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Kim M, Kang YE, Park YJ, Koo BS, Ku EJ, Choi JY, Lee EK, Kim BH. Potential impact of obesity on the aggressiveness of low- to intermediate-risk papillary thyroid carcinoma: results from a MASTER cohort study. Endocrine 2023; 82:134-142. [PMID: 37516686 DOI: 10.1007/s12020-023-03416-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/31/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE Obesity is associated with an increased risk of papillary thyroid carcinoma (PTC). Evidence of the impact of obesity on PTC aggressiveness is scarce. We aimed to evaluate the association between the body mass index (BMI) and the presence of aggressive features of low- to intermediate-risk PTC in a prospective cohort. METHODS We prospectively enrolled 1,032 patients with low- to intermediate-risk PTC who underwent lobectomy at 22 hospitals in Korea and divided into three groups according to BMI, as follows: normal/underweight ( < 23 kg/m2), overweight (23-24.9 kg/m2), and obese ( ≥ 25 kg/m2). Clinicopathological features of PTC at diagnosis were evaluated. RESULTS Obese patients had a higher rate of macro-PTC ( > 1 cm) and greater incidence of extra-thyroidal extension (ETE), vascular invasion, and intermediate-risk tumors than those not classified as obese. Increased BMI was positively associated with the incidence of macro-PTC, ETE, vascular invasion, and intermediate-risk category. After adjusting for age, sex, pathological features, metabolic syndrome, thyroid function test, and smoking habits, obesity was a risk factor for ETE (odds ratio [OR] = 1.7, 95% confidence interval [CI]: 1.2-2.5, p = 0.005) and intermediate-risk PTC (OR = 1.7, 95% CI: 1.1-2.5, p = 0.011) in women. The association between obesity and ETE was significant regardless of whether or not women had metabolic syndrome. There was no significant association between obesity and aggressive PTC features in men. CONCLUSION BMI at the time of thyroid cancer diagnosis may affect the aggressiveness of low- to intermediate-risk PTC, especially in women.
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Affiliation(s)
- Mijin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yae Eun Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bon Seok Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eun Kyung Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea.
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea.
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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Shimura H, Matsuzuka T, Suzuki S, Iwadate M, Suzuki S, Yokoya S, Ohira T, Yasumura S, Suzuki S, Ohto H, Kamiya K. Fine Needle Aspiration Cytology Implementation and Malignancy Rates in Children and Adolescents Based on Japanese Guidelines: The Fukushima Health Management Survey. Thyroid 2021; 31:1683-1692. [PMID: 34762538 DOI: 10.1089/thy.2021.0072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: The thyroid ultrasound examination (TUE) program was initiated among the residents of Fukushima Prefecture aged ≤18 years at the time of the Fukushima Dai-ichi Nuclear Power Plant accident. In this program, fine needle aspiration cytology (FNAC) was performed only in cases that conformed to the Japanese guidelines for the management of thyroid nodules. To analyze the suitability of the protocol in the TUE, we analyzed the implementation rate of FNAC and the detection rate of thyroid malignancy. Methods: There were 299,939 and 269,659 voluntary participants in the Preliminarily Baseline Survey (PLBS), first-round survey, and the first Full-scale Survey (FSS), second-round survey, of the TUE, respectively. FNAC is recommended for nodules with diameters 5.1-10.0 mm showing sonographic characteristics that are strongly suspicious for thyroid carcinoma; diameters 10.1-20.0 mm with characteristics that are suspicious for carcinoma; and all nodules with diameters >20 mm. Results: In the PLBS and the first FSS, 1362 and 1382 cases with thyroid nodules sized ≥5.1 mm in diameter were found, respectively. The implementation rates of FNAC in the PLBS were 20.1%, 63.2%, and 87.7% of subjects with nodules sized 5.1-10.0, 10.1-20.0, and ≥20.1 mm in diameter, respectively. In the first FSS, the FNAC implementation rates were 7.3%, 26.0%, and 50.0% in the subjects with nodules with diameters 5.1-10.0, 10.1-20.0, and ≥20.1 mm, respectively. In the subjects who underwent FNAC, the detection rates of malignant and suspected malignant nodules were 21.4% and 34.1% in the PLBS and first FSS, respectively. In the first FSS, malignant or suspected malignant nodules were found in 0.63% and 0.40% of subjects who had nodules of diameters ≤5.0 mm and 5.1-10.0 mm in the PLBS, respectively. In contrast, in the subjects with nodules measuring ≥10.0 mm in diameter in the PLBS, no malignancies were detected. Conclusions: The use of a protocol that conformed to the Japanese guidelines led to a reduction in the FNAC implementation rate and an increase in the malignancy detection rate in smaller nodules. In addition, the use of this strategy enabled us to avoid detection failure of thyroid carcinomas >10.0 mm.
