1
|
Zitrický F, Koskinen A, Liska V, Försti A, Hemminki A, Hemminki K. Major improvement in thyroid cancer survival of elderly patients in the Nordic countries. Eur J Endocrinol 2024; 190:K32-K36. [PMID: 38436478 DOI: 10.1093/ejendo/lvae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/06/2024] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES We describe age-specific survival in thyroid cancer (TC) from Denmark, Finland, Norway, and Sweden over a 50-year period. DESIGN Population-based survival study. METHODS Relative 5-year survival data were obtained from the NORDCAN database for the years 1972-2021. RESULTS In the first period 1972-1976, 5-year survival in TC in Finland, Norway, and Sweden was 90% or higher, but a strong negative step-wise age gradient was observed, which was worse for men than women. Over time, survival increased, and in the final period, 2017-2021, survival for all women and Danish men up to age 69 years was about 90% or higher and, for men from the other countries, only marginally lower. Even for older women survival reached 80%, for older men somewhat less. CONCLUSIONS Age disadvantage in TC survival was for the most part corrected over the 50-year period, and the remaining task is to boost survival for the oldest patients.
Collapse
Affiliation(s)
- František Zitrický
- Biomedical Center, Faculty of Medicine, Charles University Pilsen, Pilsen 30605, Czech Republic
| | - Anni Koskinen
- Department of Otorhinolaryngology- Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland
| | - Vaclav Liska
- Biomedical Center, Faculty of Medicine, Charles University Pilsen, Pilsen 30605, Czech Republic
- Biomedical Center, Charles University Medical School, 32300 Pilsen, Czech Republic
| | - Asta Försti
- Hopp Children's Cancer Center (KiTZ), 69120 Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
| | - Akseli Hemminki
- Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, 00029 Helsinki, Finland
- Comprehensive Cancer Center, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Kari Hemminki
- Biomedical Center, Faculty of Medicine, Charles University Pilsen, Pilsen 30605, Czech Republic
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, Heidelberg D-69120, Germany
| |
Collapse
|
2
|
Chaves N, Broekhuis JM, Fligor SC, Collins RA, Modest AM, Kaul S, James BC. Delay in Surgery and Papillary Thyroid Cancer Survival in the United States: A SEER-Medicare Analysis. J Clin Endocrinol Metab 2023; 108:2589-2596. [PMID: 36987566 DOI: 10.1210/clinem/dgad163] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Delays in surgery and their impact on survival in papillary thyroid cancer (PTC) is unclear. We sought to investigate the association between time to surgery and survival in patients with PTC. METHODS A total of 8170 Medicare beneficiaries with PTC who underwent thyroidectomy were identified within the Surveillance, Epidemiology, and End Results-Medicare linked data files between 1999 and 2018. Disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meir analysis, and Cox proportional hazards models were specified to estimate the association between time to surgery and survival. RESULTS Among 8170 patients with PTC, mean age 69.3 (SD+/- 11.4), 89.8% had surgery within the first 90 days, 7.8% had surgery 91 to 180 days from diagnosis, and 2.4% had surgery after 180 days. Increasing time to surgery was associated with increased mortality for OS in the >180-day group [adjusted hazard ratio (aHR) 1.24; 95% CI, 1.01-1.53]. Moreover, on stratification by summary stage, those with localized disease in the 91- to 180-day group increased risk by 25% (aHR 1.25; 95%CI, 1.05-1.51), and delaying over 180 days increased risk by 61% (aHR 1.61; 95%CI, 1.19-2.18) in OS. Those with localized disease in the >180-day group had almost 4 times the estimated rate of DSS mortality (aHR3.51; 95%CI, 1.68-7.32). When stratified by T stage, those with T2 disease in the >180 days group had double the estimated rate of all-cause mortality (aHR 2.0; 95% CI, 1.1-3.3) and almost triple the estimated rate of disease-specific mortality (aHR 2.7; 95% CI, 1.05-6.8). CONCLUSIONS Delays in surgery for PTC may impact OS and DSS in localized disease, prior to nodal metastasis.
