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Staubitz-Vernazza JI, Schwind S, Lozan O, Musholt TJ. A 16-Year Single-Center Series of Trachea Resections for Locally Advanced Thyroid Carcinoma. Cancers (Basel) 2023; 16:163. [PMID: 38201590 PMCID: PMC10778257 DOI: 10.3390/cancers16010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Infiltration of the aerodigestive tract in advanced thyroid carcinoma determines the prognosis and quality of life. Different stages of tracheal tumor invasion require customization of the surgical concept. (2) Methods: In the period from January 2007 to January 2023, patients who underwent surgery for advanced thyroid carcinomas with trachea resections were included in a retrospective observational study. The surgical resection concepts and operation-associated complications were documented. The overall survival and post-resection survival were analyzed. (3) Results: From 2007 to 2023, at the single-center UMC Mainz, 33 patients (15 female and 18 male) underwent neck surgery with trachea resections for locally advanced thyroid carcinomas. Of these, 14 were treated with non-transmural (trachea shaving) and 19 transmural trachea resections (9 "window" resections, 6 near-circular resections, 3 sleeve resections and 1 total laryngectomy with extramucosal esophageal resection). The two-year postoperative survival rate was 82.0 percent. The two-year recurrence-free survival rate was 75.0 percent (mean follow-up period: 29.2 months). (4) Conclusions: Tracheal resections for locally advanced tumor infiltration are feasible as an element of highly individualized treatment concepts.
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Affiliation(s)
| | | | | | - Thomas J. Musholt
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany; (J.I.S.-V.); (S.S.); (O.L.)
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Babu A, Lakhera KK, Patel P, Singh S, Sahni M, Nuttaki S, Singhal PM. "Flap of Hope: a Pectoralis Major Muscle Solution for Tracheal Resection Closure": Case Report. Indian J Surg Oncol 2023; 14:553-555. [PMID: 37900641 PMCID: PMC10611632 DOI: 10.1007/s13193-023-01769-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 10/31/2023] Open
Abstract
Medullary carcinoma of the thyroid is a rare type of thyroid cancer that arises from the parafollicular cells or C-cells, which produce calcitonin. It accounts for approximately 5-10% of all thyroid cancers (Leboulleux et al. in Clin Endocrinol 61(3):299-310, 2004). The main treatment for medullary thyroid carcinoma is surgery, which involves the removal of the thyroid gland and any affected lymph nodes. In advanced cases where the cancer has spread to nearby structures such as the trachea (Gupta et al. in Indian J Surg Oncol 11(1):75-79, 2020), tracheal resection followed by reconstruction may be necessary to remove the cancer (Chernichenko et al. in Curr Opin Oncol 24(1):29-34, 2012) and restore proper breathing, closure of large tracheal defect can be done with pectoralis major myocutaneous flap (Salmerón-González et al. Plast Surg Nurs 38. 162-165, 2018). In this article, we report a case of recurrent medullary carcinoma thyroid with tracheal infiltration and tracheal resection was done, both of which is extremely rare. A 38-year-old male patient with a history of total thyroidectomy presented with recurrence was referred to our department, his previous biopsy and IHC revealed medullary carcinoma thyroid. Ga-68 DOTA PET CT scan was done which showed PET avid residual mass over right side, multiple bilateral cervical nodes, and tracheal infiltration (Fig. 1) then underwent a bronchoscopy showing involvement of the second, third, and fourth tracheal ring. Bilateral neck dissection with sleeve resection of trachea with overlying residual tumor was done and was sent for frozen which revealed positive margins and re-excision of margins was done, which lead to large defect (Fig. 2) which could not be closed primarily with a Montgomery T Tube. A de-epithelized pectoralis major myocutaneous flap used to close the tracheal defect followed by placing the Montgomery T Tube (Fig. 3).Post-operative period was uneventful. The final histopathology report showed R0 resection of tumor. T tube was removed after 4 weeks.