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Affiliation(s)
- Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Laboratory Medicine; Fukushima Medical University, Fukushima, Japan
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Manabu Iwadate
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Thyroid and Endocrinology; Fukushima Medical University, Fukushima, Japan
| | - Satoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Thyroid and Endocrinology; Fukushima Medical University, Fukushima, Japan
| | - Susumu Yokoya
- Department of Thyroid and Endocrine Center, Fukushima Global Medical Science Center; Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, and Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health; School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Shinichi Suzuki
- Department of Thyroid and Endocrinology; Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Lee EK, Kang YE, Park YJ, Koo BS, Chung KW, Ku EJ, Won HR, Yoo WS, Jeon E, Paek SH, Lee YS, Lim DM, Suh YJ, Park HK, Kim HJ, Kim BH, Kim M, Kim SW, Yi KH, Park SK, Jung EJ, Choi JY, Bae JS, Hong JH, Nam KH, Lee YK, Yu HW, Go S, Kang YM, MASTER study group. A Multicenter, Randomized, Controlled Trial for Assessing the Usefulness of Suppressing Thyroid Stimulating Hormone Target Levels after Thyroid Lobectomy in Low to Intermediate Risk Thyroid Cancer Patients (MASTER): A Study Protocol. Endocrinol Metab (Seoul) 2021; 36:574-581. [PMID: 34034365 PMCID: PMC8258337 DOI: 10.3803/enm.2020.943] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/08/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy. METHODS This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years. CONCLUSION The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.
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Affiliation(s)
- Eun Kyung Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang,
Korea
| | - Yea Eun Kang
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Bon Seok Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Ki-Wook Chung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju,
Korea
| | - Ho-Ryun Won
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon,
Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong,
Korea
| | - Won Sang Yoo
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan,
Korea
| | - Eonju Jeon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu,
Korea
| | - Se Hyun Paek
- Department of Surgery, Ewha Womans University School of Medicine, Seoul,
Korea
| | - Yong Sang Lee
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Dong Mee Lim
- Department of Internal Medicine, Konyang University Hospital, Daejeon,
Korea
| | - Yong Joon Suh
- Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang,
Korea
| | - Ha Kyoung Park
- Department of Surgery, Inje University Busan Paik Hospital, Busan,
Korea
| | - Hyo-Jeong Kim
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul,
Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan,
Korea
| | - Mijin Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan,
Korea
| | - Sun Wook Kim
- Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul,
Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Cancer Research Institute, Seoul National University, Seoul,
Korea
- Convergence Graduate Program in Innovative Medical Science, Seoul,
Korea
| | - Eun-Jae Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul,
Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Ja Seong Bae
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Joon Hwa Hong
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon,
Korea
| | - Kee-Hyun Nam
- Department of Surgery, Yonsei University College of Medicine, Seoul,
Korea
| | - Young Ki Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang,
Korea
| | - Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Sujeong Go
- Center for Thyroid Cancer, National Cancer Center, Goyang,
Korea
| | - Young Mi Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon,
Korea
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Oh C, Lim J, Jung YS, Kim Y, Jung K, Hong S, Won Y. Decreasing trends in thyroid cancer incidence in South Korea: What happened in South Korea? Cancer Med 2021; 10:4087-4096. [PMID: 33979040 PMCID: PMC8209587 DOI: 10.1002/cam4.3926] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/22/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND South Korea has the highest incidence of thyroid cancer in the world. Our study examined the trends in thyroid cancer incidence by the histologic type, cancer stage, and age group and explored possible factors that affected thyroid cancer trends. METHODS We conducted a descriptive epidemiological study using the national cancer registry data and cause of death data from 1999 to 2016 in South Korea. Age-standardized rates were calculated using Segi's world standard population. Joinpoint regression analysis was applied to determine the changing point of thyroid cancer trends according to histologic type; Surveillance, Epidemiology, and End Results (SEER) summary stage; and age groups by sex. RESULTS The age-standardized incidence of thyroid cancer in both men and women increased from 6.3 per 100,000 people in 1999 to 63.4 per 100,000 in 2012 but declined from 2012 to 2016, before the debates for over diagnosis of thyroid cancer began in 2014. The age-standardized mortality rate of thyroid cancer, incidence of distant thyroid cancer, and incidence of regional and localized thyroid cancer started to decline since early 2000, 2010, and 2012, respectively. In addition, thyroid cancer prevalence in thyroid nodules showed decreasing trends from 1999-2000 to 2013-2014. CONCLUSIONS The incidence of thyroid cancer began declining from 2012, before the debates for over diagnosis of thyroid cancer began in 2014. Changes in guidelines for thyroid nodule examinations may have affected this inflection point. Moreover, the debates for over diagnosis of thyroid cancer may have accelerated the decline in thyroid cancer.