Collapse
Affiliation(s)
- Natalia Chaves
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Jordan M Broekhuis
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02215, USA
| | - Scott C Fligor
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02215, USA
| | - Reagan A Collins
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, MA 02214, USA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA 02214, USA
| | - Anna M Modest
- Harvard Medical School, Boston, MA 02215, USA
- Department of Obstetrics Gynecology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Sumedh Kaul
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Benjamin C James
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02215, USA
| |
Collapse
|
3
|
Plotuna IS, Balas M, Golu I, Amzar D, Vlad A, Moleriu LC, Vlad M. The Experience of a Single Tertiary Center Regarding Benign and Malignant Tumors in Acromegalic Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1148. [PMID: 37374352 DOI: 10.3390/medicina59061148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Acromegaly is a rare disease associated with increased levels of growth hormones (GHs) that stimulates the hepatic production of insulin growth factor-1 (IGF-1). Increased secretion of both GH and IGF-1 activates pathways, such as Janus kinase 2/signal transducer and activator of transcription 5 (JAK2/STAT5), and mitogen-activated protein kinase (MAPK), involved in the development of tumors. Materials and Methods: Given the disputed nature of the topic, we decided to study the prevalence of benign and malignant tumors in our cohort of acromegalic patients. In addition, we aimed to identify risk factors or laboratory parameters associated with the occurrence of tumors in these patients. Results: The study group included 34 patients (9 men (25.7%) and 25 women (74.3%)). No clear relationship between the levels of IGF-1 or GH and tumor development could be demonstrated, but certain risk factors, such as diabetes mellitus (DM) and obesity, were more frequent in patients with tumors. In total, 34 benign tumoral proliferations were identified, the most common being multinodular goiter. Malignant tumors were present only in women (14.70%) and the most frequent type was thyroid carcinoma. Conclusions: DM and obesity might be associated with tumoral proliferation in patients with acromegaly, and findings also present in the general population. In our study we did not find a direct link between acromegaly and tumoral proliferations.
Collapse
Affiliation(s)
- Iulia-Stefania Plotuna
- 2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Melania Balas
- 2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Ioana Golu
- 2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Daniela Amzar
- 2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Adrian Vlad
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine-Discipline of Diabetes, Nutrition and Metabolic Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Lavinia Cristina Moleriu
- Department of Functional Sciences-Discipline of Medical Informatics and Biostatistics, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| | - Mihaela Vlad
- 2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
- Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania
| |
Collapse
|
4
|
Clinicopathological characteristics, treatment and prognosis of oral adenocarcinoma: a population-based study. Eur Arch Otorhinolaryngol 2023; 280:3365-3374. [PMID: 36892615 DOI: 10.1007/s00405-023-07912-2] [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: 11/22/2022] [Accepted: 03/04/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES The aim of this study was to identify clinicopathologic features, treatment and prognosis of oral adenocarcinoma (OADC). STUDY DESIGN Retrospective cohort analysis. SETTING National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program. METHODS Patients diagnosed with OADC between 2000 to 2018 were identified from the SEER database. Overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier analyses and Cox regression models. RESULTS There were 924 OADC and 37,500 oral squamous cell carcinoma (OSCC) patients identified. Patients with OADC were more significantly associated with younger age, female gender, well differentiation and early AJCC Clinical stage. The study revealed that patients with OADC had better 10-year OS and DSS than those with OSCC (OS: 69.3% vs 40.8%, P < 0.001; DSS: 83.6% vs 53.3%, P < 0.001). The survival advantage still persisted in multivariable analyses (OS: hazard ratio [HR] = 0.427, P < 0.001; DSS: HR = 0.320, P < 0.001). For OADC, multivariable analysis showed that advanced age, stage, and histologic grade were associated with worse OS and DSS, and surgery was associated with better OS and DSS. CONCLUSIONS OADC has a significantly better prognosis than OSCC, with better differentiation, and more early stage. Surgery was the preferred treatment, for patients with lymph node metastasis, radiotherapy may afford a survival benefit.