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Affiliation(s)
- Agil Babu
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
| | | | - Pinakin Patel
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
| | - Suresh Singh
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
| | - Manish Sahni
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
| | - Srikanth Nuttaki
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
| | - Pranav M. Singhal
- Department of Surgical Oncology, SMS Medical College, Jaipur Rajasthan, India
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Piazza C, Lancini D, Tomasoni M, D’Cruz A, Hartl DM, Kowalski LP, Randolph GW, Rinaldo A, Shah JP, Shaha AR, Simo R, Vander Poorten V, Zafereo M, Ferlito A. Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients. Front Endocrinol (Lausanne) 2021; 12:779999. [PMID: 34858348 PMCID: PMC8632531 DOI: 10.3389/fendo.2021.779999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.
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Affiliation(s)
- Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Brescia, Italy
- Department of Medical, Surgical and Radiological Sciences and Public Health, School of Medicine, University of Brescia, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Brescia, Italy
- Department of Medical, Surgical and Radiological Sciences and Public Health, School of Medicine, University of Brescia, Brescia, Italy
| | - Anil D’Cruz
- Director Oncology Apollo Group of Hospitals, Mumbai, India
| | - Dana M. Hartl
- Department of Head and Neck Oncology, Gustave Roussy, Université Paris Saclay, Paris, France
| | - Luiz P. Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Antonio Cândido (AC) Camargo Cancer Center, Sao Paulo, Brazil
| | - Gregory W. Randolph
- John and Claire Bertucci Endowed Chair in Thyroid Surgical Oncology, Harvard Medical School, Boston, MA, United States
| | | | - Jatin P. Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russia
| | - Ashok R. Shaha
- Jatin P Shah Chair in Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ricard Simo
- Department of Otorhinolaryngology – Head and Neck Surgery, Head, Neck and Thyroid Oncology Unit, Guy’s and St Thomas’ Hospital National Health Service (NHS) Foundation Trust and King’s College London, London, United Kingdom
| | - Vincent Vander Poorten
- Otorhinolaryngology – Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Mark Zafereo
- Division of Surgery, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Xia X, Zhu X, Zhu Y, Diao W, Chen X. A novel classification of tracheal defects and the reconstruction strategies: A retrospective study based on 106 cases. World J Otorhinolaryngol Head Neck Surg 2021; 9:66-73. [PMID: 37006741 PMCID: PMC10050954 DOI: 10.1016/j.wjorl.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022] Open
Abstract
Objective The study aims to present a novel classification of tracheal defects and the corresponding reconstruction strategies. Methods The retrospective study was designed to analyze patients with diagnosed primary or secondary tracheal tumors from 1991 to 2020. Surgical techniques, complications and prognosis were reviewed. Airway status and patient outcomes were the principal follow-up measures. Tracheal defects were classified into two plane sizes (vertical (V) and horizontal (H) planes). Vertical defects were further categorized into three groups based on their tracheal ring numbers (V1, ≤ 5 rings; V2, 6-10 rings; and V3, > 10 rings). Tracheal defects with horizontal plane size H1 and H2 represent defects less and more than one-half the circumference of trachea. Thus, suitable reconstruction strategies were planned primarily based on "V" and "H" classifications. The reconstruction strategies performed were sleeve resection followed by an end-to-end anastomosis, window resection with sternocleidomastoid myoperiosteal flap reconstruction, defects conversion with rotation anastomosis, and modified tracheostomy with secondary flap reconstruction. Results A total of 106 patients diagnosed with tracheal defects were enrolled in the study, of whom 59 patients underwent sleeve resection followed by end-to-end anastomosis; 40 patients received window resection alongside sternocleidomastoid (SCM) myoperiosteal flap reconstruction; five patients received converting defects with rotation anastomosis and two patients underwent modified tracheostomy with secondary stage flap reconstruction. Lumen stenosis occurred in three V2H1 defect cases and were treated by a second reconstruction surgery. Iatrogenic unilateral recurrent laryngeal nerve paralysis occurred in two patients with the V3H2 defect type, who were treated by temporary tracheotomy and partial vocal cord resection and extubated successfully during follow-up. All 106 patients achieved airway patency with adequate laryngeal function at the end of follow-up. No anastomotic dehiscence or bleeding occurred in any patient postoperatively. Conclusion Though a significant number of multicenter studies concerning the reconstruction and classification of tracheal defects are needed, the study herein provides a novel classification of tracheal defects, which is primarily developed on the defect size. Therefore, the study might serve as a potential source for identifying suitable reconstruction strategies for practitioners.
