1
|
Borzooei S, Briganti G, Golparian M, Lechien JR, Tarokhian A. Machine learning for risk stratification of thyroid cancer patients: a 15-year cohort study. Eur Arch Otorhinolaryngol 2024; 281:2095-2104. [PMID: 37902840 DOI: 10.1007/s00405-023-08299-w] [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] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/17/2023] [Indexed: 11/01/2023]
Abstract
PURPOSE The objective of this study was to train machine learning models for predicting the likelihood of recurrence in patients diagnosed with well-differentiated thyroid cancer. While thyroid cancer mortality remains low, the risk of recurrence is a significant concern. Identifying individual patient recurrence risk is crucial for guiding subsequent management and follow-ups. METHODS In this prospective study, a cohort of 383 patients was observed for a minimum duration of 10 years within a 15-year timeframe. Thirteen clinicopathologic features were assessed to predict recurrence potential. Classic (K-nearest neighbors, support vector machines (SVM), tree-based models) and artificial neural networks (ANN) were trained on three distinct combinations of features: a data set with all features excluding American Thyroid Association (ATA) risk score (12 features), another with ATA risk alone, and a third with all features combined (13 features). 283 patients were allocated for the training process, and 100 patients were reserved for the validation of stage. RESULTS The patients' mean age was 40.87 ± 15.13 years, with a majority being female (81%). When using the full data set for training, the models showed the following sensitivity, specificity and AUC, respectively: SVM (99.33%, 97.14%, 99.71), K-nearest neighbors (83%, 97.14%, 98.44), Decision Tree (87%, 100%, 99.35), Random Forest (99.66%, 94.28%, 99.38), ANN (96.6%, 95.71%, 99.64). Eliminating ATA risk data increased models specificity but decreased sensitivity. Conversely, training exclusively on ATA risk data had the opposite effect. CONCLUSIONS Machine learning models, including classical and neural networks, efficiently stratify the risk of recurrence in patients with well-differentiated thyroid cancer. This can aid in tailoring treatment intensity and determining appropriate follow-up intervals.
Collapse
Affiliation(s)
- Shiva Borzooei
- Department of Endocrinology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Giovanni Briganti
- Chair of AI and Digital Medicine, Faculty of Medicine, University of Mons, Mons, France
- Department of Clinical Sciences, Faculty of Medicine, Université de Liège, Liège, Belgium
| | - Mitra Golparian
- Hamadan University of Medical Sciences, Pajoohesh Blvd., Hamadan, Iran
| | - Jerome R Lechien
- Department of Otolaryngology-Head Neck Surgery, Elsan Hospital, Paris, France
| | - Aidin Tarokhian
- Hamadan University of Medical Sciences, Pajoohesh Blvd., Hamadan, Iran.
| |
Collapse
|
2
|
Shi H, Yang B, Feng JI, Li JH, Cheng X, Li YJ, Fu Y, Xu XD, Qian LH, Tang LJ, Liu W. Radioactive iodine therapy for follicular thyroid cancer: a 15 years follow-up study of Chinese patients. Nucl Med Commun 2024; 45:169-174. [PMID: 38095140 PMCID: PMC10849129 DOI: 10.1097/mnm.0000000000001798] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/22/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To identify long-term predictors of distant metastases (DM) and the overall survival (OS) of follicular thyroid cancer (FTC) patients who underwent radioactive iodine (RAI) therapy. And to expand the knowledge about the clinical course and experience of RAI treatment for FTC. MATERIALS A total of 117 FTC patients who underwent RAI therapy at our institution from 2005 to 2020 were retrospectively studied. Patient characteristics, serum stimulating thyroglobulin (sTg) and thyroglobulin antibody levels, treatment process and follow-up data were collected until 26 April 2022. RESULTS A total of 16 patients (13.7%) were lost to follow-up. A total of 23 (19.7%) patients with DM died and all FTC without DM were still alive. DM was seen in 58.4% (59/101) of patients. The most common location for metastatic lesions was the lung. Then was bone. The mean survival time of FTC with RAI was 156 months [95% confidence interval (CI): 142-171]. Five-year and 10-year cumulative survival rates of them were 88.8% and 67.4%, respectively. As for patients with DM were 80.4% and 41.3%, respectively. Age at diagnosis [odds ratio (OR) = 1.080, P = 0.009], RAI therapy sessions (OR = 2.959, P = 0.001) and sTg level (OR = 1.006, P = 0.002) were predictive of DM occurrence in FTC with RAI. In the group of FTC with DM, survival analysis showed that males were more likely to have a lower OS than females ( P = 0.039). CONCLUSION Age, number of RAI therapy sessions, and sTg level were predictive of the occurrence of DM in FTC patients with RAI. Sex would influence the OS of FTC patients with DM.
Collapse
Affiliation(s)
- He Shi
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Bo Yang
- Department of Nuclear Medicine, The Second People’s Hospital of Lianyungang, The Cancer Hospital of Lianyungang, Lianyungang, China
| | - Jian-Iin Feng
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Jian-hua Li
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Xu Cheng
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Yong-jun Li
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Yu Fu
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Xin-dan Xu
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Lei-hang Qian
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Li-jun Tang
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Wei Liu
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing
| |
Collapse
|
3
|
Matos MDL, Pinto M, Alves M, Canberk S, Gonçalves A, Bugalho MJ, Papoila AL, Soares P. Comparative Cyto-Histological Genetic Profile in a Series of Differentiated Thyroid Carcinomas. Diagnostics (Basel) 2024; 14:278. [PMID: 38337794 PMCID: PMC10855767 DOI: 10.3390/diagnostics14030278] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Molecular tests can contribute to improve the preoperative diagnosis of thyroid nodules. Tests available are expensive and not adapted to different populations. AIM This study aimed to compare the cyto-histological genetic profile and to evaluate the reliability of molecular tests using ultrasound-guided fine needle aspiration cytology (US-FNAC) in accurately diagnosing differentiated thyroid carcinomas (DTCs) and predicting biologic behavior of papillary thyroid carcinomas (PTCs). MATERIALS AND METHODS The series included 259 patients with paired cyto-histological samples totaling 518 samples. The genetic alterations were analyzed via PCR/Sanger sequencing. The association with clinicopathologic features was evaluated in PTCs. RESULTS/DISCUSSION From the 259 patients included, histologies were 50 (19.3%) benign controls and 209 (80.7%) DTC cases, from which 182 were PTCs; cytologies were 5.8% non-diagnostic, 18.2% benign, 39% indeterminate, and 37.1% malignant. In histology, indeterminate nodules (n = 101) were 22.8% benign and 77.2% malignant. Mutation frequencies in cytology and histology specimens were, respectively, TERTp: 3.7% vs. 7.9%; BRAF: 19.5% vs. 25.1%; and RAS: 11% vs. 17.5%. The overall cyto-histological agreement of the genetic mutations was 94.9%, with Cohen's k = 0.67, and in indeterminate nodules agreement was 95.7%, k = 0.64. The identified mutations exhibited a discriminative ability in diagnosing DTC with a specificity of 100% for TERTp and BRAF, and of 94% for RAS, albeit with low sensitivity. TERTp and BRAF mutations were associated with aggressive clinicopathological features and tumor progression in PTCs (p < 0.001). The obtained good cyto-histological agreement suggests that molecular analysis via US-FNAC may anticipate the genetic profile and the behavior of thyroid tumors, confirming malignancy and contributing to referring patients to surgery.
Collapse
Affiliation(s)
- Maria de Lurdes Matos
- Department of Endocrinology, Diabetes and Metabolismo, Centro Hospitalar Universitário de Lisboa Central, Hospital Curry Cabral, 1050-099 Lisbon, Portugal
| | - Mafalda Pinto
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), i3S—Institute for Research & Innovation in Health, 4200-135 Porto, Portugal; (M.P.); (S.C.)
| | - Marta Alves
- Gabinete de Estatística do Centro de Investigação do Centro Hospitalar Universitário de Lisboa Central, EPE, Nova Medical School, 1169-045 Lisbon, Portugal; (M.A.); (A.L.P.)
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), 1749-016 Lisbon, Portugal
| | - Sule Canberk
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), i3S—Institute for Research & Innovation in Health, 4200-135 Porto, Portugal; (M.P.); (S.C.)
| | - Ana Gonçalves
- Department of Pathology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal;
| | - Maria João Bugalho
- Department of Endocrinology, Centro Hospitalar Universitário de Lisboa Norte, Hospital de Santa Maria, 1649-028 Lisboa, Portugal;
- Medical Faculty, University of Lisbon, 1649-028 Lisboa, Portugal
| | - Ana Luísa Papoila
- Gabinete de Estatística do Centro de Investigação do Centro Hospitalar Universitário de Lisboa Central, EPE, Nova Medical School, 1169-045 Lisbon, Portugal; (M.A.); (A.L.P.)
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), 1749-016 Lisbon, Portugal
| | - Paula Soares
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), i3S—Institute for Research & Innovation in Health, 4200-135 Porto, Portugal; (M.P.); (S.C.)
- Medical Faculty, University of Porto, 4200-135 Porto, Portugal
| |
Collapse
|
4
|
Pałyga I, Rumian M, Kosel A, Albrzykowski M, Krawczyk P, Kalwat A, Gąsior-Perczak D, Walczyk A, Kuchareczko A, Kopczyński J, Chrapek M, Góźdź S, Kowalska A. The Frequency of Differentiated Thyroid Cancer Recurrence in 2302 Patients With Excellent Response to Primary Therapy. J Clin Endocrinol Metab 2024; 109:e569-e578. [PMID: 37768152 DOI: 10.1210/clinem/dgad571] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/18/2023] [Accepted: 09/27/2023] [Indexed: 09/29/2023]
Abstract
CONTEXT Discrepant data on the recurrence rate of differentiated thyroid cancer (DTC) are reported. OBJECTIVE To evaluate the frequency and risk factors of true recurrence in DTC patients with excellent responses (ExR) to initial therapy. METHODS A retrospective analysis of the 2302 consecutive DTC patients with ExR to primary therapy, treated during 24 years at single center. The percentage of recurrence and cumulative recurrence rate (CRR) were analyzed. Risk factors for recurrence for patients with papillary thyroid cancer (PTC) were investigated and methods for establishing a diagnosis of recurrence were evaluated. RESULTS Of DTC patients, 32 (1.4%) experienced recurrence. PTC patients with recurrence were more likely to have younger age (P = .0182), larger tumor size (P = .0013), lymph node metastases (P = .0013), incomplete resection (P = .0446), higher ATA risk (P = .0002), and had more frequently been treated with 131I (P = .0203). CRRs at 5, 10, 15, 20, and 24 years after surgery were 1.2%, 1.9%, 2.5%, 2.9%, and 2.9%, respectively. The CRRs according to histological type were highest for poorly differentiated thyroid cancer (PDTC), lower for oncocytic (OTC) and follicular thyroid cancer (FTC), and lowest for PTC. Most recurrences occurred within the first 5 years of observation. The most effective method for detecting local recurrence was ultrasonography with fine needle aspiration cytology, and for distant metastases, 18F-FDG PET. CONCLUSION True recurrence is rare in DTC patients. PTC patients with ExR to primary therapy and N0/Nx can be dismissed from oncological follow-up. Despite ExR to primary therapy, DTC patients with N1, and PDTC, OTC, FTC should remain under oncological follow-up.
Collapse
Affiliation(s)
- Iwona Pałyga
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Maciej Rumian
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
| | - Alicja Kosel
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
| | | | - Paulina Krawczyk
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
| | - Agata Kalwat
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
| | - Danuta Gąsior-Perczak
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Agnieszka Walczyk
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Artur Kuchareczko
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Janusz Kopczyński
- Department of Pathology, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Magdalena Chrapek
- Department of Mathematics, Faculty of Natural Sciences, Jan Kochanowski University, Kielce 25-406, Poland
| | - Stanisław Góźdź
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Department of Clinical Oncology, Holycross Cancer Centre, Kielce 25-734, Poland
| | - Aldona Kowalska
- Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland
- Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland
| |
Collapse
|
5
|
Jing H, Yan L, Xiao J, Li X, Jiang B, Yang Z, Li Y, Sun B, Zhang M, Luo Y. Radiofrequency ablation for papillary thyroid microcarcinoma with a trachea-adjacent versus trachea-distant location. Int J Hyperthermia 2024; 41:2270671. [PMID: 38214143 DOI: 10.1080/02656736.2023.2270671] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To evaluate the outcomes of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) adjacent to the trachea and compare them with those of PTMC distant from the trachea. METHODS Patients who received RFA for solitary low-risk PTMC between June 2014 and July 2020 were reviewed and classified into adjacent and distant groups. To balance between-group confounders, the propensity score matching approach was employed. Volume, volume reduction ratio (VRR), tumor disappearance, complications, and disease progression were assessed and compared between the groups. Furthermore, factors affecting disease progression were evaluated. RESULTS A total of 122 and 470 patients were included in the adjacent and distant groups, respectively. Overall VRR was 99.5% ± 3.1 and cumulative tumor disappearance rate was 99.4% after a mean follow-up time of 40.1 months ± 16.2. Overall disease progression and complications incidence were 3.7% and 1.0%, respectively. No substantial differences were observed between the two groups in the latest volume (0.8 mm3 ± 4.1 vs. 0.9 mm3 ± 4.2, p = .77), VRR (99.7% ± 1.6 vs. 99.5% ± 2.7, p = .75), cumulative tumor disappearance rate (92.6% vs. 94.2%, p = .58), and incidence of disease progression (4.1% vs. 4.5%, p = .70) and complication (1.7% vs. 0.8%, p = .86) after 1:2 matching. Additionally, tracheal adjacency exhibited no association with disease progression in multivariate Cox regression analysis (p = .73). CONCLUSION For eligible patients with PTMC located adjacent to or distant from the trachea, RFA may offer a safe and effective alternative treatment method.
