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Ahn H, Kim Y, Kim E, Park K, Park I, Sym S, Park S, Shin D. A pilot study of exercise intervention during chemotherapy in patients with metastatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy444.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park JH, Kim E, Park K, Kang S, Ahn H, Kim Y, Park I, Sym S, Shin D. A pilot study of exercise intervention in patients with metastatic cancer: Feasibility, safety, and patient reported outcome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Byun J, Jung H, Bae WK, Lee HJ, Park S, Kim H, Maeng C, Park I, Sohn B, Kim J, Lee K, Im D, Kim J, Jang H, Kim S. Comparative effectiveness of neoadjuvant chemotherapy followed by cystectomy versus cystectomy followed by adjuvant chemotherapy versus palliative chemotherapy versus cystectomy for node-positive bladder cancer: A retrospective analysis: KCSG GU 17-03. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yeo J, Ahn H, Park I, Kim Y, Sym S, Cho E, Shin D. Left ventricular ejection fraction (LVEF) change for the first 6 months predicts development of trastuzumab-related cardiotoxicity in patients with breast cancer: An implication for the more efficient cardiac surveillance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Choi JH, Han H, Bae YG, Hwang ST, Kim HY, Park I, Kim SM, Choe YH, Moon YJ. P4629Computationally simulated fractional flow reserve from coronary computed tomography angiography based on fractional myocardial mass. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Choi JH, Bae YG, Hwang ST, Han H, Kim SM, Kim HY, Park I, Lee JM, Moon YJ. P1711Non-invasive coronary physiology based on computational analysis of intracoronary transluminal attenuation gradient. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Park I, Choi JH, Kim EK, Kim SM, Yang JH, Song YB, Hahn JY, Choi SH, Gwon HC, Lee SH, Choi YH, Oh JK. P1790Non-invasive identification of coronary collateral vessels by coronary computed tomography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Park I, Pasquetti T, Malheiros RD, Ferket PR, Kim SW. Effects of supplemental L-methionine on growth performance and redox status of turkey poults compared with the use of DL-methionine. Poult Sci 2018; 97:102-109. [PMID: 29077910 PMCID: PMC5850274 DOI: 10.3382/ps/pex259] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/03/2017] [Indexed: 01/11/2023] Open
Abstract
This study was conducted to test the effects of dietary supplementation of feed grade L-Met on growth performance and redox status of turkey poults compared with the use of conventional DL-Met. Three hundred and eighty five newly hatched turkey poults were weighed and allotted to 5 treatments in a completely randomized design and the birds were fed dietary treatments for 28 d, including a basal diet (BD), the BD + 0.17 or 0.33% DL-Met or L-Met (representing 60, 75, and 90% of the requirement by National Research Council (NRC) for S containing AA, respectively). Increasing Met supplementation from 0 to 0.33% increased (P < 0.05) weight gain (690 to 746 g) and feed intake (1,123 to 1,248 g) of turkey poults. Supplementing L-Met tended (P = 0.053) to reduce feed to gain ratio (1.70 to 1.63) compared with DL-Met. The relative bioavailability of L-Met to DL-Met was 160% based on a multilinear regression analysis of weight gain. Supplementing Met regardless of its sources decreased (P < 0.05) malondialdehyde (3.29 to 2.47 nmol/mg protein) in duodenal mucosa compared with birds in the BD. Supplementing L-Met tended (P = 0.094) to decrease malondialdehyde (1.27 to 1.16 nmol/mg protein) and increase glutathione (3.21 to 3.45 nmol/mg protein) in the liver compared with DL-Met. Total antioxidant capacity, protein carbonyl, and morphology of duodenum and jejunum were not affected by Met sources. In conclusion, dietary supplementation of 0.33% Met to a diet with S containing AA meeting 60% of the NRC requirement enhanced weight gain, feed intake, and redox status by reducing oxidative stress in the gut and liver of turkey poults during the first 28 d of age. Use of L-Met tended to enhance feed efficiency and was more effective in reducing oxidative stress and increasing glutathione in the liver compared with the use of DL-Met. The use of L-Met as a source of Met replacing DL-Met seems to be beneficial to turkey poults during the first 28 d of age.