Collapse
|
5
|
Tian T, Zhang Z, Chen T. PSG7 indicates that age at diagnosis is associated with papillary thyroid carcinoma: A study based on the cancer genome atlas data. Front Genet 2022; 13:952981. [PMID: 36276966 PMCID: PMC9579346 DOI: 10.3389/fgene.2022.952981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
The age of the patients at diagnosis (age at diagnosis) is a self-contained element of danger for the prognosis of patients with papillary thyroid carcinoma (PTC), which has been well recognized and continuously adopted by the international cancer staging system. However, few studies have investigated its intrinsic mechanisms. In this study, we aim to comprehensively reveal the age-related pathogenesis of PTC and identify potential prognostic biomarkers. We divided the samples into two groups, young and elderly, to filter differentially expressed genes in The Cancer Genome Atlas (TCGA), with an age of 55 years serving as a cutoff. Moreover, we combined univariate, LASSO, and multivariate Cox regression analyses to construct age-related signatures for predicting progression-free survival. Additionally, functional enrichment analysis, immune infiltration analysis, differential expression analysis, clinicopathological correlation analysis, and drug sensitivity analysis were performed in different risk subgroups and expression subgroups. We screened 88 upregulated genes and 58 downregulated genes. Both the LASSO regression model that is validated in TCGA and the model of six age-related prognostic genes (IGF2BP1, GPRC6A, IL37, CRCT1, SEMG1, and PSG7) can be used to evaluate the progression-free survival of PTC patients. The GO, KEGG, and GSEA analyses revealed that each key gene was closely associated with PTC development. Furthermore, CD8+ T cells decreased significantly, while regulatory T cells increased dramatically in the high-risk and PSG7 high expression groups. PSG7 was remarkably correlated with clinicopathological parameters (pathologic stage, T stage, and N stage) of PTC patients, and PSG7 expression was elevated in tumor samples from both TCGA and the Gene Expression Omnibus and was strongly associated with progressive stage and poor prognosis. Our results provide an innovative understanding of the age-related molecular mechanisms of PTC development. PSG7 was identified to exert a critical role in PTC progression and may serve as a promising strategy for predicting the prognosis of PTC.
Collapse
Affiliation(s)
- Tianjie Tian
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Zixiong Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Ting Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- *Correspondence: Ting Chen,
| |
Collapse
|
6
|
Taziki M, Rajaei S, Firouzei G, Hashemzadeh F, Rajabalian M, Mansoury M, Sedaghat S, Ghahraman F, Ghasemi-Kebria F, Weiderpass E, Roshandel G. Five-year relative survival and determinants of excess mortality in patients with head and neck and thyroid cancers: A population-based study from Golestan province, Northern Iran. Cancer Epidemiol 2022; 80:102247. [PMID: 36081275 DOI: 10.1016/j.canep.2022.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND We aimed to assess relative survival (RS) and determinants of excess mortality rate in patients with head and neck squamous cell carcinomas (HNSCC) and thyroid cancer in Golestan province, Northern Iran. METHODS We recruited new primary HNSCC and thyroid cancer cases from Golestan, 2006-2016. Five-year age-standardized RS with their 95% confidence intervals (CIs) were calculated. The relationships between different variables with excess mortality rates were assessed by estimating adjusted excess hazard ratios (aEHRs) with their 95% CIs. RESULTS Overall, 718 cases of HNSCC and 386 thyroid cancer cases were enrolled. Five-year age-standardized RS (95% CI) were 36% (31-41) and 61% (52-69) in HNSCC and thyroid cancer patients, respectively. There were significant relationship between excess mortality rates in HNSCC patients with metastasis (aEHR= 3.31; 95%CI: 2.26-4.84), treatment type (4.19; 2.54-6.91, for no treatment as compared to receiving both surgery and chemoradiotherapy), age (2.16; 1.57-2.96, for older age group) and smoking (2.00; 1.45-2.75, for smokers as compared to non-smokers). Determinant of the excess mortality in thyroid cancer patients included metastasis (19.65; 8.08-47.79), tumor morphology (12.27; 4.62-32.58, for anaplastic cancer as compared to papillary cancer), treatment type (8.95, 4.13-19.4, for no treatment as compared to receiving both surgery and iodine therapy) and age (2.31; 1.17-4.54, for older age group). CONCLUSION Our findings suggested low RS for thyroid cancer in our population, while the estimates for HNSCC were comparable with other population. Metastasis, treatment type and age were determinants of mortality both in thyroid and HNSCC patients.