Collapse
Affiliation(s)
- Haoyu Jing
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Xiao
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xinyang Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Jiang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhen Yang
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yingying Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bin Sun
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
6
|
Jing H, Yan L, Xiao J, Li X, Jiang B, Yang Z, Zhang M, Luo Y. Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients. Eur Radiol 2024:10.1007/s00330-023-10490-w. [PMID: 38170265 DOI: 10.1007/s00330-023-10490-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/12/2023] [Accepted: 10/29/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To assess the safety and efficacy of radiofrequency ablation (RFA) for capsular-located papillary thyroid microcarcinoma (PTMC) in a large cohort and to compare its outcomes with those of noncapsular-located PTMC. METHODS We retrospectively reviewed patients who underwent RFA for solitary capsular-located and noncapsular-located low-risk PTMC (n = 1095) from June 2014 to October 2020. To balance confounding variables between capsular and noncapsular groups, we employed the 1:1 propensity score matching approach. We evaluated and compared tumor changes, disease progression, and complications in both groups. Furthermore, we analyzed the association between capsular location and disease progression using multivariable Cox regression. RESULTS During a mean follow-up time of 29.86 ± 16.14 months and 29.73 ± 15.69 months, no substantial difference was observed between capsular and noncapsular groups in the latest volume (0.83 ± 3.66 mm3 vs. 0.85 ± 3.67 mm3, p = 0.44) and volume reduction ratio (99.29 ± 4.04% vs. 99.43 ± 3.03%, p = 0.43), and cumulative disappearance rate (87.87% vs. 86.07%, p = 0.31). In addition, no significant differences were observed in complication incidence (1.35% vs. 1.12%, p = 0.76) and progression-free survival (p = 0.53). Based on adjusted multivariate Cox proportional hazard analysis, the association between capsular location and disease progression was nonsignificant (all p > 0.05). CONCLUSION This study demonstrates that the short-term outcomes of RFA for capsular-located PTMCs are comparable to those of noncapsular-located PTMCs. These findings indicate that RFA may be a viable and effective alternative for eligible patients with solitary capsular-located PTMC. CLINICAL RELEVANCE STATEMENT Radiofrequency ablation may serve as a safe and effective alternative treatment method for eligible patients with capsular-located and noncapsular-located papillary thyroid microcarcinoma. KEY POINTS • The safety and efficacy of radiofrequency ablation for capsular-located and noncapsular-located papillary thyroid microcarcinomas were comparable. • Disease progression did not differ significantly between capsular-located and noncapsular-located papillary thyroid microcarcinomas. • The incidence of complications for capsular-located papillary thyroid microcarcinoma was low.
Collapse
Affiliation(s)
- Haoyu Jing
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Xiao
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xinyang Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Jiang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhen Yang
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Yukun Luo
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
7
|
Bae HL, Ahn JH, Kwak J, Kim HS, Yoon SG, Yi JW, Kim SJ, Lee KE. Intraoperative pathologic evaluation of central compartment lymph nodes in patients undergoing lobectomy for unilateral papillary thyroid carcinoma. Asian J Surg 2024; 47:360-366. [PMID: 37891110 DOI: 10.1016/j.asjsur.2023.08.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND/OBJECTIVE Although papillary thyroid carcinoma (PTC) has an excellent prognosis, it can cause central lymph node metastasis (CLNM) which can increase local recurrence. Intraoperative pathologic evaluation (IOPE) can provide evidence regarding CLNM and help surgeons determine the appropriate surgical approach. The aim of this study was to evaluate the efficacy of IOPE and to determine risk factors associated with CLNM in unilateral PTC without preoperative clinical evidence of CLNM. METHODS Medical charts of 227 patients who had unilateral PTC without clinical lymph node metastasis preoperatively were reviewed retrospectively. They were scheduled for thyroid lobectomy and prophylactic central lymphadenectomy (CND) from January 1, 2017 to December 31, 2017. RESULTS Total follow-up period was 47.6 ± 10.6 months. CLNM was identified in 57 (25.1%) patients during IOPE and in 72 (31.7%) patients during final pathological analysis. The sensitivity and specificity of IOPE were 76.4% and 98.7%, respectively. IOPE through central lymph node dissection was safely performed with low complications (vocal cord palsy, 5.7%; hypoparathyroidism, 22.8%). Age < 55 years, echogenic foci on preoperative ultrasonography, and extrathyroidal extension at final pathological report were significantly associated with an increased risk of CLNM (p = 0.006, p < 0.001, and p < 0.001, respectively). In terms of oncological outcomes, there was no significant difference between the true negative and false negative results in IOPE. CONCLUSION IOPE can safely provide accurate information for determining disease status and surgical extent. Further long-term studies are needed to evaluate clinical benefits of IOPE.
Collapse
Affiliation(s)
- Hye Lim Bae
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong-Hyuk Ahn
- Department of Surgery, Chungbuk National University Hospital, Chungbuk, South Korea; Department of Surgery, Inha University College of Medicine, Incheon, South Korea
| | - JungHak Kwak
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyun Soo Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Seoul National University Seoul Surgery Clinic, Seoul, South Korea
| | - Sang Gab Yoon
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Department of Surgery, Young Do Hospital, Busan, South Korea
| | - Jin Wook Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Department of Surgery, Inha University College of Medicine, Incheon, South Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, South Korea.
| |
Collapse
|
8
|
Rodrigues MT, Michelli APP, Caso GF, de Oliveira PR, Rodrigues-Junior DM, Morale MG, Machado Júnior J, Bortoluci KR, Tamura RE, da Silva TRC, Raminelli C, Chau E, Godin B, Calil-Silveira J, Rubio IGS. Lysicamine Reduces Protein Kinase B (AKT) Activation and Promotes Necrosis in Anaplastic Thyroid Cancer. Pharmaceuticals (Basel) 2023; 16:1687. [PMID: 38139812 PMCID: PMC10748177 DOI: 10.3390/ph16121687] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Anaplastic thyroid cancer (ATC) is an aggressive form of thyroid cancer (TC), accounting for 50% of total TC-related deaths. Although therapeutic approaches against TC have improved in recent years, the survival rate remains low, and severe adverse effects are commonly reported. However, unexplored alternatives based on natural compounds, such as lysicamine, an alkaloid found in plants with established cytotoxicity against breast and liver cancers, offer promise. Therefore, this study aimed to explore the antineoplastic effects of lysicamine in papillary TC (BCPAP) and ATC (HTH83 and KTC-2) cells. Lysicamine treatment reduced cell viability, motility, colony formation, and AKT activation while increasing the percentage of necrotic cells. The absence of caspase activity confirmed apoptosis-independent cell death. Necrostatin-1 (NEC-1)-mediated necrosome inhibition reduced lysicamine-induced necrosis in KTC-2, suggesting necroptosis induction via a reactive oxygen species (ROS)-independent mechanism. Additionally, in silico analysis predicted lysicamine target proteins, particularly those related to MAPK and TGF-β signaling. Our study demonstrated lysicamine's potential as an antineoplastic compound in ATC cells with a proposed mechanism related to inhibiting AKT activation and inducing cell death.
Collapse
Affiliation(s)
- Mariana Teixeira Rodrigues
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Structural and Functional Biology Post-Graduate Program, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Ana Paula Picaro Michelli
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Gustavo Felisola Caso
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Paloma Ramos de Oliveira
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Dorival Mendes Rodrigues-Junior
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Biomedical Center, Uppsala University, 752 36 Uppsala, Sweden;
| | - Mirian Galliote Morale
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Joel Machado Júnior
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
| | - Karina Ramalho Bortoluci
- Pharmacology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil;
| | - Rodrigo Esaki Tamura
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
- Biology–Chemistry Post-Graduate Program, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil
| | - Tamiris Reissa Cipriano da Silva
- Department of Chemistry, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil; (T.R.C.d.S.); (C.R.)
| | - Cristiano Raminelli
- Department of Chemistry, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil; (T.R.C.d.S.); (C.R.)
| | - Eric Chau
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; (E.C.); (B.G.)
| | - Biana Godin
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; (E.C.); (B.G.)
- Department of Obstetrics and Gynecology, Weill Cornell Medicine College, New York, NY 10065, USA
| | - Jamile Calil-Silveira
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Health Board III, Universidade Nove de Julho, São Paulo 01525-000, Brazil
| | - Ileana G. Sanchez Rubio
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Structural and Functional Biology Post-Graduate Program, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
| |
Collapse
|
9
|
Lu Y, Guo X, Yang M, Wang K, Cao G, Liu Y, Hou X, Chen L, Liang K. BRAF V600E genetic testing should be recommended for Bethesda III or V thyroid nodules based on fine-needle aspiration. Sci Rep 2023; 13:17129. [PMID: 37816788 PMCID: PMC10564976 DOI: 10.1038/s41598-023-44464-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/09/2023] [Indexed: 10/12/2023] Open
Abstract
The preoperative diagnosis of thyroid nodules now routinely includes BRAFV600E genetic testing in most provincial and municipal hospitals in China. This study identified the most suitable patients of thyroid nodule for BRAFV600E genetic testing. We retrospectively collected data of patients from the Hospital Information System that had undergone fine needle aspiration biopsy (FNAB) from May 2019 to December 2021. Data of FNAB, BRAFV600E genetic testing, and post-surgical pathological diagnosis were collected. A total of 12,392 patients were included in this study. Among them, 7,010 patients underwent solely FNAB, while 5,382 patients had both FNAB and BRAFV600E genetic testing. In the FNAB group, 2,065 thyroid nodules were surgically removed, with a 93.12% malignancy rate. In the FNAB + BRAF group, 2,005 nodules were dissected, and the malignancy rate was 98.20%. However, it was evident that in the subgroups, the combination of FNAB and BRAFV600E genetic testing only benefited Bethesda III (p < 0.001) and V (p = 0.001) nodules. Overall, the combination of FNAB with BRAFV600E genetic testing significantly improved the malignancy rate of surgical thyroid nodes at our hospital when compared to FNAB alone. The subgroup analysis showed that BRAFV600E genetic testing only benefited Bethesda III and V nodules. These findings provide a clinical reference for rationally selecting the most suitable population for BRAFV600E genetic testing.
Collapse
Affiliation(s)
- Yiran Lu
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
| | - Xinghong Guo
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Mengmeng Yang
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
| | - Kewei Wang
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
| | - Guanglei Cao
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
| | - Yan Liu
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
| | - Xinguo Hou
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Li Chen
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China.
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China.
| | - Kai Liang
- Department of Endocrine and Metabolic Diseases, Qilu Hospital of Shandong University, Jinan, China.