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Park I, Jung S, Seo Y, Oh S, Lee K, Kim S, Lee Y, Kim S. 0982 Differential Role of Sleep Disturbance and Stress Level on Depressive Symptoms and Anxiety. Sleep 2018. [DOI: 10.1093/sleep/zsy061.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lim SY, Choi M, Baek JY, Park I. Moderating effect of synthesized docosahexaenoic acid-enriched phosphatidylcholine on production of Th1 and Th2 cytokine in lipopolysaccharide-induced inflammation. Asian Pac J Trop Biomed 2018. [DOI: 10.4103/2221-1691.237076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abbaneo D, Abbas M, Abbrescia M, Abi Akl M, Aboamer O, Acosta D, Ahmad A, Ahmed W, Aleksandrov A, Altieri P, Asawatangtrakuldee C, Aspell P, Assran Y, Awan I, Bally S, Ban Y, Banerjee S, Barashko V, Barria P, Bencze G, Beni N, Benussi L, Bhopatkar V, Bianco S, Bos J, Bouhali O, Braghieri A, Braibant S, Buontempo S, Calabria C, Caponero M, Caputo C, Cassese F, Castaneda A, Cauwenbergh S, Cavallo F, Celik A, Choi M, Choi S, Christiansen J, Cimmino A, Colafranceschi S, Colaleo A, Conde Garcia A, Czellar S, Dabrowski M, De Lentdecker G, De Oliveira R, de Robertis G, Dildick S, Dorney B, Endroczi G, Errico F, Fenyvesi A, Ferry S, Furic I, Giacomelli P, Gilmore J, Golovtsov V, Guiducci L, Guilloux F, Gutierrez A, Hadjiiska R, Hauser J, Hoepfner K, Hohlmann M, Hoorani H, Iaydjiev P, Jeng Y, Kamon T, Karchin P, Korytov A, Krutelyov S, Kumar A, Kim H, Lee J, Lenzi T, Litov L, Loddo F, Madorsky A, Maerschalk T, Maggi M, Magnani A, Mal P, Mandal K, Marchioro A, Marinov A, Majumdar N, Merlin J, Mitselmakher G, Mohanty A, Mohapatra A, Molnar J, Muhammad S, Mukhopadhyay S, Naimuddin M, Nuzzo S, Oliveri E, Pant L, Paolucci P, Park I, Passeggio G, Pavlov B, Philipps B, Piccolo D, Postema H, Puig Baranac A, Radi A, Radogna R, Raffone G, Ranieri A, Rashevski G, Riccardi C, Rodozov M, Rodrigues A, Ropelewski L, RoyChowdhury S, Ryu G, Ryu M, Safonov A, Salva S, Saviano G, Sharma A, Sharma A, Sharma R, Shah A, Shopova M, Sturdy J, Sultanov G, Swain S, Szillasi Z, Talvitie J, Tatarinov A, Tuuva T, Tytgat M, Vai I, Van Stenis M, Venditti R, Verhagen E, Verwilligen P, Vitulo P, Volkov S, Vorobyev A, Wang D, Wang M, Yang U, Yang Y, Yonamine R, Zaganidis N, Zenoni F, Zhang A. Quality control for the first large areas of triple-GEM chambers for the CMS endcaps. EPJ WEB OF CONFERENCES 2018. [DOI: 10.1051/epjconf/201817403003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The CMS Collaboration plans to equip the very forward muon system with triple-GEM detectors that can withstand the environment of the High-Luminosity LHC. This project is at the final stages of R&D and moving to production. An unprecedented large area of several 100 m2 are to be instrumented with GEM detectors which will be produced in six different sites around the world. A common construction and quality control procedure is required to ensure the performance of each detector. The quality control steps will include optical inspection, cleaning and baking of all materials and parts used to build the detector, leakage current tests of the GEM foils, high voltage tests, gas leak tests of the chambers and monitoring pressure drop vs. time, gain calibration to know the optimal operation region of the detector, gain uniformity tests, and studying the efficiency, noise and tracking performance of the detectors in a cosmic stand using scintillators.