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Xia X, Cai Y, Zhu X, Zhu Y, Shen L, Zhou Y, Diao W, Chen X. Tracheal window resection and reconstruction via sternocleidomastoid flap for invasive thyroid carcinoma. Interact Cardiovasc Thorac Surg 2021; 33:899-904. [PMID: 34293120 DOI: 10.1093/icvts/ivab193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/13/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to present surgical techniques and evaluate outcomes of a sternocleidomastoid muscle (SCM) myoperiosteal flap used for the reconstruction of tracheal or laryngotracheal defects after the radical resection of invasive thyroid carcinoma. METHODS A retrospective study was performed for patients at Peking Union Medical College Hospital from January 2008 to December 2018 of papillary thyroid carcinoma with tracheal or laryngotracheal invasion. Patients were enrolled only when they received window resection and reconstruction via an SCM myoperiosteal flap. The primary outcome was a stable airway, and the secondary outcome was survival. RESULTS A total of 15 invasive thyroid carcinoma patients were enrolled in this study. Laryngotracheal and tracheal reconstruction were performed in 11 and 4 patients respectively, with a median vertical defect of 3.5 cm (3.0, 4.5). A stable airway was achieved in 14 patients postoperatively. One patient experienced tracheal stenosis and received a second operation of tracheal sleeve resection and end-to-end anastomosis 105 days after the first operation. Tracheostomy was conducted in 5 out of 15 patients in whom the vertical defects were larger than 4 cm, and the tubes were extubated after a median time of 56 days (32, 84). The median observation time was 55 months (48, 86), and all 15 patients achieved a stable airway and showed no evidence of local recurrence at the end of follow-up. CONCLUSIONS For thyroid carcinoma with tracheal or laryngotracheal invasions, window resection with the SCM myoperiosteal flap reconstruction presented positive results in terms of a stable airway as well as oncological outcomes. The SCM myoperiosteal flap can be an appropriate reconstruction strategy, especially when the defects reach the thyroid cartilage.
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Affiliation(s)
- Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yonghua Cai
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Le Shen
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yalin Zhou
- Operating Room, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Lorntzsen B, Brøndbo K, Osnes T. From the clavicle to the windpipe: Tracheal window resections reconstructed with calcifying periosteum in thyroid cancer. Laryngoscope Investig Otolaryngol 2020; 5:961-968. [PMID: 33134546 PMCID: PMC7585236 DOI: 10.1002/lio2.463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/08/2020] [Accepted: 09/13/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES We aimed to evaluate the outcomes of tracheal window resection and reconstruction using a vascularized periosteal flap (intended for calcification) harvested from the medial clavicle. This is one of several surgical techniques for tracheal resection and reconstruction used for patients with thyroid carcinoma invading the trachea. Importantly, in partial tracheal resection postoperative dynamic airway collapse must be prevented. Reconstruction of the tracheal defect with a vascularized periosteal flap is one method of achieving a stable airway. METHODS Twelve patients with locally advanced thyroid carcinoma who underwent tracheal resection and reconstruction at Oslo University Hospital from 2004 to 2017 were studied retrospectively. The primary outcome was a stable airway not requiring airway stenting. The secondary outcomes were the time to decannulation, morbidity, and survival. RESULTS Eleven of 12 patients did not require airway stenting postoperatively after a median of 111 days. Seven patients developed postoperative complications. The median observation time was 74.8 months (range 10.5-153.5) for all patients. The median disease-free survival was 40 months (range 0-147). By February 1, 2020, seven patients were alive, of whom five showed no evidence of disease. CONCLUSIONS Tracheal reconstruction with a vascularized periosteal flap yielded good results in terms of establishing a stable airway. This procedure is a viable reconstructive option that allows for decannulation by preventing airway collapse, thereby potentially mitigating the need for end-to-end (ETE) anastomosis or sleeve resections. For selected patients, this procedure may prevent local fatal complications from thyroid cancer invading the trachea. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Bianca Lorntzsen