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China.
| |
Collapse
|
10
|
Choi YM, Kim MJ, Lee J, Kwak MK, Jeon MJ, Kim TY, Hong EG, Kim WB, Kim WG. Long-Term Changes in the Mortality Rates of Thyroid Cancer in Korea: Analysis of Korean National Data from 1985 to 2020. Endocrinol Metab (Seoul) 2023; 38:588-595. [PMID: 37679950 PMCID: PMC10613776 DOI: 10.3803/enm.2023.1723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/04/2023] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGRUOUND Thyroid cancer mortality has been largely overlooked as relatively stable given the large gap between thyroid cancer incidence and mortality. This study evaluated long-term trends in age-standardized mortality rates (ASMRs) throughout Korea and compared them with mortality data reported by the Surveillance, Epidemiology, and End Results (SEER). METHODS Cancer-specific mortality data from 1985 to 2020 were obtained from Statistics Korea. ASMRs from thyroid cancer were calculated based on the Korean mid-year resident registration population of 2005. We assessed SEER*Explorer and downloaded the mortality data. RESULTS The ASMR increased from 0.19 to 0.77/100,000 between 1985 and 2002 but decreased continuously to 0.36/100,000 in 2020. The annual percent change (APC) in the ASMR between 1985 and 2003 and between 2003 and 2020 was 6.204 and -4.218, respectively, with similar patterns observed in both men and women. The ASMR of the SEER showed a modest increase from 1988 to 2016 and then stabilized. In subgroup analysis, the ASMR of the old age group (≥55 years) increased significantly from 0.82 in 1985 to 3.92/100,000 in 2002 (APC 6.917) but then decreased again to 1.86/100,000 in 2020 (APC -4.136). ASMRs according to the age group in the SEER showed a relatively stable trend even in the elderly group. CONCLUSION The ASMR of thyroid cancer in Korea had increased from 1985 to 2002 but has since been steadily decreasing. This trend was mainly attributed to elderly people aged 55 or over. The absolute APC value of Korea was much higher than that of the SEER.
Collapse
Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea
| | - Jiwoo Lee
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Mi Kyung Kwak
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun-Gyoung Hong
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Lai M, Zhang MM, Qin QQ, An Y, Li YT, Yuan WZ. Cost-effectiveness of active surveillance versus early surgery for thyroid micropapillary carcinoma based on diagnostic and treatment norms in China. Front Endocrinol (Lausanne) 2023; 14:1166433. [PMID: 37664842 PMCID: PMC10471146 DOI: 10.3389/fendo.2023.1166433] [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: 02/15/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives In this study, we compared the cost-effectiveness comparison of the active surveillance (AS) and early surgery (ES) approaches for papillary thyroid microcarcinoma (PTMC) from the perspective of the Chinese healthcare system. Methods We performed a cost-effectiveness analysis using a Markov model of PTMC we developed to evaluate the incremental cost-effectiveness ratio of AS and ES. Our reference case was of a 40-year-old woman diagnosed with unifocal (<10 mm) PTMC. Relevant data were extracted after an extensive literature review, and the cost incurred in each state was determined using China Medicare data on payments for ES and AS. The willingness-to-pay threshold was set at ¥242,928/quality-adjusted life-year (QALY) gained. Sensitivity analyses were performed to account for any uncertainty in the model's variables. Additional subgroup analyses were performed to determine whether AS was cost-effective when different initial monitoring ages were used. Results ES exhibited an effectiveness of 5.2 QALYs, whereas AS showed an effectiveness of 25.8 QALYs. Furthermore, the incremental cost-effectiveness ratio for ES versus AS was ¥1,009/QALY. The findings of all sensitivity analyses were robust. Compared with ES, AS was found to be the cost-effective strategy at initial monitoring ages of 20 and 60 years, with an incremental cost-effectiveness ratio of ¥3,431/QALY and -¥1,316/QALY at 20 and 60 years, respectively. AS was a more cost-effective strategy in patients with PTMC aged more than 60. Conclusions With respect to the norms of the Chinese healthcare system, AS was more cost-effective for PTMC over lifetime surveillance than ES. Furthermore, it was cost-effective even when the initial monitoring ages were different. In addition, if AS is incorporated into the management plan for PTMC in China at the earliest possible stage, a predicted savings of ¥10 × 108/year could be enabled for every 50,000 cases of PTMC, which indicates a good economic return for future management programs. The identification of such nuances can help physicians and patients determine the best and most individualized long-term management strategy for low-risk PTMC.
Collapse
Affiliation(s)
- Min Lai
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Miao Miao Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Qing Qing Qin
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yu An
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yan Ting Li
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Wen Zhen Yuan
- Department of Oncological Surgery, First Hospital of Lanzhou University, Lanzhou, China
| |
Collapse
|
12
|
Al-Ibraheem A, Al-Rasheed U, Mashhadani N, Abdlkadir AS, Al-Adhami DA, Ruzzeh S, Istatieh F, Mansour A, Hamdan B, Kheetan R, Al-Shatti M, Mohamad I, Juweid ME, Abu Sheikha A, Al-Rabi K, Sykiotis GP, Kreissl MC, Ismael T, Sultan I, Abdel-Razeq H. Long-Term Survival Analysis and Prognostic Factors of Arabic Patients with Differentiated Thyroid Carcinoma: A 20-Year Observational Study at the King Hussein Cancer Center (KHCC) Involving 528 Patients. Cancers (Basel) 2023; 15:4102. [PMID: 37627130 PMCID: PMC10452119 DOI: 10.3390/cancers15164102] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan-Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center's (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.
Collapse
Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Al-Jubeiha, Amman 11942, Jordan
| | - Ula Al-Rasheed
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Noor Mashhadani
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Dhuha Ali Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Saad Ruzzeh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Feras Istatieh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Areen Mansour
- Office of Scientific Affairs and Research, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Basem Hamdan
- Department of Surgery, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Reem Kheetan
- Department of Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Marwa Al-Shatti
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Malik E. Juweid
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Al-Jubeiha, Amman 11942, Jordan
| | - Areej Abu Sheikha
- Department of Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Kamal Al-Rabi
- Department of Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Gerasimos P. Sykiotis
- Department of Endocrinology, Diabetology and Metabolism, Vaud University Hospital Center (CHUV), CH-1011 Lausanne, Switzerland
| | - Michael C. Kreissl
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, 39120 Magdeburg, Germany
| | - Taleb Ismael
- Department of Pediatrics, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Iyad Sultan
- Department of Pediatrics, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Hikmat Abdel-Razeq
- Department of Medicine, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| |
Collapse
|
13
|
Xie J, Liu Z, Ren L, He L, Lu S, Meng X, Zhang X, Su Z, Jing S, Shan T, Wang J, Xia R, Feng W, Li Y, Liu N, Liu Y. Global, regional, and national time trends in cancer mortality attributable to high fasting plasma glucose: an age-period cohort analysis. BMC Public Health 2023; 23:1361. [PMID: 37454041 PMCID: PMC10349485 DOI: 10.1186/s12889-023-16076-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND High fasting plasma glucose (HFPG) is the fastest-growing risk factor for cancer deaths worldwide. We reported the cancer mortality attributable to HFPG at global, regional, and national levels over the past three decades and associations with age, period, and birth cohort. METHODS Data for this study were retrieved from the Global Burden of Disease Study 2019, and we used age-period-cohort modelling to estimate age, cohort and period effects, as well as net drift (overall annual percentage change) and local drift (annual percentage change in each age group). RESULTS Over the past 30 years, the global age-standardized mortality rate (ASMR) attributable to HFPG has increased by 27.8%. The ASMR in 2019 was highest in the male population in high sociodemographic index (SDI) areas (8.70; 95% CI, 2.23-18.04). The net drift for mortality was highest in the female population in low SDI areas (2.33; 95% CI, 2.12-2.55). Unfavourable period and cohort effects were found across all SDI quintiles. Cancer subtypes such as "trachea, bronchus, and lung cancers", "colon and rectal cancers", "breast cancer" and "pancreatic cancer" exhibited similar trends. CONCLUSIONS The cancer mortality attributable to HFPG has surged during the past three decades. Unfavourable age-period-cohort effects on mortality were observed across all SDI quintiles, and the cancer mortality attributable to HFPG is expected to continue to increase rapidly in the future, particularly in lower SDI locations. This is a grim global public health issue that requires immediate attention.
Collapse
Affiliation(s)
- Jing Xie
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zeye Liu
- National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
| | - Liqun Ren
- Department of Gerontology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Liyun He
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shan Lu
- Department of Outpatient, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Xiangzhi Meng
- Department of Thoracic Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xin Zhang
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhanhao Su
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shenqi Jing
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Shan
- Department of Outpatient, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Junjie Wang
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Ruibing Xia
- Department of Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Wei Feng
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Yakun Li
- Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Naifeng Liu
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
| | - Yun Liu
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
14
|
Xiao F, Li JM, Han ZY, Liu FY, Yu J, Xie MX, Zhou P, Liang L, Zhou GM, Che Y, Wang SR, Liu C, Cong ZB, Liang P. Multimodality US versus Thyroid Imaging Reporting and Data System Criteria in Recommending Fine-Needle Aspiration of Thyroid Nodules. Radiology 2023; 307:e221408. [PMID: 37367448 DOI: 10.1148/radiol.221408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background Current guidelines recommend the use of conventional US for risk stratification and management of thyroid nodules. However, fine-needle aspiration (FNA) is often recommended in benign nodules. Purpose To compare the diagnostic performance of multimodality US (including conventional US, strain elastography, and contrast-enhanced US [CEUS]) with the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) in the recommendation of FNA for thyroid nodules to reduce unnecessary biopsies. Materials and Methods In this prospective study, 445 consecutive participants with thyroid nodules from nine tertiary referral hospitals were recruited between October 2020 and May 2021. With univariable and multivariable logistic regression, the prediction models incorporating sonographic features, evaluated with interobserver agreement, were constructed and internally validated with bootstrap resampling technique. In addition, discrimination, calibration, and decision curve analysis were performed. Results A total of 434 thyroid nodules confirmed at pathologic analysis (259 malignant thyroid nodules) in 434 participants (mean age, 45 years ± 12 [SD]; 307 female participants) were included. Four multivariable models incorporated participant age, nodule features at US (proportion of cystic components, echogenicity, margin, shape, punctate echogenic foci), elastography features (stiffness), and CEUS features (blood volume). In recommending FNA in thyroid nodules, the highest area under the receiver operating characteristic curve (AUC) was 0.85 (95% CI: 0.81, 0.89) for the multimodality US model, and the lowest AUC was 0.63 (95% CI: 0.59, 0.68) for TI-RADS (P < .001). At the 50% risk threshold, 31% (95% CI: 26, 38) of FNA procedures could be avoided with multimodality US compared with 15% (95% CI: 12, 19) with TI-RADS (P < .001). Conclusion Multimodality US had better performance in recommending FNA to avoid unnecessary biopsies than the TI-RADS. Clinical trial registration no. NCT04574258 © RSNA, 2023 Supplemental material is available for this article.
Collapse
Affiliation(s)
- Fan Xiao
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Jian-Ming Li
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Zhi-Yu Han
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Fang-Yi Liu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Jie Yu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ming-Xing Xie
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ping Zhou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Lei Liang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Gui-Ming Zhou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ying Che
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Shu-Rong Wang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Cun Liu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Zhi-Bin Cong
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ping Liang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| |
Collapse
|
15
|
Ludwig B, Ludwig M, Dziekiewicz A, Mikuła A, Cisek J, Biernat S, Kaliszewski K. Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications. Cancers (Basel) 2023; 15:cancers15112931. [PMID: 37296896 DOI: 10.3390/cancers15112931] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Thyroid cancer is the most common cancer of the endocrine system, and, in recent years, there has been a phenomenon of overdiagnosis followed by subsequent overtreatment. This results in an increasing number of thyroidectomy complications being faced in clinical practice. In this paper, we present the current state of knowledge and the latest findings in the fields of modern surgical techniques, thermal ablation, the identification and assessment of parathyroid function, recurrent laryngeal nerve monitoring and treatment and perioperative bleeding. We reviewed 485 papers, from which we selected 125 papers that are the most relevant. The main merit of this article is its comprehensive view of the subject under discussion-both general, concerning the selection of the appropriate method of surgery, and particular, concerning the selection of the appropriate method of prevention or treatment of selected perioperative complications.