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Abbaneo D, Abbas M, Abbrescia M, Abi Akl M, Aboamer O, Acosta D, Ahmad A, Ahmed W, Aleksandrov A, Altieri P, Asawatangtrakuldee C, Aspell P, Assran Y, Awan I, Bally S, Ban Y, Banerjee S, Barashko V, Barria P, Bencze G, Beni N, Benussi L, Bhopatkar V, Bianco S, Bos J, Bouhali O, Braghieri A, Braibant S, Buontempo S, Calabria C, Caponero M, Caputo C, Cassese F, Castaneda A, Cauwenbergh S, Cavallo F, Celik A, Choi M, Choi S, Christiansen J, Cimmino A, Colafranceschi S, Colaleo A, Conde Garcia A, Czellar S, Dabrowski M, De Lentdecker G, De Oliveira R, de Robertis G, Dildick S, Dorney B, Endroczi G, Errico F, Fenyvesi A, Ferrini M, Ferry S, Furic I, Giacomelli P, Gilmore J, Golovtsov V, Guiducci L, Guilloux F, Gutierrez A, Hadjiiska R, Hauser J, Hoepfner K, Hohlmann M, Hoorani H, Iaydjiev P, Jeng Y, Kamon T, Karchin P, Korytov A, Krutelyov S, Kumar A, Kim H, Lalli A, Lee J, Lenzi T, Litov L, Loddo F, Madorsky A, Maerschalk T, Maggi M, Magnani A, Mal P, Mandal K, Marchioro A, Marinov A, Majumdar N, Merlin J, Mitselmakher G, Mohanty A, Mohapatra A, Molnar J, Muhammad S, Mukhopadhyay S, Naimuddin M, Nuzzo S, Oliveri E, Pant L, Paolucci P, Park I, Passamonti L, Passeggio G, Pavlov B, Philipps B, Piccolo D, Pierluigi D, Postema H, Primavera F, Puig Baranac A, Radi A, Radogna R, Raffone G, Ranieri A, Rashevski G, Riccardi C, Rodozov M, Rodrigues A, Ropelewski L, RoyChowdhury S, Russo A, Ryu G, Ryu M, Safonov A, Salva S, Saviano G, Sharma A, Sharma A, Sharma R, Shah A, Shopova M, Sturdy J, Sultanov G, Swain S, Szillasi Z, Talvitie J, Tatarinov A, Tuuva T, Tytgat M, Valente M, Vai I, Van Stenis M, Venditti R, Verhagen E, Verwilligen P, Vitulo P, Volkov S, Vorobyev A, Wang D, Wang M, Yang U, Yang Y, Yonamine R, Zaganidis N, Zenoni F, Zhang A. A novel application of Fiber Bragg Grating (FBG) sensors in MPGD. EPJ WEB OF CONFERENCES 2018. [DOI: 10.1051/epjconf/201817403002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We present a novel application of Fiber Bragg Grating (FBG) sensors in the construction and characterisation of Micro Pattern Gaseous Detector (MPGD), with particular attention to the realisation of the largest triple (Gas electron Multiplier) GEM chambers so far operated, the GE1/1 chambers of the CMS experiment at LHC. The GE1/1 CMS project consists of 144 GEM chambers of about 0.5 m2 active area each, employing three GEM foils per chamber, to be installed in the forward region of the CMS endcap during the long shutdown of LHC in 2108-2019. The large active area of each GE1/1 chamber consists of GEM foils that are mechanically stretched in order to secure their flatness and the consequent uniform performance of the GE1/1 chamber across its whole active surface. So far FBGs have been used in high energy physics mainly as high precision positioning and re-positioning sensors and as low cost, easy to mount, low space consuming temperature sensors. FBGs are also commonly used for very precise strain measurements in material studies. In this work we present a novel use of FBGs as flatness and mechanical tensioning sensors applied to the wide GEM foils of the GE1/1 chambers. A network of FBG sensors have been used to determine the optimal mechanical tension applied and to characterise the mechanical tension that should be applied to the foils. We discuss the results of the test done on a full-sized GE1/1 final prototype, the studies done to fully characterise the GEM material, how this information was used to define a standard assembly procedure and possible future developments.