Collapse
Affiliation(s)
| | - Siamak Rajaei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Golare Firouzei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahdis Rajabalian
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Mansoury
- Department of Statistics and Information Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fahimeh Ghahraman
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran.
| |
Collapse
|
7
|
Anwar SL, Cahyono R, Suwardjo S, Hardiyanto H. Extrathyroidal extension and cervical node infiltration are associated with recurrences and shorter recurrence-free survival in differentiated thyroid cancer: a cohort study. Thyroid Res 2022; 15:13. [PMID: 35883150 PMCID: PMC9327162 DOI: 10.1186/s13044-022-00131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Differentiated thyroid cancer has excellent overall survival. However, around 20% of patients experience recurrent diseases after a certain time of follow-up. Therefore, identification of risk factors for recurrence is necessary to adjust treatment and surveillance planning. Methods A retrospective study was conducted of 312 patients with differentiated thyroid cancer who received surgery with and without adjuvant treatment. Clinical and pathological risk factors were analyzed for recurrences. Results After median follow-up of 57 months, 109 of 312 patients (34.9%) developed recurrences. Extrathyroidal extension and positive cervical nodes were significantly associated with recurrences (OR = 2.449, 95%CI:1.260–4.760, P = 0.008 and OR = 3.511, 95%CI:1.860–6.626, P < 0.001; respectively). Lympho-vascular invasion (LVI) and tumor multifocality were also associated with increased risk of recurrence (OR = 2.577, 95%CI:1.380–4.812, P = 0.003 and OR = 1.602, 95%CI:1.001–2.495, P = 0.050; respectively). Using multivariable regression, only older age and tumor infiltration to the lymph nodes were significantly associated with recurrences (OR = 2.227, 95%CI:1.037–4.782, P = 0.040 and OR = 2.966, 95%CI:1.470–5.986, P = 0.002; respectively). In addition, T4, cervical lymph node infiltration, older age, and LVI were associated with shorter recurrence-free survival. Conclusion Recurrence rates in our study population are relatively high. Extrathyroidal extension, positive neck lymph node, and older age were associated with recurrence risks of well differentiated thyroid cancers.
Collapse
Affiliation(s)
- Sumadi Lukman Anwar
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia.