Collapse
Affiliation(s)
- Bartłomiej Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Maksymilian Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Anna Dziekiewicz
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Agnieszka Mikuła
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Jakub Cisek
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Szymon Biernat
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Krzysztof Kaliszewski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| |
Collapse
|
16
|
Hueber S, Biermann V, Tomandl J, Warkentin L, Schedlbauer A, Tauchmann H, Klemperer D, Lehmann M, Donnachie E, Kühlein T. Consequences of early thyroid ultrasound on subsequent tests, morbidity and costs: an explorative analysis of routine health data from German ambulatory care. BMJ Open 2023; 13:e059016. [PMID: 36889825 PMCID: PMC10008444 DOI: 10.1136/bmjopen-2021-059016] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVES This study aims to evaluate whether the use of thyroid ultrasound (US) early in the work-up of suspected thyroid disorders triggers cascade effects of medical procedures and to analyse effects on morbidity, healthcare usage and costs. STUDY DESIGN Retrospective analysis of claims data from ambulatory care (2012-2017). SETTING Primary care in Bavaria, Germany, 13 million inhabitants. PARTICIPANTS Patients having received a thyroid stimulating hormone (TSH) test were allocated to (1) observation group: TSH test followed by an early US within 28 days or (2) control group: TSH test, but no early US. Propensity score matching was used adjusting for socio-demographic characteristics, morbidity and symptom diagnosis (N=41 065 per group after matching). PRIMARY AND SECONDARY OUTCOME MEASURES Using cluster analysis, groups were identified regarding frequency of follow-up TSH tests and/or US and compared. RESULTS Four subgroups were identified: cluster 1: 22.8% of patients, mean (M)=1.6 TSH tests; cluster 2: 16.6% of patients, M=4.7 TSH tests; cluster 3: 54.4% of patients, M=3.3 TSH tests, 1.8 US; cluster 4: 6.2% of patients, M=10.9 TSH tests, 3.9 US. Overall, reasons that explain the tests could rarely be found. An early US was mostly found in clusters 3 and 4 (83.2% and 76.1%, respectively, were part of the observation group). In cluster 4 there were more women, thyroid-specific morbidity and costs were higher and the early US was more likely to be performed by specialists in nuclear medicine or radiologists. CONCLUSION Presumably unnecessary tests in the field of suspected thyroid diseases seem to be frequent, contributing to cascades effects. Neither German nor international guidelines provide clear recommendations for or against US screening. Therefore, guidelines on when to apply US and when not are urgently needed.
Collapse
Affiliation(s)
- Susann Hueber
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| | - Valeria Biermann
- Chair of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - Johanna Tomandl
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| | - Lisette Warkentin
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| | - Angela Schedlbauer
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| | - Harald Tauchmann
- Professorship of Health Economics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - David Klemperer
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| | - Maria Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Ewan Donnachie
- Bavarian Association of Statutory Health Insurance Physicians, Munich, Germany
| | - Thomas Kühlein
- Institute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
| |
Collapse
|
17
|
Scherer HC, Fernandes PM, Scheffel RS, Zanella AB, Maia AL, Dora JM. Papillary Thyroid Microcarcinoma: Insights from a Cohort of 257 Thyroidectomized Patients. Horm Metab Res 2023; 55:161-168. [PMID: 36796412 DOI: 10.1055/a-2008-0824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Papillary thyroid microcarcinoma management evolved, and less aggressive strategies are now considered. Questions, however, remain on these tumors' behavior, particularly on developing countries' real ground healthcare scenarios. Our aim is to gather insights on the natural history of papillary thyroid microcarcinoma on patients treated with thyroidectomy in Brazil. Consecutive patients diagnosed with papillary thyroid microcarcinoma had their clinical characteristics, interventions, and outcomes described. Patients were classified as incidental or nonincidental based on the diagnosis after or before surgery, respectively. A sum of 257 patients were included, 84.0% of which were women, and the mean age was of 48.3±13.5 years. The mean tumor size was of 0.68±0.26 cm, 30.4% were multifocal, 24.5% had cervical metastasis, and 0.4% distant metastasis. The nonincidental and incidental tumors differed in tumor size (0.72±0.24 and 0.60±0.28 cm, respectively, p=0.003) and in presence of cervical metastasis (31.3% and 11.9%, respectively, p<0.001). Male sex, nonincidental diagnosis, and younger age were independent predictors of cervical metastasis. After 5.5 years (P25-75 2.5-9.7) of follow-up, only 3.8% of patients had persistent structural disease (3.4% cervical). Predictors of persistent disease at multivariate analysis included cervical metastasis and multicentricity. In conclusion, incidental and nonincidental papillary thyroid microcarcinoma patients of the population studied displayed excellent outcomes. Cervical metastasis and multicentricity were frequent findings and prognostic factors for persistent disease.
Collapse
Affiliation(s)
| | | | - Rafael Selbach Scheffel
- Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - André Borsatto Zanella
- Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Endocrinology, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
| | - Ana Luiza Maia
- Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jose Miguel Dora
- Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
18
|
Ludwig M, Ludwig B, Mikuła A, Biernat S, Rudnicki J, Kaliszewski K. The Use of Artificial Intelligence in the Diagnosis and Classification of Thyroid Nodules: An Update. Cancers (Basel) 2023; 15. [PMID: 36765671 DOI: 10.3390/cancers15030708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
The incidence of thyroid nodules diagnosed is increasing every year, leading to a greater risk of unnecessary procedures being performed or wrong diagnoses being made. In our paper, we present the latest knowledge on the use of artificial intelligence in diagnosing and classifying thyroid nodules. We particularly focus on the usefulness of artificial intelligence in ultrasonography for the diagnosis and characterization of pathology, as these are the two most developed fields. In our search of the latest innovations, we reviewed only the latest publications of specific types published from 2018 to 2022. We analyzed 930 papers in total, from which we selected 33 that were the most relevant to the topic of our work. In conclusion, there is great scope for the use of artificial intelligence in future thyroid nodule classification and diagnosis. In addition to the most typical uses of artificial intelligence in cancer differentiation, we identified several other novel applications of artificial intelligence during our review.
Collapse
|
19
|
Park J, Kang IK, Bae JS, Kim JS, Kim K. Clinical Significance of the Lymph Node Ratio of the Second Operation to Predict Re-Recurrence in Thyroid Carcinoma. Cancers (Basel) 2023; 15:cancers15030624. [PMID: 36765580 PMCID: PMC9913116 DOI: 10.3390/cancers15030624] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
The purpose of this study was to establish the risk factors for re-recurrences and disease-specific mortality (DSM) in recurrent thyroid cancer. Patients with recurrent thyroid cancer who underwent initial thyroid surgery from January 2000 to December 2019 at Seoul St. Mary's Hospital (Seoul, Korea) were assessed. Clinicopathological characteristics and long-term oncologic outcomes were compared between patients with one recurrence (n = 202) and patients with re-recurrences (n = 44). Logistic regression and cox-regression analyses were conducted to determine the risk factors for re-recurrences and DSM, respectively. Receiver-operating characteristic curve analysis was performed to determine the cutoff value for lymph node ratio (LNR) as a predictor of re-recurrences. DSM was significantly higher in the re-recurrence group compared with the single-recurrence group (6.8% vs. 0.5%, p = 0.019). Surgical treatment at the first recurrence significantly lowered the risk of re-recurrences. Age (≥55), male sex, and LNR (≥0.15) were independent significant risk factors for re-recurrences in patients who underwent surgery at the first recurrence. Surgical resection is the optimal treatment for initial thyroid cancer recurrence. LNR at re-operation is more effective in predicting re-recurrence than the absolute number of metastatic LNs.
Collapse
Affiliation(s)
| | | | | | | | - Kwangsoon Kim
- Correspondence: ; Tel.: +82-2-2258-6784; Fax: +82-2-2258-2138
| |
Collapse
|
20
|
Huang J, Ngai CH, Deng Y, Pun CN, Lok V, Zhang L, Xu Q, Lucero-Prisno DE, Xu W, Zheng ZJ, Elcarte E, Withers M, Wong MCS. Incidence and mortality of thyroid cancer in 50 countries: a joinpoint regression analysis of global trends. Endocrine 2023; 80:355-365. [PMID: 36607509 DOI: 10.1007/s12020-022-03274-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate the incidence and mortality trend of thyroid cancer, and compare its global incidence trends among different countries by age group and sex. METHODS Data on age-standardized incidence and mortality rate of thyroid cancer among 50 countries were collected from the Cancer Incidence in Five Continents Volume XI; the Surveillance, Epidemiology, and End Results Program (SEER), the National Cancer Institute; the Nordic Cancer Registries (NORDCAN), and the WHO mortality database. The Average Annual Percent Change (AAPC) of the incidence and mortality trends was calculated by joinpoint regression analysis. RESULTS The age-standardized incidence of thyroid cancer was 3.1 and 10.1 cases per 100,000 persons in men and women, respectively. The incidence of thyroid cancer increased in most countries among individuals irrespective of age groups, and increased in populations aged <40 years in several countries, including Korea (male: AAPC 25.3, 95% C.I. 22.3-28.4, p < 0.001; female: AAPC 18.5, 95% C.I. 16.2-20.9, p < 0.001), Poland (male: AAPC 19.1, 95% C.I. 1.4-39.7, p = 0.036; female: AAPC 13.7, 95% C.I. 7.6-20.2), and China (male: AAPC 18.6, 95% C.I. 12.1-25.5, p < 0.001; female: AAPC 13.3, 95%C.I. 11.5-15.1, p < 0.001). CONCLUSION An increasing incidence of thyroid cancer was observed in younger subjects in a majority of countries, highlighting the need for more preventive strategies in this population and possible avoidance of over-diagnosis.
Collapse
Affiliation(s)
- Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun Ho Ngai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yunyang Deng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ching Nei Pun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Veeleah Lok
- Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Lin Zhang
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Wanghong Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Edmar Elcarte
- University of the Philippines, Manila, The Philippines
| | - Mellissa Withers
- Department of of Population and Health Sciences, Institute for Global Health, University of Southern California, Los Angeles, CA, USA.
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Education and Health Promotion, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
- School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- School of Public Health, Fudan University, Shanghai, China.
- Department of Global Health, School of Public Health, Peking University, Beijing, China.
| |
Collapse
|
21
|
Dralle H, Weber F, Machens A, Brandenburg T, Schmid KW, Führer-Sakel D. [Hemithyroidectomy or total thyroidectomy for low-risk papillary thyroid cancer? : Surgical criteria for primary and secondary choice of treatment in an interdisciplinary treatment concept]. Chirurgie (Heidelb) 2023; 94:79-92. [PMID: 36121448 DOI: 10.1007/s00104-022-01726-4] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/21/2023]
Abstract
The increase in small intrathyroid papillary thyroid cancer (PTC) observed worldwide over the past two decades, with no increase in cancer-specific mortality, has challenged the previous concept of total thyroidectomy as a one-size-fits-all panacea. After exclusion of papillary microcarcinomas, a systematic review of 20 clinical studies published since 2002, which compared hemithyroidectomy (HT) to total thyroidectomy (TT), found comparable long-term oncological outcomes for low-risk papillary thyroid cancer (LRPTC) 1-4 cm in diameter, whereas postoperative complication rates were markedly lower for HT. To refine individual treatment plans, HT should be combined with ipsilateral central lymph node dissection and intraoperative frozen section analysis for staging. Based on recent evidence from studies and in consideration of individual risk factors, patients with LRPTC can be offered the concept of HT as an alternative to the standard TT. A prerequisite for the treatment selection and decision is a comprehensive patient clarification of the possible advantages and disadvantages of both approaches.
Collapse
Affiliation(s)
- H Dralle
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - F Weber
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - A Machens
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - T Brandenburg
- Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - K W Schmid
- Institut für Pathologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - D Führer-Sakel
- Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| |
Collapse
|
22
|
Xu L, Cao ZX, Weng X, Wang CF. Global thyroid cancer incidence trend and age-period-cohort model analysis based on Global Burden of Disease Study from 1990 to 2019. Front Endocrinol (Lausanne) 2023; 14:1133098. [PMID: 37124740 PMCID: PMC10130642 DOI: 10.3389/fendo.2023.1133098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Background In view of the rapid increase in the incidence of thyroid cancer (TC) and the spread of overdiagnosis around the world, the quantitative evaluation of the effect of age, period and birth cohort on the incidence of TC, and the analysis of the role of different factors in the incidence trend can provide scientific basis and data support for the national health departments to formulate reasonable prevention and treatment policies. Methods The study collated the global burden disease study data of TC incidence from 1990 to 2019, and used APC model to analyze the contribution of age, period and birth cohort to the incidence trend of TC. Results There was an obvious unfavorable upward trend in terms of age and cohort effect all over the world. Since 2007, the growth rate of risk slowed down and the risk in female even decreased since 2012, which mainly contributed to the developed countries. In all SDI countries, 2002 is the dividing point of risk between male and female. In 2019, The global age-standardized incidence rate (ASIR) of TC in the 5 SDI countries all showed a significant upward trend, with the largest upward trend in the middle SDI countries. Conclusion The trend of rapid increase in the incidence of TC has begun to slow down, but the global incidence of TC has obvious gender and regional/national heterogeneity. Policy makers should tailor specific local strategies to the risk factors of each country to further reduce the burden of TC.