- Institute of Clinical Medicine, Faculty of Medicine, University of OsloNorway
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive SurgeryOslo University HospitalOsloNorway
| | - Kjell Brøndbo
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive SurgeryOslo University HospitalOsloNorway
| | - Terje Osnes
- Institute of Clinical Medicine, Faculty of Medicine, University of OsloNorway
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Head, Neck and Reconstructive SurgeryOslo University HospitalOsloNorway
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Allen M, Spillinger A, Arianpour K, Johnson J, Johnson AP, Folbe AJ, Hotaling J, Svider PF. Tracheal Resection in the Management of Thyroid Cancer: An Evidence-Based Approach. Laryngoscope 2020; 131:932-946. [PMID: 32985692 DOI: 10.1002/lary.29112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Determine the effect of patient demographics and surgical approach on patient outcomes after tracheal resection in the management of thyroid cancer. STUDY DESIGN Systematic review and meta-analysis. METHODS Systematic review of literature was performed using PubMed, Embase, and Cochrane Library to identify patients with thyroid carcinoma who underwent tracheal resection. Pooled estimates for patient demographics, presenting findings, complications, and outcomes are determined using random-effects meta-analyses. RESULTS Ninety-six relevant studies encompassing 1,179 patients met inclusion criteria. Meta-analysis pooled rates of complications: 1.7% (confidence interval [CI] 0.8-2.5; P < .001; I2 = 1.85%) airway complications, 2.8% (CI 1.6-3.9; P < .001; I2 = 13.34%) bilateral recurrent laryngeal nerve paralysis, 2.2% (CI 1.2-3.1; P < .001; I2 = 6.72%) anastomotic dehiscence. Circumferential resection pooled estimates major complications, locoregional recurrence, distal recurrence, overall survival: 14.1% (CI 8.3-19.9; P < .001; I2 = 35.26%), 15% (CI 9.6-20.3; P < .001; I2 = 38.2%), 19.7% (CI 13.7-25.8; P < .001; I2 = 28.83%), 74.5% (CI 64.4-84.6; P < .001; I2 = 85.07%). Window resection estimates: 19.8% (CI 6.9-32.8; P < .001; I2 = 18.83%) major complications, 25.6% (CI 5.1-46.1; P < .014; I2 = 84.68%) locoregional recurrence, 15.6% (CI 9.7-21.5; P < .001; I2 = 0%) distal recurrence, 77.1% (CI 58-96.2; P < .001; I2 = 78.77%) overall survival. CONCLUSION Management of invasive thyroid carcinoma may require tracheal resection to achieve locoregional control. Nevertheless, postoperative complications are not insignificant, and therefore this risk cannot be overlooked when counseling patients perioperatively. Laryngoscope, 131:932-946, 2021.
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Affiliation(s)
- Meredith Allen
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, U.S.A
| | - Aviv Spillinger
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, U.S.A
| | | | - Jared Johnson
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Andrew P Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Medical School, Aurora, Colorado, U.S.A
| | - Adam J Folbe
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, U.S.A
| | - Jeffrey Hotaling
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.,Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Peter F Svider
- Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, New Jersey, U.S.A
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Liu J, Tang X, Shi F, Li C, Zhang K, Liu J, Wang G, Yin J, Li Z. Genetic polymorphism contributes to 131I radiotherapy-induced toxicities in patients with differentiated thyroid cancer. Pharmacogenomics 2018; 19:1335-1344. [PMID: 30430914 DOI: 10.2217/pgs-2018-0070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM To investigate the association between SNPs in DNA damage response pathways and toxicities following 131I radiotherapy of differentiated thyroid cancer (DTC). Materials & methods: We identified 22 functional SNPs of genes in DNA damage response pathways. MassArray was used to sequence SNP genotypes in 203 DTC patients. Hardy-Weinberg equilibrium and the associations between the two alleles of each SNP and toxicity reactions were evaluated using χ2 analysis. RESULTS Ataxia-telangiectasia mutated (ATM) rs620815 T-allele carriers were at increased risk of 131I radiation-induced gastrointestinal reaction compared with C allele carriers. TNFα rs1800629 GA genotype may increase the incidence of neck pain compared with GG genotype. Furthermore, TNFα rs1800629, ATM rs11212570, NF-κβ rs230493, and TGF-β rs1800469, rs2241716 were associated with throat pain following 131I radiotherapy. CONCLUSION The identified SNPs might serve as novel biomarkers for DTC treated with 131I radiotherapy.