| | - Roby Cahyono
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
| | - Suwardjo Suwardjo
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
| | - Herjuna Hardiyanto
- Department of Surgery, Division of Surgical Oncology, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl Kesehatan No. 1, Yogyakarta, 55281, Indonesia
| |
Collapse
|
8
|
Is there a relationship between patient age, tumor multifocality, and capsular invasion in papillary thyroid carcinoma? Retrospective evaluation of pathology specimens. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1061503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Jin M, Ahn J, Lee YM, Sung TY, Song DE, Kim TY, Chung KW, Ryu JS, Kim WB, Shong YK, Jeon MJ, Kim WG. Clinical implications of age and excellent response to therapy in patients with high-risk differentiated thyroid carcinoma. Clin Endocrinol (Oxf) 2021; 95:882-890. [PMID: 34160840 DOI: 10.1111/cen.14543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patients with American Thyroid Association (ATA) high-risk differentiated thyroid carcinoma (DTC) have poor clinical outcomes. This study aimed to evaluate the clinical implications of age and response to therapy classification in patients with ATA high-risk DTC. DESIGN AND PATIENTS This study included 222 patients with high-risk DTC who initially underwent therapy between 2000 and 2010 in a single tertiary center in Korea. We evaluated the prognostic parameters associated with progression-free survival (PFS) and disease-specific survival (DSS) with a focus on age and achieving an excellent response (ER). RESULTS During the median follow-up period of 11.3 years, disease progression was detected in 77 patients (34.7%), and disease-specific mortality was reported in 31 patients (14.0%). Older age (≥55 years) and not achieving ER (not-ER) were independent risk factors associated with PFS (age, p < .001; not-ER, p < .001) and DSS (age, p < .001; not-ER, p = .015). Of the 74 patients in the ER group, 7 (9.5%) displayed disease progression and 1 (1.4%) died from DTC. There were no significant differences in PFS and DSS according to age in the ER group. However, older patients had significantly worse PFS and DSS than younger patients in the not-ER group (p = .002 and p < .001, respectively). CONCLUSIONS Response to therapy classification is important for predicting PFS and DSS in patients with high-risk DTC. Patients in the ER group had a relatively good prognosis, but disease progression occurred in 9.5% of patients. Age was a key predictor of both PFS and DSS in high-risk patients who did not achieve ER.
Collapse
Affiliation(s)
- Meihua Jin
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jonghwa Ahn
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yu-Mi Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Tae-Yon Sung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ki-Wook Chung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin-Sook Ryu
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| |
Collapse
|
10
|
Ye L, Hu L, Liu W, Luo Y, Li Z, Ding Z, Hu C, Wang L, Zhu Y, Liu L, Ma X, Kong Y, Huang L. Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study. BMC Cancer 2021; 21:1250. [PMID: 34800991 PMCID: PMC8605523 DOI: 10.1186/s12885-021-08875-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In patients with papillary thyroid cancer (PTC), cervical lymph node metastasis (LNM) must be carefully assessed to determine the extent of lymph node dissection required and patient prognosis. Few studies attempted to determine whether the ultrasound (US) appearance of the primary thyroid tumor could be used to predict cervical lymph node involvement. This study aimed to identify the US features of the tumor that could predict cervical LNM in patients with PTC. METHODS This was a retrospective study of patients with pathologically confirmed PTC. We evaluated the following US characteristics: lobe, isthmus, and tumor size; tumor position; parenchymal echogenicity; the number of lesions (i.e., tumor multifocality); parenchymal and lesional vascularity; tumor margins and shape; calcifications; capsular extension; tumor consistency; and the lymph nodes along the carotid vessels. The patients were grouped as no LNM (NLNM), central LNM (CLNM) alone, and lateral LNM (LLNM) with/without CLNM, according to the postoperative pathological examination. RESULTS Totally, 247 patients, there were 67 men and 180 women. Tumor size of > 10 mm was significantly more common in the CLNM (70.2%) and LLNM groups (89.6%) than in the NLNM group (45.4%). At US, capsular extension > 50% was most common in the LLNM group (35.4%). The multivariable analysis revealed that age (OR = 0.203, 95%CI: 0.095-0.431, P < 0.001) and tumor size (OR = 2.657, 95%CI: 1.144-6.168, P = 0.023) were independently associated with CLNM compared with NLNM. In addition, age (OR = 0.277, 95%CI: 0.127-0.603, P = 0.001), tumor size (OR = 6.069, 95%CI: 2.075-17.75, P = 0.001), and capsular extension (OR = 2.09, 95%CI: 1.326-3.294, P = 0.001) were independently associated with LLNM compared with NLNM. CONCLUSION Percentage of capsular extension at ultrasound is associated with LLNM. US-guided puncture cytology and eluent thyroglobulin examination could be performed as appropriate to minimize the missed diagnosis of LNM.