Collapse
Affiliation(s)
- Le Xu
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Xu Cao
- Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Weng
- Department of Pathology, The First Affiliated Hospital, Nanhua University, Hengyang, Hunan, China
| | - Can Fei Wang
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Can Fei Wang,
| |
Collapse
|
23
|
Wang L, Yao B, Yang J, Tian Z, He J. Construction of a novel cuproptosis-related gene signature for predicting prognosis and estimating tumor immune microenvironment status in papillary thyroid carcinoma. BMC Cancer 2022; 22:1131. [PMID: 36333684 PMCID: PMC9635208 DOI: 10.1186/s12885-022-10175-5] [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: 08/12/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cuproptosis, a new form of programmed cell death, has been recently reported to be closely related to tumor progression. However, the significance of cuproptosis-related genes (CRGs) in papillary thyroid carcinoma (PTC) is still unclear. Therefore, this study aimed to investigate the role of the CRG signature in prognosis prediction and immunotherapeutic effect estimation in patients with PTC. METHODS RNA-seq data and the corresponding clinical information of patients with PTC were obtained from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Comprehensive analyses, namely, consensus clustering, immune analyses, functional enrichment, least absolute shrinkage and selection operator-multivariate Cox regression, and nomogram analysis, were performed to identify new molecular subgroups, determine the tumor immune microenvironment (TIME) status of the identified subgroups, and construct a clinical model. Independent verification cohort data and quantitative real-time polymerase chain reaction (qPCR) was performed to validate the expression of specific prognosis-related and differentially expressed CRGs (P-DECRGs). RESULTS In the TCGA database, 476 patients with PTC who had complete clinical and follow-up information were included. Among 135 CRGs, 21 were identified as P-DECRGs. Two molecular subgroups with significantly different disease-free survival and TIME statuses were identified based on these 21 P-DECRGs. The differentially expressed genes between the two subgroups were mainly associated with immune regulation. The risk model and nomogram were constructed based on four specific P-DECRGs and validated as accurate prognostic predictions and TIME status estimation for PTC by TCGA and GEO verification cohorts. Finally, the qPCR results of 20 PTC and paracancerous thyroid tissues validated those in the TCGA database. CONCLUSIONS Four specific P-DECRGs in PTC were identified, and a clinical model based on them was established, which may be helpful for individualized immunotherapeutic strategies and prognostic prediction in patients with PTC.
Collapse
Affiliation(s)
- Lidong Wang
- grid.412467.20000 0004 1806 3501Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Baiyu Yao
- grid.412467.20000 0004 1806 3501Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Jiapeng Yang
- grid.412467.20000 0004 1806 3501Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Zhong Tian
- grid.412467.20000 0004 1806 3501Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Jingni He
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
| |
Collapse
|
24
|
Li Y, Che W, Yu Z, Zheng S, Xie S, Chen C, Qiao M, Lyu J. The Incidence Trend of Papillary Thyroid Carcinoma in the United States During 2003-2017. Cancer Control 2022; 29:10732748221135447. [PMID: 36256588 PMCID: PMC9583193 DOI: 10.1177/10732748221135447] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 12/02/2022] Open
Abstract
Background The rapid increase in the detection rate of thyroid cancer over the past few
decades has caused some unexpected economic burdens. However, that of
papillary thyroid carcinoma (PTC) seems to have had the opposite trend,
which is worthy of further comprehensive exploration. Methods The Surveillance, Epidemiology, and End Results 18 database was used to
identify patients with PTC diagnosed during 2003-2017. The incidence trends
were analyzed using joinpoint analysis and an age-period-cohort model. Results The overall PTC incidence rate increased from 9.9 to 16.1 per 100 000 between
2003 and 2017. The joinpoint analysis indicated that the incidence growth
rate began to slow down in 2009 (annual percentage change [APC] = 3.1%, 95%
confidence interval [CI] = 1.9%–4.4%). After reaching its peak in 2015, it
began to decrease by 2.8% (95% CI = −4.6% to −1.0%) per year. The stratified
analysis indicated that the incidence patterns of different sexes, age
groups, races, and tumor stages and sizes had similar downward trends,
including for the localized (APC = −4.5%, 95% CI = −7% to −1.9%) and distant
(APC = −1.3%, 95% CI = −2.7% to −.1%) stages, and larger tumors (APC = −4%,
95% CI = −12% to 4.7%). The age-period-cohort model indicated a significant
period effect on PTC, which gradually weakened after 2008-2012. The cohort
effect indicates that the risk of late birth cohorts is gradually
stabilizing and lower than that of early birth cohorts. Conclusion The analysis results of the recent downward trend and period effect for the
incidence of each subgroup further support the important role of correcting
overdiagnosis in reducing the prevalence of PTC. Future research needs to
analyze more-recent data to verify these downward trends.
Collapse
Affiliation(s)
- Yunmei Li
- Department of Clinical Research, The First Affiliated Hospital of
Jinan University, Guangzhou, China,School of Basic Medicine and Public
Health, Jinan University, Guangzhou, China
| | - Wenqiang Che
- Department of Neurosurgery, The First Affiliated Hospital of
Jinan University, Guangzhou, China
| | - Zhong Yu
- School of Public Health, Shannxi University of Chinese
Medicine, Xianyang, China
| | - Shuai Zheng
- School of Public Health, Shannxi University of Chinese
Medicine, Xianyang, China
| | - Shuping Xie
- Department of Clinical Research, The First Affiliated Hospital of
Jinan University, Guangzhou, China,School of Basic Medicine and Public
Health, Jinan University, Guangzhou, China
| | - Chong Chen
- School of Public Health, Shannxi University of Chinese
Medicine, Xianyang, China
| | - Mengmeng Qiao
- School of Public Health, Shannxi University of Chinese
Medicine, Xianyang, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of
Jinan University, Guangzhou, China,Guangdong Provincial Key Laboratory
of Traditional Chinese Medicine Informatization, Guangzhou, China,Jun Lyu, Department of Clinical Research,
The First Affiliated Hospital of Jinan University, 613 W.Huangpu Avenue,
Guangzhou 510630, People’s Republic of China.
| |
Collapse
|
25
|
Yang H, Park H, Ryu HJ, Heo J, Kim JS, Oh YL, Choe JH, Kim JH, Kim JS, Jang HW, Kim TH, Kim SW, Chung JH. Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients. Endocrinol Metab (Seoul) 2022; 37:652-663. [PMID: 35864728 PMCID: PMC9449103 DOI: 10.3803/enm.2022.1477] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/13/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGRUOUND Telomerase reverse transcriptase (TERT) promoter mutations are associated with increased recurrence and mortality in patients with thyroid carcinoma. Previous studies on TERT promoter mutations were retrospectively conducted on a limited number of patients. METHODS We prospectively collected data on all consecutive patients who underwent thyroid carcinoma surgery between January 2019 and December 2020 at the Samsung Medical Center, Seoul, Korea. We included 2,092 patients with thyroid carcinoma. RESULTS Of 2,092 patients, 72 patients (3.4%) had TERT promoter mutations. However, the frequency of TERT promoter mutations was 0.5% in papillary thyroid microcarcinoma (PTMC) ≤1 cm and it was 5.8% in papillary thyroid carcinoma (PTC) >1 cm. The frequency of TERT promoter mutations was significantly associated with older age at diagnosis (odds ratio [OR], 1.12; P<0.001), larger primary tumor size (OR, 2.02; P<0.001), and aggressive histological type (OR, 7.78 in follicular thyroid carcinoma; OR, 10.33 in poorly differentiated thyroid carcinoma; OR, 45.92 in anaplastic thyroid carcinoma; P<0.001). Advanced T stage, advanced N stage, and distant metastasis at diagnosis were highly prevalent in mutated thyroid cancers. However, initial distant metastasis was not present in patients with TERT promoter mutations in PTMC. Although the C228T mutation was more highly detected than the C250T mutation (64 cases vs. 7 cases), there were no significant clinicopathological differences. CONCLUSION This study is the first attempt to investigate the frequency of TERT promoter mutations in a real-world setting. The frequency of TERT promoter mutations in PTC was lower than expected, and in PTMC, young patients, and female patients, the frequency was very low.
Collapse
Affiliation(s)
- Heera Yang
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyunju Park
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Jin Ryu
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Heo
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Sun Kim
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Ho Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Won Jang
- Department of Medical Education, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Corresponding author: Jae Hoon Chung. Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-3434, Fax: +82-2-3410-3849, E-mail:
| |
Collapse
|
26
|
Afrashteh S, Fararouei M, Parad MT, Mirahmadizadeh A. Sleep quality, stress and thyroid cancer: a case-control study. J Endocrinol Invest 2022; 45:1219-1226. [PMID: 35112324 DOI: 10.1007/s40618-022-01751-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stress and sleep disturbance have been found to be associated with numerous adverse health outcomes, including cancer. Our study aimed to measure the association between quality of sleep, short-temperedness, and stress in life with the risk of thyroid cancer. METHODS The present study is conducted on 361 newly diagnosed TC patients and 347 sex-age frequency matched controls. Control and case participants were registered with the same health centers. We used multiple logistic regression to investigate the association between TC risk and the interested factors. RESULTS Based on the results of the multivariate analysis, stress (ORalways stressful/often calm = 3.07, 95% CI 1.42-6.63) and short-temperedness (ORnervous/calm = 2.00, 95% CI 1.28-3.11) were directly associated with the risk of TC. On the other hand having a quality sleep (ORsometimes/never = 0.36, 95% CI 0.16-0.79) and quality sleep (ORoften/no = 0.45, 95% CI 0.21-0.96, P = 0.041) seems to be a protective factor. CONCLUSIONS Some community-based interventions, e.g., lowering stress levels and improving sleep quality, may help in preventing different types of cancer, including TC. We suggest further evaluation of these important findings in the prevention of TC cancer.
Collapse
Affiliation(s)
- S Afrashteh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Fararouei
- HIV/AIDs Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - M T Parad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A Mirahmadizadeh
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
27
|
Wang G, Nie F, Wang Y, Wang P, Wang L, Fan X, Ma Z. Value of Echogenic Foci in Diagnosing Papillary Thyroid Carcinoma and Predicting Aggressive Biological Behavior. J Ultrasound Med 2022; 41:1237-1245. [PMID: 34415647 DOI: 10.1002/jum.15815] [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] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/17/2021] [Accepted: 07/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To assess the diagnostic value of echogenic foci in papillary thyroid carcinoma (PTC) and the relationship between echogenic foci and aggressiveness of PTC. METHODS From January 2018 to January 2021, a total of 950 patients diagnosed with thyroid nodules (n = 1113) in our hospital were retrospectively analyzed. Among the 1113 nodules, single PTC in 527 patients confirmed by surgery was studied for their aggressive biological behavior. The patterns of echogenic foci were classified as: no echogenic foci, sparse punctate echogenic foci, focal punctate echogenic foci, diffuse punctate echogenic foci, petal-like punctate echogenic foci, comet-tail artifacts, coarse echogenic foci, peripheral rim (eggshell echogenic foci), and mixed echogenic foci. The clinical and ultrasonographic characteristics were also analyzed. A univariate analysis was performed, and binary logistic regression was performed to screen independent risk factors. RESULTS For the differential diagnosis of PTC, age < 50 years, size <1.1 cm, hypoechoic or very hypoechoic, aspect ratio > 1, irregular shape, types II (punctate echogenic foci) and VI (mixed echogenic foci) were independent risk factors. For the aggressive biological behavior of PTC, male sex, age<42 years, size <1.0 cm, types IIb (focal punctate echogenic foci), IIc (diffuse punctate echogenic foci), and VI (mixed echogenic foci) were independent risk factors for predicting cervical lymph node metastasis of PTC. CONCLUSION Echogenic foci are useful in diagnosing PTC and predicting aggressiveness of PTC, which contribute to screening invasive PTC and avoiding overdiagnosis and overtreatment.