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Affiliation(s)
- Jianqiu Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Xinyue Tang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China.,Department of Center for ADR Monitoring of Hubei, Wuhan 430071, PR China
| | - Feng Shi
- Department of Thyroid internal medicine, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China
| | - Cuilin Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Ke Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Jie Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Guo Wang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Jiye Yin
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Zhi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China.,Institute of Clinical Pharmacology, Central South University & Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
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Kim BY, Choi JE, Lee E, Son YI, Baek CH, Kim SW, Chung MK. Prognostic factors for recurrence of locally advanced differentiated thyroid cancer. J Surg Oncol 2017. [PMID: 28650576 DOI: 10.1002/jso.24740] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and Objectives To present treatment outcomes and prognostic factors for surgical management of locally advanced differentiated thyroid cancer (DTC). METHODS Retrospective review of 70 patients in a single, tertiary referral institution was done. Clinical pathology characteristics were analyzed to investigate prognosticators, based on primary endpoints; locoregional recurrence alone (LRR), total recurrence (LRR or distant metastasis (DM)), and recurrence-free survival. RESULTS Recurrent laryngeal nerve (n = 31) and trachea (n = 30) were most commonly invaded organs by tumor. At the mean follow-up of 81.7 months, LRR occurred in 15 patients and/or DM was detected in 15 patients (10 developed LRR and DM). By multivariate analysis, R1 resection (positive margin) and pN1b stage increased risk of LRR with a fold of 3.16 [95%CI 1.08-9.24, P = 0.03] and 5.92 [1.61-21.7, P = 0.007], respectively. Also, they increased risk of total recurrence with a fold of 3.04 [95%CI 1.26-7.31, P = 0.01] and 3.42 [95%CI 1.16-10.0, P = 0.02], respectively. Patients with pN1b stage showed better LRR-free survival than pN0/N1a stage (P = 0.03). Conclusions Along with careful preoperative evaluation of the extent of primary and neck disease, obtaining negative resection margin and aggressive neck management is critical to improve oncologic outcomes of locally advanced DTC.
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Affiliation(s)
- Bo-Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Eun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunkyu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sun Woo Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Abstract
The differential diagnosis of neuroendocrine neoplasms of the larynx is broad and includes lesions of epithelial, mesenchymal, and neuroectodermal origin. These lesions have overlapping clinical and pathologic aspects and must be carefully considered in the differential diagnosis of laryngeal neoplasms. The prognosis and treatment are also different among these tumor types, which necessitates making these distinctions clinically. The current literature was reviewed to provide updated information regarding the epithelial-derived tumors, including carcinoid, atypical carcinoid, small cell neuroendocrine carcinomas, large cell neuroendocrine carcinoma, and squamous cell carcinoma with neuroendocrine component. These tumors are compared and contrasted with non-epithelial-derived tumors such as paraganglioma and nonmucosal tumors, such as medullary thyroid carcinoma. The morphologic and cytologic features are discussed, along with helpful immunohistochemical and ancillary investigations.
