearman R between cDOIMR and pDOI was R = 0.83 and between cDOIIOUS and pDOI was R = 0.76. Both radiological techniques showed high performance for the correct identification, with the optimum cut-off of 5 mm, of patients with a pDOI ≥ 4 mm and amenable to a neck dissection, with an AUC of 0.92 and 0.82 for MR and IOUS, respectively. Conclusion Both examinations were valid approaches for preoperative determination of DOI in OCSCC, although with different cost-effectiveness profiles and indications. Electronic supplementary material The online version of this article (10.1007/s00405-020-06421-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marta Filauro
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy.,Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Francesco Missale
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Filippo Marchi
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Andrea Iandelli
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy
| | - Andrea Luigi Camillo Carobbio
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. .,Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy.
| | - Francesco Mazzola
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
| | | | - Emanuele Barabino
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Department of Diagnostic Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Giuseppe Cittadini
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Department of Diagnostic Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Davide Farina
- Department of Radiology, University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy
| | - Giorgio Peretti
- IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.,Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
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