Collapse
Affiliation(s)
- Guojuan Wang
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Fang Nie
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Yanfang Wang
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Peihua Wang
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Lan Wang
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xiao Fan
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Zhenxian Ma
- Department of Ultrasound, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| |
Collapse
|
28
|
Chan AJ, Sarrazin J, Halperin IJ, Hack K, Weinerman A. Quality improvement initiative to standardise thyroid ultrasound reports and reduce unnecessary fine-needle aspiration biopsies of thyroid nodules. BMJ Open Qual 2022; 11:bmjoq-2021-001769. [PMID: 35318245 PMCID: PMC8943732 DOI: 10.1136/bmjoq-2021-001769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/12/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Alvita J Chan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Josee Sarrazin
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ilana J Halperin
- Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kalesha Hack
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Adina Weinerman
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| |
Collapse
|
29
|
Dong WW, Zhang DL, Wang ZH, Lv CZ, Zhang P, Zhang H. Different types of diabetes mellitus and risk of thyroid cancer: A meta-analysis of cohort studies. Front Endocrinol (Lausanne) 2022; 13:971213. [PMID: 36213272 PMCID: PMC9537385 DOI: 10.3389/fendo.2022.971213] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Sex-specific thyroid cancer risk exists in patients diagnosed with diabetes mellitus (DM). However, thyroid cancer risk in different types of DM is still unclear. This meta-analysis aims to identify the real correlation between different types of DM and thyroid cancer risk in both sexes. METHODS Studies were identified by an electronic search of PubMed, EMBASE, and Cochrane Library on 16 January 2022. A random-effects model was used to estimate the relative risks (RRs). The Cochran's Q and I2 statistics were computed to detect heterogeneity between studies. RESULTS In comparison with non-DM counterparts, patients with DM had a 1.32-fold higher risk of thyroid cancer (95% CI, 1.22-1.44) with 1.26-fold (95% CI, 1.12-1.41) in men and 1.36-fold (95% CI, 1.22-1.52) in women, respectively. Subgroup analysis by the type of DM showed that the RR of thyroid cancer in patients with type 2 diabetes was 1.34 (95% CI, 1.17-1.53) in the study population with 1.32 (95% CI, 1.12-1.54) in men and 1.37 (95% CI, 1.12-1.68) in women, respectively; the RR of thyroid cancer was 1.30 (95% CI, 1.17-1.43) in patients with gestational diabetes; the risk of thyroid cancer in patients with type 1 diabetes was 1.51-fold in women but not in men. Although there were some heterogeneities, it did not affect the above results of this study. CONCLUSION This study indicates that, compared with non-DM individuals, patients with any type of DM have an elevated thyroid cancer risk. This positive correlation between type 2 diabetes and thyroid cancer risk exists in both men and women. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, CRD42022304028.
Collapse
|
30
|
Markantes GK, Karakioulaki M, Papanikolopoulou S, Theodoropoulou A, Markou KB, Vagenakis AG, Spyridonidis T, Goulis DG, Michalaki MA. Improving the prediction of persistent and recurrent differentiated thyroid cancer using the American Thyroid Association 2015 risk stratification system. Hormones (Athens) 2021; 20:761-768. [PMID: 34383288 DOI: 10.1007/s42000-021-00313-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/10/2021] [Accepted: 07/22/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The 2015 American Thyroid Association risk stratification system (ATA RSS) is used in patients with differentiated thyroid carcinoma (DTC) to assess their risk of persistent/recurrent disease. Our aims were to validate the 2015 ATA RSS in a registry of DTC patients and to examine whether the addition of factors not included in it, such as pre-radioactive iodine therapy stimulated thyroglobulin (pre-RAI sTg), gender, and age could increase its predictive ability. METHODS We studied 403 patients with DTC, treated at a tertiary center from 1990 to 2018 and subjected to total thyroidectomy. All patients had received RAI therapy, except those with low-risk papillary microcarcinoma. RESULTS Of our patients, 81.9% were women and 91.1% had papillary thyroid carcinoma. After a median follow-up of 5.0 years, 53 cases of persistent and 21 cases of recurrent disease were recorded. The proportion of variance explained (PVE) regarding the outcome (presence or absence of recurrent/persistent disease) using the 2015 ATA RSS alone was 18.3% (persistence) and 16.9% (recurrence), increasing to 74.4% and 52.0%, respectively, when pre-RAI sTg was added to the logistic regression model. Gender and age were not associated with the disease outcome. In ROC analysis, pre-RAI sTg had a high predictive value for persistent (AUC 0.983, 95% CI 0.962-1.000) and recurrent disease (AUC 0.856, 95% CI 0.715-0.997). The optimal cut-offs and sensitivity, specificity, and positive and negative predictive value for pre-RAI sTg were the following: for persistence 12.75 ng/ml, 100%, 90.5%, 64%, and 100%, and for recurrence 8.05 ng/ml, 77.8%, 85.5%, 36.8%, and 97%. CONCLUSIONS The 2015 ATA RSS displayed moderate performance in predicting recurrent/persistent disease in patients with DTC, which improved with the inclusion of pre-RAI sTg values; pre-RAI sTg was an independent predictor of the disease outcome, with high negative prognostic value.
Collapse
Affiliation(s)
- Georgios K Markantes
- Department of Internal Medicine, Division of Endocrinology, University of Patras Medical School, Patras, Greece
| | - Meropi Karakioulaki
- 1st Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula Papanikolopoulou
- 1st Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Theodoropoulou
- Department of Internal Medicine, Division of Endocrinology, University of Patras Medical School, Patras, Greece
| | - Kostas B Markou
- Department of Internal Medicine, Division of Endocrinology, University of Patras Medical School, Patras, Greece
| | - Apostolos G Vagenakis
- Department of Internal Medicine, Division of Endocrinology, University of Patras Medical School, Patras, Greece
| | - Trifon Spyridonidis
- Department of Nuclear Medicine, University Hospital of Patras, Patras, Greece
| | - Dimitrios G Goulis
- 1st Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marina A Michalaki
- Department of Internal Medicine, Division of Endocrinology, University of Patras Medical School, Patras, Greece.
| |
Collapse
|
31
|
Li M, Delafosse P, Meheus F, Borson-Chazot F, Lifante JC, Simon R, Groclaude P, Combes JD, Dal Maso L, Polazzi S, Duclos A, Colonna M, Vaccarella S. Temporal and geographical variations of thyroid cancer incidence and mortality in France during 1986-2015: The impact of overdiagnosis. Cancer Epidemiol 2021; 75:102051. [PMID: 34743057 DOI: 10.1016/j.canep.2021.102051] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/07/2021] [Accepted: 10/14/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND France is among the countries showing fastest growth of thyroid cancer (TC) incidence and highest incidence rates in Europe. This study aimed to clarify the temporal and geographical variations of TC in France and to quantify the impact of overdiagnosis. METHODS We obtained TC incidence data in 1986-2015, and mortality data in 1976-2015, for eight French departments covering 8% of the national population, and calculated the age-standardised rates (ASR). We estimated the average annual percent changes (AAPC) of TC incidence, overall and by department and histological subtype. Numbers and proportions of TC cases attributable to overdiagnosis were estimated by department and period, based on the comparison between the shape of the age-specific curves with that observed prior to changes in diagnostic practice. RESULTS During 1986-2015, there were 13,557 TC cases aged 15-84 years. Large variations of TC incidence were observed across departments, with the highest ASR and the fastest increase in Isère. Papillary subtype accounted for 82.8% of the cases, and presented an AAPC of 7.0% and 7.6% in women and men, respectively. Anaplastic TC incidence decreased annually 3.0% in women and 0.8% in men. Mortality rates declined consistently for all departments. The absolute number (and proportion) of TC cases attributable to overdiagnosis grew from 1074 (66%) in 1986-1995 to 3830 (72%) in 2006-2015 in women, and varied substantially across departments. CONCLUSIONS Overdiagnosis plays an important role in the temporal and regional variations of TC incidence in France. Monitoring the time trends and regulating the regional healthcare practice are needed to reduce its impact.
Collapse
Affiliation(s)
- Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; International Agency for Research on Cancer, Lyon, France
| | | | - Filip Meheus
- International Agency for Research on Cancer, Lyon, France
| | - Françoise Borson-Chazot
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Fédération d'Endocrinologie, Groupement Hospitalier Est and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Lifante
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Service de Chirurgie Endocrinienne, Groupement Hospitalier Sud and Registre des Cancers Thyroïdiens du Rhône, Hospices Civils de Lyon, Lyon, France
| | - Raphael Simon
- International Agency for Research on Cancer, Lyon, France
| | - Pascale Groclaude
- Claudius Regaud Institute, IUCT-Oncopole, Tarn Cancer Registry, Toulouse, France
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Stéphanie Polazzi
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Health data department, Lyon University Hospital, Lyon, France
| | - Antoine Duclos
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France; Health data department, Lyon University Hospital, Lyon, France
| | - Marc Colonna
- Registre du cancer de l'Isère, Grenoble, France.
| | | |
Collapse
|
32
|
Edwards MK, Iñiguez-Ariza NM, Singh Ospina N, Lincango-Naranjo E, Maraka S, Brito JP. Inappropriate use of thyroid ultrasound: a systematic review and meta-analysis. Endocrine 2021; 74:263-269. [PMID: 34379311 DOI: 10.1007/s12020-021-02820-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/12/2021] [Accepted: 07/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Nearly half the cases of thyroid cancer, a malignancy rapidly rising in incidence within the United States, are attributable to small and asymptomatic papillary thyroid cancers that will not increase mortality. A primary driver of thyroid cancer overdiagnosis is ultrasound use. It is therefore valuable to understand how inappropriate use of thyroid ultrasound is defined, analyze the current evidence for its frequency, and identify interventions to lessen misuse. METHODS Ovid MEDLINE(R), Ovid EMBASE, and Scopus databases were searched from inception to June 2020 for studies assessing inappropriate use of thyroid ultrasound. Reviewers, working independently and in duplicate, evaluated studies for inclusion, extracted data, and graded risk of bias. We used a random-effects model with a generalized linear mixed approach to calculate the mean overall proportion estimates of inappropriate use. RESULTS Seven studies (total n = 1573) met the inclusion criteria with moderate to high risk of bias. Inappropriate thyroid ultrasound use was described variably, using published practice guidelines, third-party expert reviewers, or author interpretations of the literature. The overall frequency of inappropriate thyroid ultrasound use was 46% (95% CI 15-82%; n = 388) and 34% (95% CI 16-57%; n = 190) among studies using guideline based definitions. The pooled frequency of iUS due to thyroid dysfunction (either hypothyroidism or thyrotoxicosis) was 17% (95% CI 7-37%; n = 191) and the frequency of iUS due to nonspecific symptoms without a palpable mass was 11% (95% CI 5-22%; n = 124). No study examined interventions to address inappropriate use. CONCLUSIONS Low quality evidence suggests that inappropriate use of thyroid ultrasound is common. Interventional studies aiming to decrease the inappropriate use of thyroid ultrasound are urgently needed.
Collapse
Affiliation(s)
- Matthew K Edwards
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nicole M Iñiguez-Ariza
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Naykky Singh Ospina
- University of Florida, Division of Endocrinology, Department of Medicine, Gainesville, FL, USA
| | - Eddy Lincango-Naranjo
- Mayo Clinic, Knowledge and Evaluation Research Unit, 200 First Street Southwest, Rochester, MN, 55905, USA
- CaTaLiNA: Cancer de tiroides en Latinoamerica, Quito, Ecuador
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Juan P Brito
- Mayo Clinic, Knowledge and Evaluation Research Unit, 200 First Street Southwest, Rochester, MN, 55905, USA.
- Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.
| |
Collapse
|
33
|
Venturi S. Cesium in Biology, Pancreatic Cancer, and Controversy in High and Low Radiation Exposure Damage-Scientific, Environmental, Geopolitical, and Economic Aspects. Int J Environ Res Public Health 2021; 18:8934. [PMID: 34501532 PMCID: PMC8431133 DOI: 10.3390/ijerph18178934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022]
Abstract
Radionuclide contamination in terrestrial ecosystems has reached a dangerous level. The major artificial radionuclide present in the environment is cesium-137 (137-Cs). In humans, animals, and plants cesium ion (Cs+) behaves like potassium ion (K+) and it is localized mainly inside the cells. Pancreas and salivary glands secrete Cs in the intestine thus eliminating about 14% of ingested Cs with the feces, the remaining 86% is eliminated by the kidney with the urine. Ingested radiocesium can also cause in humans several cases of pancreatitis with secondary diabetes (type 3c), which are both on the rise in the world. The Author studied the correlation between the geographical map of mortality from pancreatic cancer (PC) and the map of nuclear plant accidents, atomic bomb testing, and radioactive fallout. The worldwide death rate of PC is increasing, but the exact cause is still not known. Published data in medical literature at World, European and Italian levels are reviewed and compared. 137-Cs, with a half-life of about 30 years, is still present in the environment for about 300-600 years. Autoradiographic studies in mice have shown that 137-Cs is concentrated in greater quantity in the pancreas, particularly in exocrine cells, where most malignant PCs originate. Some methods of radiocesium removal and PC prevention are also suggested. But there is still a persistent, and not entirely disinterested, the controversy between damage from high and low exposure to ionizing radiations.