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Wan F, Peng L, Zhu C, Zhang X, Chen F, Liu T. Knockdown of Latent Transforming Growth Factor-β (TGF-β)-Binding Protein 2 (LTBP2) Inhibits Invasion and Tumorigenesis in Thyroid Carcinoma Cells. Oncol Res 2016; 25:503-510. [PMID: 27712597 PMCID: PMC7841189 DOI: 10.3727/096504016x14755368915591] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Latent transforming growth factor-β (TGF-β)-binding protein 2 (LTBP2) is one of four proteins in the LTBP family of proteins (LTBP1-4) and was shown to play a vital role in tumorigenesis. However, little is known regarding the functional role of LTBP2 in thyroid carcinoma. Therefore, the current study aimed to evaluate the effect of LTBP2 expression on the proliferation, invasion, and tumorigenesis in thyroid carcinoma cells and to explore the molecular mechanism of LTBP2 in tumor progression. Our results showed that the expression of LTBP2 is upregulated in human thyroid carcinoma and cell lines. Knockdown of LTBP2 inhibits the proliferation, invasion, and EMT phenotype in thyroid carcinoma cells. Furthermore, knockdown of LTBP2 attenuates thyroid carcinoma growth in nude mice. Finally, knockdown of LTBP2 inhibits activation of the PI3K/Akt pathway in thyroid carcinoma cells. In summary, the present study has provided further evidence that knockdown of LTBP2 inhibits invasion and tumorigenesis in thyroid carcinoma cells. Our findings may help to further elucidate the molecular mechanisms underlying thyroid carcinoma progression and provide candidate targets for the prevention and treatment of thyroid carcinoma.
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Affiliation(s)
- Fuqiang Wan
- Department of Head and Neck Surgery, Linyi Tumor Hospital, Linyi, P.R. China
| | - Li Peng
- Department of Head and Neck Surgery, Linyi Tumor Hospital, Linyi, P.R. China
| | - ChaoYu Zhu
- Department No. 2 of Abdominal Surgery, Linyi Tumor Hospital, Linyi, P.R. China
| | - XinFa Zhang
- Department of Breast Surgery, Linyi Tumor Hospital, Linyi, P.R. China
| | - FangWen Chen
- Department of Head and Neck Surgery, Linyi Tumor Hospital, Linyi, P.R. China
| | - Tao Liu
- Department of General Surgery, Linyi People's Hospital, Linyi, P.R. China
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Piazza C, Del Bon F, Barbieri D, Grazioli P, Paderno A, Perotti P, Lombardi D, Peretti G, Nicolai P. Tracheal and Crico-Tracheal Resection and Anastomosis for Malignancies Involving the Thyroid Gland and the Airway. Ann Otol Rhinol Laryngol 2015; 125:97-104. [DOI: 10.1177/0003489415599000] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objectives: To evaluate outcomes in different malignancies involving the thyroid and infiltrating the airway submitted to tracheal (TRA) or crico-tracheal resection and anastomosis (CTRA). Methods: Retrospective charts review of 27 patients affected by thyroid malignancies involving the airway treated by TRA/CTRA in a single academic institution. Kaplan-Meier curves were used to evaluate the overall (OS) and disease-specific (DSS) survivals and local (LC) and loco-regional control (LRC). Impact on survival of age, comorbidities, previous radiotherapy, types of TRA/CTRA, Shin’s stage (II, III, IV), grading (well vs poorly differentiated), and length of airway resected was calculated by the log-rank test. Results: Overall survival and DSS at 3 and 5 years were 82.3% and 71.6%, respectively. Local control and LRC in the entire group were 82.3% at 3 and 5 years. Crico-tracheal resection and anastomosis involving the cricoid arch and plate (type C) and tumor differentiation significantly affected OS and DSS (both P < .001). Type C CTRA and tumor differentiation significantly impacted on LC ( P = .002 and P = .009, respectively). Conclusions: Grading and extension of CTRA to the cricoid plate are the most important factors for oncologic outcomes in thyroid malignancies infiltrating the airway. Except for poorly differentiated tumors, TRA/CTRA allows adequate LC even in advanced stage lesions involving the crico-tracheal junction.
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Affiliation(s)
- Cesare Piazza
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Francesca Del Bon
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Diego Barbieri
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Paola Grazioli
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Alberto Paderno
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Pietro Perotti
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Davide Lombardi
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Giorgio Peretti
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Genoa, Genoa, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Brescia, Brescia, Italy
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