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Park I, Kim YS, Sym SJ, Ahn HK, Kim KK, Park YH, Lee JN, Shin DB. Metastasectomy for recurrent or metastatic biliary tract cancers: A single center experience. Indian J Cancer 2017; 54:57-62. [PMID: 29199665 DOI: 10.4103/0019-509x.219581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess efficacy or long-term result of metastasectomy for recurrent or metastatic biliary tract carcinoma (BTC), we conducted a retrospective review of the outcomes of metastasectomy for recurrent or metastatic BTCs, comprising intrahepatic cholangiocellular carcinoma (IHCCC), proximal and distal common bile duct cancer (pCBDC and dCBDC), gallbladder cancer (GBC), and ampulla of Vater cancer (AoVC). PATIENTS AND METHODS The clinicopathological features and outcomes of BTC patients who underwent surgical resection for the primary and metastatic disease at the Gachon University Gil Medical Centre from 2003 to 2013 were reviewed retrospectively. RESULTS We found 19 eligible patients. Primary sites were GBC (seven patients, 37%), IHCCC (five patients, 26%), dCBDC (three patients, 16%), pCBDC (two patients, 11%), and AoVC (two patients, 11%). Eight patients (42%) had synchronous metastasis whereas 11 (58%) had metachronous metastasis. The most common metastatic site was liver (nine patients, 47%), lymph node (nine patients, 47%), and peritoneum (three patients, 16%). Nine patients (47%) achieved R0 resection, whereas four (21%) and six (32%) patients had R1 and R2 resection, respectively. With a median follow-up period of 26.7 months, the estimated median overall survival (OS) was 18.2 months (95% confidence interval, 13.6-22.9 months). Lower Eastern Cooperative Oncology Group performance status (P = 0.023), metachronous metastasis (P = 0.04), absence of lymph node metastasis (P = 0.009), lower numbers of metastatic organs (P < 0.001), normal postoperative CA19-9 level (P = 0.034), and time from diagnosis to metastasectomy more than 1 year (P = 0.019) were identified as prognostic factors for a longer OS after metastasectomy. CONCLUSIONS For recurrent or metastatic BTCs, metastasectomy can be a viable option for selected patients.
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Choi Y, Akazawa N, Nakamura Y, Park I, Tokuyama K, Maeda S. The effects of bright light exposure at night on circadian rhythms and energy metabolism. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Park J, Park SW, Cho SI, Park I, Kim YH, Park EY, Oh JK, Kim SJ, Park JH, Lim MK. Planning of national prospective study on tobacco behavior transition among adolescents in Korea. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Park I, Lee K, Sun H, Kim J, Chi H, Kim S, Kim Y, Park J, Yoo C, Jo J. Effect of interval between ovulation trigger and oocyte aspiration in GnRH antagonist cycles. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sun H, Lee K, Park I, Kim J, Chi H, Kim S, Kim Y, Park J, Jo J. Does luteal phase support improve pregnancy outcome in natural frozen-thawed embryo transfer cycles? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Park I, Choi J, Bae Y, Moon Y, Lee J, Yang J, Song Y, Hahn J, Choi S, Gwon H, Lee S. P853Non-invasive assessment of vessel-specific coronary blood flow by computational analysis of intracoronary transluminal attenuation gradient. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Duarte ME, Park I, Parnsen W, Zhou FX, Kim SW. 409 Effects of combinational use of xylanase and protease on growth performance and gut health of newly weaned pigs. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zheng L, Park I, Kim SW. 395 Effects of dietary lysophospholipid complex on apparent ileal digestibility of fatty acids, intestinal morphology and barrier function, and growth performance in nursery pigs. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chen H, Park I, Zhang S, Kim SW. 394 Effect of supplemental protease on growth performance, nutrient digestibility, and gut health in nursery pigs fed diets with corn or sorghum. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park I, Parnsen W, Duarte ME, Yiannikouris A, Kim SW. 406 Effects of modified yeast cell wall extract on gut health and growth of newly weaned pigs under chronic dietary challenges of aflatoxin, deoxynivalenol, and fumonisin. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Parnsen W, Park I, Kim SW. 405 Functional difference of free L-Lysine and L-Lysine HCl on growth performances, intestinal health, and intestinal integrity in newly weaned pigs. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kim EY, Lee HY, Kim YS, Park I, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of cachexia score assessed by CT in male patients with small cell lung cancer. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28426181 DOI: 10.1111/ecc.12695] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2017] [Indexed: 11/26/2022]
Abstract
To determine the prognostic significance of CT-determined cachexia scores (CSs) in 127 consecutive male small cell lung cancer (SCLC) patients, cross-sectional areas of muscle and fat tissues at the third lumbar vertebra (L3) were retrospectively measured on baseline CT images. CSs were determined based on the presence of sarcopenia and/or adipopenia. According to the presence of sarcopenia (L3 muscle index <55 cm2 /m2 , 86.8%) and adipopenia (L3 fat index <22 cm2 /m2 , 11.8%), CSs were defined as follows: CS2 (sarcopenia and adipopenia, 11.8%), CS1 (sarcopenia only, 74.8%) and CS0 (13.4%). CS2 was significantly related to lower body mass index (p < .001) and poor performance status (p = .002), and patients with CS2 had shorter OS than patients with CS1 or CS0 (median OS, 5.0 months vs. 8.9 months vs. 18.3 months; p = .007). Multivariable analysis revealed that CS was an independent prognostic factor of poor survival (HR, 1.99 for CS1 and 2.59 for CS2, p = .036 and .023, CS0 as a reference), along with extensive stage (p < .001), supportive care only (p < .001) and an elevated lactate dehydrogenase (p = .005). CT-determined CSs, based on the presence of sarcopenia and/or adipopenia, could be used to predict prognosis in male SCLC.
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Kim SK, Park I, Hur N, Choe JH, Kim JH, Kim JS. Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma. Br J Surg 2017; 104:857-867. [PMID: 28295219 DOI: 10.1002/bjs.10514] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/18/2016] [Accepted: 01/28/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND The patterns, predictive factors and prognostic impact of multilevel metastasis in patients with N1b papillary thyroid carcinoma (PTC) were investigated. METHODS A retrospective review of patients with N1b PTC from a tertiary referral centre in Korea who underwent unilateral modified radical neck dissection was undertaken. RESULTS Of 658 patients, multilevel metastasis was found in 73·9 per cent; the most common type was metastasis in two levels. Tumour size per 0·1-cm increment (adjusted odds ratio (OR) 1·33, 95 per cent c.i. 1·08 to 1·64), microscopic extrathyroidal extension (adjusted OR 1·72, 1·10 to 2·71), gross extrathyroidal extension (adjusted OR 2·35, 1·24 to 4·46), unilateral central lymph node metastasis (adjusted OR 2·45, 1·53 to 3·92) and bilateral central lymph node metastasis (adjusted OR 4·06, 2·29 to 7·18) were independent predictors of multilevel metastasis. Only four-level metastasis significantly increased the risk of overall locoregional recurrence (LRR) (adjusted hazard ratio (HR) 7·41, 95 per cent c.i. 2·20 to 24·53) and lateral neck LRR (adjusted HR 7·22, 1·82 to 28·65), compared with one-level metastasis. Two subgroup analyses were conducted, showing that only three-level metastasis including metastasis in level V significantly increased the risk of overall LRR (adjusted HR 5·66, 1·20 to 26·75). In addition, having level V metastasis was an independent predictor of both overall (adjusted HR 3·26, 1·72 to 6·18; P < 0·001) and lateral neck (adjusted HR 3·28, 1·50 to 7·16; P = 0·003) LRR. CONCLUSION Level V metastasis rather than multilevel metastasis itself is associated with an increased risk of LRR. Patients with N1b PTC and level V metastasis require risk restratification and meticulous follow-up.
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