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Affiliation(s)
- Chang‐Mo Oh
- Department of Preventive MedicineSchool of MedicineKyung Hee UniversitySeoulSouth Korea
| | - Jiwon Lim
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Yuh Seog Jung
- Department of Otolaryngology‐Head and Neck SurgeryHead & Neck Oncology ClinicCenter for Thyroid CancerNational Cancer Center HospitalGoyangSouth Korea
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
| | - Yeol Kim
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
- Division of Cancer Management & PolicyNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Kyu‐Won Jung
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Seri Hong
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Young‐Joo Won
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
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Tribulova N, Kurahara LH, Hlivak P, Hirano K, Szeiffova Bacova B. Pro-Arrhythmic Signaling of Thyroid Hormones and Its Relevance in Subclinical Hyperthyroidism. Int J Mol Sci 2020; 21:E2844. [PMID: 32325836 PMCID: PMC7215427 DOI: 10.3390/ijms21082844] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/06/2020] [Accepted: 04/17/2020] [Indexed: 12/18/2022] Open
Abstract
A perennial task is to prevent the occurrence and/or recurrence of most frequent or life-threatening cardiac arrhythmias such as atrial fibrillation (AF) and ventricular fibrillation (VF). VF may be lethal in cases without an implantable cardioverter defibrillator or with failure of this device. Incidences of AF, even the asymptomatic ones, jeopardize the patient's life due to its complication, notably the high risk of embolic stroke. Therefore, there has been a growing interest in subclinical AF screening and searching for novel electrophysiological and molecular markers. Considering the worldwide increase in cases of thyroid dysfunction and diseases, including thyroid carcinoma, we aimed to explore the implication of thyroid hormones in pro-arrhythmic signaling in the pathophysiological setting. The present review provides updated information about the impact of altered thyroid status on both the occurrence and recurrence of cardiac arrhythmias, predominantly AF. Moreover, it emphasizes the importance of both thyroid status monitoring and AF screening in the general population, as well as in patients with thyroid dysfunction and malignancies. Real-world data on early AF identification in relation to thyroid function are scarce. Even though symptomatic AF is rare in patients with thyroid malignancies, who are under thyroid suppressive therapy, clinicians should be aware of potential interaction with asymptomatic AF. It may prevent adverse consequences and improve the quality of life. This issue may be challenging for an updated registry of AF in clinical practice. Thyroid hormones should be considered a biomarker for cardiac arrhythmias screening and their tailored management because of their multifaceted cellular actions.
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Affiliation(s)
- Narcis Tribulova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, 84104 Bratislava, Slovakia
| | - Lin Hai Kurahara
- Department of Cardiovascular Physiology, Faculty of Medicine, Kagawa University, Kagawa 76 0793, Japan; (L.H.K.); (K.H.)
| | - Peter Hlivak
- Department of Arrhythmias and Pacing, National Institute of Cardiovascular Diseases, Pod Krásnou Hôrkou 1, 83348 Bratislava, Slovakia;
| | - Katsuya Hirano
- Department of Cardiovascular Physiology, Faculty of Medicine, Kagawa University, Kagawa 76 0793, Japan; (L.H.K.); (K.H.)