Collapse
|
34
|
Megwalu UC, Ma Y, Osazuwa‐Peters N, Orloff LA. Clinical presentation and survival outcomes of well-differentiated thyroid cancer in Filipinos. Cancer Med 2021; 10:5964-5973. [PMID: 34288520 PMCID: PMC8419748 DOI: 10.1002/cam4.4149] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/25/2022] Open
Abstract
Background Filipinos have higher recurrence rates compared to other racial/ethnic groups, which might suggest a higher propensity for aggressive disease. The goal of this study was to perform a population‐based analysis of disease extent at diagnosis and survival outcomes in Filipino patients with well‐differentiated thyroid cancer relative to other racial/ethnic groups. Methods The study cohort comprised adult patients with well‐differentiated thyroid cancer diagnosed between 2004 and 2015, identified in the California Cancer Registry. Rates of extrathyroidal extension, nodal metastasis, and distant metastasis were compared between Filipinos, Non‐Filipino Asians, and Non‐Asians using multilevel logistic regression models. Survival outcomes were compared using Cox regression models, utilizing a sequential modeling approach. Results Filipino ethnicity was associated with extrathyroidal extension (OR 1.35, 95% CI 1.11–1.63) compared with non‐Asians and non‐Filipino Asians. Filipino ethnicity was also associated with nodal metastasis (OR 1.32, 95% CI 1.18–1.46), and with worse OS (Hazard Ratio [HR] 1.45, 95% CI 1.20–1.75) and DSS (HR 1.51, 95% CI 1.12–2.04). After adjusting for demographic and clinical factors, Filipino ethnicity was no longer associated with OS (HR 1.03, 95% CI 0.84–1.25) or DSS (HR 0.93, 95% CI 0.68–1.28). Conclusion Filipino patients with thyroid cancer are more likely to present with locoregionally advanced disease compared with non‐Filipino Asians and non‐Asians. Furthermore, Filipino patients have worse survival outcomes compared with non‐Filipino Asians and non‐Asians. However, this appears to be driven by the higher rates of locoregionally advanced disease in Filipino patients.
Collapse
Affiliation(s)
- Uchechukwu C. Megwalu
- Department of Otolaryngology—Head and Neck SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Yifei Ma
- Department of Otolaryngology—Head and Neck SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| | - Nosayaba Osazuwa‐Peters
- Department of Head and Neck Surgery and Communication SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lisa A. Orloff
- Department of Otolaryngology—Head and Neck SurgeryStanford University School of MedicineStanfordCaliforniaUSA
| |
Collapse
|
35
|
Li M, Zheng R, Dal Maso L, Zhang S, Wei W, Vaccarella S. Mapping overdiagnosis of thyroid cancer in China. Lancet Diabetes Endocrinol 2021; 9:330-332. [PMID: 33891886 DOI: 10.1016/s2213-8587(21)00083-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/28/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon 69372, France
| | - Rongshou Zheng
- National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Siwei Zhang
- National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Salvatore Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon 69372, France.
| |
Collapse
|
36
|
Miranda-Filho A, Lortet-Tieulent J, Bray F, Cao B, Franceschi S, Vaccarella S, Dal Maso L. Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol 2021; 9:225-234. [PMID: 33662333 DOI: 10.1016/s2213-8587(21)00027-9] [Citation(s) in RCA: 201] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The incidence of thyroid cancer has increased in different populations worldwide in the past 30 years. We present here an overview of international trends of thyroid cancer incidence by major histological subtypes. METHODS We did a population-based study with data for thyroid cancer incidence collected by the International Agency for Research on Cancer (IARC) for the period 1998-2012. Data were extracted from the Cancer Incidence in Five Continents plus compendium. We selected data for 25 countries that had a population of more than 2 million individuals covered by cancer registration (87 registries in total). Further criteria were that the selected registration areas had to have a proportion of unspecified thyroid cancer of less than 10% and analyses were restricted to individuals aged 20-84 years. We calculated age-specific incidence rates and age-standardised rates per 100 000 person-years for individuals aged 20 to 84 years, and assessed trends by country, sex, and major histological subtype (papillary, follicular, medullary, or anaplastic) based on absolute changes in age-standardised incidence rates between 1998-2002 and 2008-12. FINDINGS Papillary thyroid cancer was the main contributor to overall thyroid cancer in all the studied countries, and was the only histological subtype that increased systematically in all countries, although with large variability between countries. In women, the age-standardised incidence rate of papillary thyroid cancer during 2008-12 ranged from 4·3-5·3 cases per 100 000 person-years in the Netherlands, the UK, and Denmark, to 143·3 cases per 100 000 women in South Korea. For men during the same period, the age-standardised incidence rates of papillary thyroid cancer per 100 000 person-years ranged from 1·2 cases per 100 000 in Thailand to 30·7 cases per 100 000 in South Korea. In many countries in Asia, the increase in papillary thyroid cancer rates in women was particularly pronounced after the year 2000; rates stabilised since around 2009 in the USA, Austria, Croatia, Germany, Slovenia, Spain, Lithuania, and Bulgaria. Temporal trends for follicular and medullary thyroid cancer did not show consistent patterns across countries, but slight decreases were seen for anaplastic thyroid cancer in 21 of 25 countries between 1998-2002, and 2008-12. In 2008-12, age-standardised rates for the follicular subtype ranged between 0·5 and 2·5 cases per 100 000 women (and between 0·3 and 1·5 per 100 000 men), while those for the medullary subtype were always less than 1 case per 100 000 women or men, and for anaplastic thyroid cancer less than 0·2 cases per 100 000 women or men. INTERPRETATION In the period from 1998 to 2012, the rapid increases in thyroid cancer incidence were observed only for papillary thyroid cancer, the subtype more likely to be found in a subclinical form and therefore detected by intense scrutiny of the thyroid gland. FUNDING French Institut National du Cancer, Italian Association for Cancer Research, Italian Ministry of Health.
Collapse
Affiliation(s)
| | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Bochen Cao
- Department of Data and Analytics, WHO, Geneve, Switzerland
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| |
Collapse
|
37
|
Drozd V, Saenko V, Branovan DI, Brown K, Yamashita S, Reiners C. A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima: Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis. Int J Environ Res Public Health 2021; 18:3444. [PMID: 33810323 DOI: 10.3390/ijerph18073444] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 12/28/2022]
Abstract
The incidence of differentiated thyroid cancer (DTC) is steadily increasing globally. Epidemiologists usually explain this global upsurge as the result of new diagnostic modalities, screening and overdiagnosis as well as results of lifestyle changes including obesity and comorbidity. However, there is evidence that there is a real increase of DTC incidence worldwide in all age groups. Here, we review studies on pediatric DTC after nuclear accidents in Belarus after Chernobyl and Japan after Fukushima as compared to cohorts without radiation exposure of those two countries. According to the Chernobyl data, radiation-induced DTC may be characterized by a lag time of 4–5 years until detection, a higher incidence in boys, in children of youngest age, extrathyroidal extension and distant metastases. Radiation doses to the thyroid were considerably lower by appr. two orders of magnitude in children and adolescents exposed to Fukushima as compared to Chernobyl. In DTC patients detected after Fukushima by population-based screening, most of those characteristics were not reported, which can be taken as proof against the hypothesis, that radiation is the (main) cause of those tumors. However, roughly 80% of the Fukushima cases presented with tumor stages higher than microcarcinomas pT1a and 80% with lymph node metastases pN1. Mortality rates in pediatric DTC patients are generally very low, even at higher tumor stages. However, those cases considered to be clinically relevant should be followed-up carefully after treatment because of the risk of recurrencies which is expected to be not negligible. Considering that thyroid doses from the Fukushima accident were quite small, it makes sense to assess the role of other environmental and lifestyle-related factors in thyroid carcinogenesis. Well-designed studies with assessment of radiation doses from medical procedures and exposure to confounders/modifiers from the environment as e.g., nitrate are required to quantify their combined effect on thyroid cancer risk.
Collapse
|
38
|
Vaccarella S, Lortet-Tieulent J, Colombet M, Davies L, Stiller CA, Schüz J, Togawa K, Bray F, Franceschi S, Dal Maso L, Steliarova-Foucher E. Global patterns and trends in incidence and mortality of thyroid cancer in children and adolescents: a population-based study. Lancet Diabetes Endocrinol 2021; 9:144-152. [PMID: 33482107 DOI: 10.1016/s2213-8587(20)30401-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND There has been a considerable increase in thyroid cancer incidence among adults in several countries in the past three decades, attributed primarily to overdiagnosis. We aimed to assess global patterns and trends in incidence and mortality of thyroid cancer in children and adolescents, in view of the increased incidence among adults. METHODS We did a population-based study of the observed incidence (in 49 countries and territories) and mortality (in 27 countries) of thyroid cancer in children and adolescents aged 0-19 years using data from the International Incidence of Childhood Cancer Volume 3 study database, the WHO mortality database, and the cancer incidence in five continents database (CI5plus; for adult data [age 20-74 years]). We analysed temporal trends in incidence rates, including absolute changes in rates, and the strength of the correlation between incidence rates in children and adolescents and in adults. We calculated the average annual number of thyroid cancer deaths and the age-standardised mortality rates for children and adolescents. FINDINGS Age-standardised incidence rates of thyroid cancer among children and adolescents aged 0-19 years ranged from 0·4 (in Uganda and Kenya) to 13·4 (in Belarus) cancers per 1 million person-years in 2008-12. The variability in the incidence rates was mostly accounted for by the papillary tumour subtype. Incidence rates were almost always higher in girls than in boys and increased with age in both sexes. Rapid increases in incidence between 1998-2002 and 2008-12 were observed in almost all countries. Country-specific incidence rates in children and adolescents were strongly correlated (r>0·8) with rates in adults, as were the temporal changes in the respective incidence rates (r>0·6). Thyroid cancer deaths in those aged younger than 20 years were less than 0·1 per 10 million person-years in each country. INTERPRETATION The pattern of thyroid cancer incidence in children and adolescents mirrors the pattern seen in adults, suggesting a major role for overdiagnosis, which, in turn, can lead to overtreatment, lifelong medical care, and side effects that can negatively affect quality of life. We suggest that the existing recommendation against screening for thyroid cancer in the asymptomatic adult population who are free from specific risk factors should be extended to explicitly recommend against screening for thyroid cancer in similar populations of children and adolescents. FUNDING International Agency for Research on Cancer and the Union for International Cancer Control; French Institut National du Cancer; Italian Association of Cancer Research; and Italian Ministry of Health.
Collapse
Affiliation(s)
- Salvatore Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France.
| | - Joannie Lortet-Tieulent
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| | - Murielle Colombet
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| | - Louise Davies
- VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT, USA; Dartmouth Institute for Health Policy and Clinical Outcomes, Lebanon, NH, USA
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Oxford, UK
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Kayo Togawa
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| |
Collapse
|
39
|
Affiliation(s)
- Salvatore Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon CEDEX 08, France.
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| |
Collapse
|
40
|
Cheng F, Xiao J, Shao C, Huang F, Wang L, Ju Y, Jia H. Burden of Thyroid Cancer From 1990 to 2019 and Projections of Incidence and Mortality Until 2039 in China: Findings From Global Burden of Disease Study. Front Endocrinol (Lausanne) 2021; 12:738213. [PMID: 34690931 PMCID: PMC8527095 DOI: 10.3389/fendo.2021.738213] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
Projecting the burden of thyroid cancer (TC) over time provides essential information to effectively plan measures for its management and prevention. This research obtained data from the Global Burden of Disease (GBD) Study from between 1990 and 2019 to model how TC will affect China until 2039 by conducting the Bayesian age-period-cohort analysis. The number of new TC cases in China was 10,030 in 1990, 39,080 in 2019, and is projected to be 47,820 in 2039. This corresponds to 3,320, 7,240, and 4,160 deaths, respectively. Disability-adjusted life years (DALYs) cases increased from 103,490 in 1990 to 187,320 in 2019. The age-standardized rate (ASR) of incidence increased from 1.01 to 2.05 during 1990-2019 and was projected to increase to 3.37 per 100,000 person-years until 2039. The ASR of mortality (ASMR) remained stable during the study period and was projected to have a mild decline from 0.39 to 0.29/100,000 during 2020-2039. Although the ASMR in male patients has maintained increasing at a rate of 2.2% per year over the past 30 years, it is expected to decline at a rate of 1.07% per year in 2019-2039. The most significant increase in crude incidence occurred in people aged 45-65 from 1990 to 2019, however, this will shift into young people aged 10-24 from 2020 to 2039. In addition, the proportion of deaths and DALYs caused by obesity increased from 1990 to 2019 and affected men more than women. In conclusion, a substantial increase in counts of incidence of TC in China is projected over the next two decades, combined with the slightly declining mortality, indicating that rational health policies are needed in the future to cope with the increasing number of TC patients, especially among males and adolescents.