| | - Barbara Szeiffova Bacova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, 84104 Bratislava, Slovakia
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Zhang HS, Lee EK, Jung YS, Nam BH, Jung KW, Kong HJ, Won YJ, Park B. Total thyroidectomy's association with survival in papillary thyroid cancers and the high proportion of total thyroidectomy in low-risk patients: Analysis of Korean nationwide data. Surgery 2018; 165:629-636. [PMID: 30342774 DOI: 10.1016/j.surg.2018.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/12/2018] [Accepted: 08/28/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Papillary thyroid cancer has an excellent prognosis, but the appropriate level of treatment is controversial. We compared survival between total thyroidectomy and less-than-total thyroidectomy, and examined the proportion of patients with papillary thyroid cancer in Korea undergoing total thyroidectomy. METHODS A nationwide sample of 5,230 papillary thyroid cancer patients was included (total thyroidectomy: 4,262, less-than-total thyroidectomy: 968). Using multivariate Cox regression, we compared overall survival and cause-specific survival by the extent of thyroidectomy (total thyroidectomy versus less-than-total thyroidectomy) for a 1:1 optimal match via the propensity score and for the total study population. We also compared overall survival by extent of thyroidectomy and the proportion of total thyroidectomy in different risk groups using papillary thyroid cancer staging systems. RESULTS We saw no difference in overall survival by extent of thyroidectomy in the propensity score matched population and the total study population (hazard ratio for less-than-total thyroidectomy 0.82, 95% confidence interval 0.52-1.29; hazard ratio for less-than-total thyroidectomy 1.03, 95% confidence interval 0.71-1.48, respectively). Similarly, there were no differences in thyroid cancer-specific survival by extent of thyroidectomy. None of the different risk groups showed differences in overall survival by surgical extent, although total thyroidectomy improved overall survival in older females with larger tumors. The proportion of papillary thyroid cancer patients who received a total thyroidectomy was 80% or greater regardless of risk group classification. CONCLUSION Total thyroidectomy had no survival advantage over less-than-total thyroidectomy in Korean papillary thyroid cancer patients except in a specific high-risk group. 80% or more of low-risk papillary thyroid cancer patients received a total thyroidectomy. These results suggest that further patient-centered treatment which considers both quality of life and clinical outcome is needed.
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Affiliation(s)
- Hyun-Soo Zhang
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Eun-Kyung Lee
- Center for Thyroid Cancer, Head and Neck Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Yuh-Seog Jung
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea; Center for Thyroid Cancer, Head and Neck Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Byung-Ho Nam
- Herings, Institute of Advanced Clinical and Biomedical Research, Seoul, Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Center for Thyroid Cancer, Head and Neck Oncology Clinic, National Cancer Center, Goyang, Korea; National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Boyoung Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Korea.
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Florenzano P, Guarda FJ, Jaimovich R, Droppelmann N, González H, Domínguez JM. Radioactive Iodine Administration Is Associated with Persistent Related Symptoms in Patients with Differentiated Thyroid Cancer. Int J Endocrinol 2016; 2016:2586512. [PMID: 27867395 PMCID: PMC5102728 DOI: 10.1155/2016/2586512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/14/2016] [Indexed: 11/17/2022] Open
Abstract
Context. Radioiodine (RAI) administration has adverse effects in patients treated for thyroid cancer (DTC), but there is scarce information regarding their intensity and duration. Objective. To evaluate frequency and intensity of early and late RAI-related symptoms in patients with DTC. Design. Observational prospective study. Patients. DTC patients who underwent thyroidectomy, with or without RAI. Measurements. Patients answered 2 surveys: (1) from 0 to 6 months and (2) between 6 and 18 months after initial treatment. Results. 110 patients answered the first survey and 61 both. Nearly 80 percent received RAI. Among early symptoms, periorbital edema, excessive tearing, salivary gland disturbances, dry mouth, taste disorders, and nausea were more frequent and intense among RAI patients. Regarding late symptoms, periorbital edema, salivary gland pain and swelling, and dry mouth were more frequent and intense in RAI patients. Frequency and intensity of adverse effects were not different between low and high RAI doses (50 versus ≥100 mCi). Conclusion. RAI-related symptoms are frequent and usually persist after 6 months of administration, even when low doses are given. This finding must be considered when deciding RAI administration, especially in low risk patients, among whom RAI benefit is controversial.
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Affiliation(s)
- Pablo Florenzano
- Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco J. Guarda
- Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Jaimovich
- Department of Nuclear Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Droppelmann
- Department of Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hernán González
- Department of Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José M. Domínguez
- Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- *José M. Domínguez:
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