Collapse
Affiliation(s)
- Fang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Juan Xiao
- Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chunchun Shao
- Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fengyan Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lihua Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanli Ju
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongying Jia
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Hongying Jia,
| |
Collapse
|
41
|
Markantes GK, Tsochatzis S, Panagopoulos K, Melachrinou M, Kyriazopoulou VE, Markou KB, Michalaki MA. A shift to more targeted thyroidectomies increased the detection of thyroid cancer and in particular low-risk papillary tumors in Southwestern Greece the decade 2007 to 2016. Laryngoscope Investig Otolaryngol 2020; 5:1260-1265. [PMID: 33364420 PMCID: PMC7752045 DOI: 10.1002/lio2.504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/22/2020] [Revised: 10/14/2020] [Accepted: 11/13/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Data regarding thyroid cancer (TC) epidemiology in Greece in the last decade are scarce, so we investigated the trends in TC detection during 2007 to 2016. METHODS We retrospectively studied 2040 pathology reports of total thyroidectomies performed at our institution from 2007 to 2016. RESULTS A number of 478 cases of TC were identified in the studied decade. The overall incidence of TC among thyroidectomies rose over the years. The proportion of papillary T1 tumors among thyroidectomies increased in the second period of our study (2012-2016), while that of papillary T2 to T4 tumors and other TC subtypes remained unchanged. Papillary T1 tumors represented 63.6% of all TC cases and 75.3% of them were low-risk microcarcinomas (papillary thyroid microcarcinoma). The strategy of fine needle aspiration (FNA) prior to surgery in the management of thyroid nodules was adopted by more clinical endocrinologists in the area of Southwestern (SW) Greece in the second period of our study (2012-2016:29.7% vs 2007-2011:18.4%, P < .001). Consequently, the indication for thyroidectomy was set by FNA more frequently in 2012 to 2016 than in 2007 to 2011 (42.5% vs 26.4% of cases, P < .001). CONCLUSIONS The wider use of FNA in the triage of thyroid nodules led to increased rates of TC in thyroidectomies performed in SW Greece during the decade 2007 to 2016; low-risk, small papillary tumors represented the majority of TC cases.
Collapse
Affiliation(s)
- Georgios K. Markantes
- Division of Endocrinology, Department of Internal MedicineUniversity of Patras School of Health SciencesPatrasGreece
| | - Stylianos Tsochatzis
- Department of General SurgeryUniversity of Patras School of Health SciencesPatrasGreece
| | | | - Maria Melachrinou
- Department of PathologyUniversity of Patras School of Health SciencesPatrasGreece
| | - Venetsana E. Kyriazopoulou
- Division of Endocrinology, Department of Internal MedicineUniversity of Patras School of Health SciencesPatrasGreece
| | - Kostas B. Markou
- Division of Endocrinology, Department of Internal MedicineUniversity of Patras School of Health SciencesPatrasGreece
| | - Marina A. Michalaki
- Division of Endocrinology, Department of Internal MedicineUniversity of Patras School of Health SciencesPatrasGreece
| |
Collapse
|
42
|
Du L, Zhao Z, Zheng R, Li H, Zhang S, Li R, Wei W, He J. Epidemiology of Thyroid Cancer: Incidence and Mortality in China, 2015. Front Oncol 2020; 10:1702. [PMID: 33240801 PMCID: PMC7683719 DOI: 10.3389/fonc.2020.01702] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 05/22/2020] [Accepted: 07/30/2020] [Indexed: 01/06/2023] Open
Abstract
Objective: Using data from cancer registries to estimate thyroid cancer incidence and mortality in China, 2015. Methods: Data submitted from local cancer registries were checked and evaluated according to the criteria of data quality control, a total of 368 cancer registries' data were qualified for the final analysis. Data were stratified by area (urban/rural, eastern/central/western), sex and age, combined with national population data to estimate thyroid cancer incidence and mortality in China, 2015. Results: Approximately 200,700 new cases were diagnosed in 2015, accounting for 5.11% of all cancer cases. The crude incidence rate was 14.60/100,000. Age-standardized incidence rates by Chinese standard population (ASIRC) and world standard population (ASIRW) were 12.05/100,000 and 10.44/100,000, with the cumulative incidence rate (0-74 years old) of 1.00%. About 7,900 deaths of thyroid cancer were reported in 2015, accounting for 0.34% of all cancer deaths. The crude mortality rate was 0.58/100,000, age-standardized mortality rates by Chinese standard population (ASMRC) and world standard population (ASMRW) were 0.37/100,000 and 0.36/100,000. The age-standardized incidence and mortality in females were significantly higher than those in males (P < 0.001). The rates in urban areas were higher than those in rural areas (P < 0.001). The ASIRC in eastern areas was higher than that in central and western areas (P < 0.001), while the ASMRC in central areas was higher than that in eastern and western areas (P < 0.001). Conclusions: The burden of thyroid cancer was heavy in China, cancer control faces the problem of the disparity between geographic areas, and the incidence and mortality rates were varied by sex and age. Targeted cancer preventive measures should be put into practice.
Collapse
Affiliation(s)
- Lingbin Du
- Department of Cancer Prevention, Institute of Cancer and Basic Medicine, Zhejiang Cancer Hospital, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Zixuan Zhao
- Center for Health Policy Studies, School of Medicine, Zhejiang University, Hangzhou, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center, National Clinical Research Center for Cancer, Peking Union Medical College, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huizhang Li
- Department of Cancer Prevention, Institute of Cancer and Basic Medicine, Zhejiang Cancer Hospital, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Siwei Zhang
- Office for Cancer Registry, National Cancer Center, National Clinical Research Center for Cancer, Peking Union Medical College, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Runhua Li
- Department of Prevention & Health Care, Institute of Cancer and Basic Medicine, Zhejiang Cancer Hospital, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center, National Clinical Research Center for Cancer, Peking Union Medical College, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Peking Union Medical College, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
43
|
Tian R, Zhang S, Sun D, Bei C, Li D, Zheng C, Song X, Chen M, Tan S, Zhu X, Zhang H. M6A Demethylase FTO Plays a Tumor Suppressor Role in Thyroid Cancer. DNA Cell Biol 2020; 39:2184-2193. [PMID: 33054406 DOI: 10.1089/dna.2020.5956] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to investigate the expression and clinical significance of N6-methyladenosine demethylase FTO in thyroid cancer. Bioinformatic analysis showed that FTO expression was downregulated in thyroid cancer tissues and correlated with lymph node metastasis in thyroid cancer patients. We conducted experimental verification by collecting Asian samples. The results of quantitative reverse transcription-PCR showed that the mRNA expression of FTO in the blood of 30 thyroid cancer patients was lower than that of the control population. At the same time, we found that FTO expression was negative in tissues of 16/56 (28.57%) thyroid cancer cases and 4/40 (10.00%) nontumor thyroid cases through the immunohistochemical method, indicating a lower FTO expression in thyroid cancer tissues than nontumor thyroid tissues (p < 0.05). In addition, the protein expression of FTO was significantly related to the tumor grade and lymph node metastasis in thyroid cancer patients (p < 0.05), but not to other clinicopathological features. Multivariate logistic regression analysis showed that FTO expression was an independent risk factor for tumor grade. Survival analysis showed no significant difference in the disease-free survival time of thyroid cancer patients between high expression and low expression groups of FTO. Furthermore, bioinformatic analysis found that promoter DNA methylation and copy number variation might cause downregulated FTO and then affect TP53 pathways in thyroid cancer. We found that FTO expression was downregulated in thyroid cancer tissues and related to the progression of thyroid cancer, suggesting a tumor suppressor role of FTO in thyroid cancer.
Collapse
Affiliation(s)
- Run Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Shidong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Daxin Sun
- Department of Thyroid Diseases, The First Affiliated Hospital of Guilin Medical University, Guilin, P.R. China
| | - Chunhua Bei
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Di Li
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Chuanjun Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Xin Song
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Mengshi Chen
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, P.R. China
| | - Shengkui Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, P.R. China
| | - Xiaonian Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| | - Huixia Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, P.R. China
| |
Collapse
|
44
|
Panato C, Vaccarella S, Dal Maso L, Basu P, Franceschi S, Serraino D, Wang K, Lei F, Chen Q, Huang B, Mathew A. Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis. J Clin Endocrinol Metab 2020; 105:dgaa192. [PMID: 32297630 PMCID: PMC7947989 DOI: 10.1210/clinem/dgaa192] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/14/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT/OBJECTIVE Increases of thyroid cancer (TC) incidence emerged in the past several decades in several countries. This study aimed to estimate time trends of TC incidence in India and the proportion of TC cases potentially attributable to overdiagnosis by sex, age, and area. DESIGN TC cases aged 0 to 74 years reported to Indian cancer registries during 2006 through 2014 were included. Age-standardized incidence rates (ASR) and TC overdiagnosis were estimated by sex, period, age, and area. RESULTS Between 2006 to 2008 and 2012 to 2014, the ASRs for TC in India increased from 2.5 to 3.5/100,000 women (+37%) and from 1.0 to 1.3/100,000 men (+27%). However, up to a 10-fold difference was found among regions in both sexes. Highest ASRs emerged in Thiruvananthapuram (14.6/100,000 women and 4.1/100,000 men in 2012-2014), with 93% increase in women and 64% in men compared with 2006 to 2008. No evidence of overdiagnosis was found in Indian men. Conversely, overdiagnosis accounted for 51% of TC in Indian women: 74% in those aged < 35 years, 50% at ages 35 to 54 years, and 30% at ages 55 to 64 years. In particular, 80% of TC overdiagnosis in women emerged in Thiruvananthapuram, whereas none or limited evidence of overdiagnosis emerged in Kamrup, Dibrugarh, Bhopal, or Sikkim. CONCLUSIONS Relatively high and increasing TC ASRs emerged in Indian regions where better access to health care was reported. In India, as elsewhere, new strategies are needed to discourage opportunistic screening practice, particularly in young women, and to avoid unnecessary and expensive treatments. Present results may serve as a warning also for other transitioning countries.
Collapse
Affiliation(s)
- Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Partha Basu
- International Agency for Research on Cancer, Lyon, France
| | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Kevin Wang
- Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, USA
| | - Feitong Lei
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Quan Chen
- Biostatistics and Bioinformatics Shared Facility, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Biostatistics and Bioinformatics Shared Facility, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Aju Mathew
- Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, USA
- MOSC Medical College Kolenchery, Kerala, India
| |
Collapse
|
45
|
Li M, Dal Maso L, Vaccarella S. Global trends in thyroid cancer incidence and the impact of overdiagnosis. Lancet Diabetes Endocrinol 2020; 8:468-470. [PMID: 32445733 DOI: 10.1016/s2213-8587(20)30115-7] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Mengmeng Li
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon 69372, France
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Salvatore Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon 69372, France.
| |
Collapse
|
46
|
Krajewska J, Kukulska A, Oczko-Wojciechowska M, Kotecka-Blicharz A, Drosik-Rutowicz K, Haras-Gil M, Jarzab B, Handkiewicz-Junak D. Early Diagnosis of Low-Risk Papillary Thyroid Cancer Results Rather in Overtreatment Than a Better Survival. Front Endocrinol (Lausanne) 2020; 11:571421. [PMID: 33123090 PMCID: PMC7573306 DOI: 10.3389/fendo.2020.571421] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022] Open
Abstract
We are witnessing a rapid worldwide increase in the incidence of papillary thyroid carcinoma (PTC) in the last thirty years. Extensive implementation of cancer screening and wide availability of neck ultrasound or other imaging studies is the main reason responsible for this phenomenon. It resulted in a detection of a growing number of clinically asymptomatic PTCs, mainly low-risk tumors, without any beneficial impact on survival. An indolent nature of low-risk PTC, particularly papillary thyroid microcarcinoma (PTMC), and the excellent outcomes raise an ongoing discussion regarding the adequacy of treatment applied. The question of whether PTMC is overtreated or not is currently completed by another, whether PTMC requires any treatment. Current ATA guidelines propose less extensive preoperative diagnostics and, if differentiated thyroid cancer is diagnosed, less aggressive surgical approach and limit indications for postoperative radioiodine therapy. However, in intrathyroidal PTMCs in the absence of lymph node or distant metastases, active surveillance may constitute alternative management with a low progression rate of 1%-5% and without any increase in the risk of poorer outcomes related to delayed surgery in patients, in whom it was necessary. This review summarizes the current knowledge and future perspectives of active surveillance in low-risk PTC.
Collapse
Affiliation(s)
- Jolanta Krajewska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- *Correspondence: Jolanta Krajewska,
| | - Aleksandra Kukulska
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Oczko-Wojciechowska
- Department of Genetic and Molecular Diagnostics of Cancer, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Agnieszka Kotecka-Blicharz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Katarzyna Drosik-Rutowicz
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Malgorzata Haras-Gil
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Daria Handkiewicz-Junak
- Department of Nuclear Medicine and Endocrine Oncology, M.Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| |
Collapse
|