Collapse
Affiliation(s)
- Lei Ye
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China.
| | - Lei Hu
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Weiyong Liu
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China.
| | - Yuanyuan Luo
- Department of Laboratory, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230036, Anhui, China
| | - Zhe Li
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Zuopeng Ding
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Chunmei Hu
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Lin Wang
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Yajuan Zhu
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Le Liu
- Department of Ultrasound, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, No. 1, Tianehu Road, Hefei, 230036, Anhui, China
| | - Xiaopeng Ma
- Department of Surgery, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230036, Anhui, China
| | - Yuan Kong
- Department of Surgery, Division of Life Science and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230036, Anhui, China
| | - Liangliang Huang
- Department of Pathology, Division of Life Science and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230036, Anhui, China
| |
Collapse
|
11
|
Arora C, Kaur D, Naorem LD, Raghava GPS. Prognostic biomarkers for predicting papillary thyroid carcinoma patients at high risk using nine genes of apoptotic pathway. PLoS One 2021; 16:e0259534. [PMID: 34767591 PMCID: PMC8589158 DOI: 10.1371/journal.pone.0259534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/20/2021] [Indexed: 12/12/2022] Open
Abstract
Aberrant expressions of apoptotic genes have been associated with papillary thyroid carcinoma (PTC) in the past, however, their prognostic role and utility as biomarkers remains poorly understood. In this study, we analysed 505 PTC patients by employing Cox-PH regression techniques, prognostic index models and machine learning methods to elucidate the relationship between overall survival (OS) of PTC patients and 165 apoptosis related genes. It was observed that nine genes (ANXA1, TGFBR3, CLU, PSEN1, TNFRSF12A, GPX4, TIMP3, LEF1, BNIP3L) showed significant association with OS of PTC patients. Five out of nine genes were found to be positively correlated with OS of the patients, while the remaining four genes were negatively correlated. These genes were used for developing risk prediction models, which can be utilized to classify patients with a higher risk of death from the patients which have a good prognosis. Our voting-based model achieved highest performance (HR = 41.59, p = 3.36x10-4, C = 0.84, logrank-p = 3.8x10-8). The performance of voting-based model improved significantly when we used the age of patients with prognostic biomarker genes and achieved HR = 57.04 with p = 10−4 (C = 0.88, logrank-p = 1.44x10-9). We also developed classification models that can classify high risk patients (survival ≤ 6 years) and low risk patients (survival > 6 years). Our best model achieved AUROC of 0.92. Further, the expression pattern of the prognostic genes was verified at mRNA level, which showed their differential expression between normal and PTC samples. Also, the immunostaining results from HPA validated these findings. Since these genes can also be used as potential therapeutic targets in PTC, we also identified potential drug molecules which could modulate their expression profile. The study briefly revealed the key prognostic biomarker genes in the apoptotic pathway whose altered expression is associated with PTC progression and aggressiveness. In addition to this, risk assessment models proposed here can help in efficient management of PTC patients.
Collapse
Affiliation(s)
- Chakit Arora
- Indraprastha Institute of Information Technology-Delhi, Department of Computational Biology, New Delhi, India
| | - Dilraj Kaur
- Indraprastha Institute of Information Technology-Delhi, Department of Computational Biology, New Delhi, India
| | - Leimarembi Devi Naorem
- Indraprastha Institute of Information Technology-Delhi, Department of Computational Biology, New Delhi, India
| | - Gajendra P. S. Raghava
- Indraprastha Institute of Information Technology-Delhi, Department of Computational Biology, New Delhi, India
- * E-mail:
| |
Collapse
|
12
|
Saliba M, Mohanty AS, Ho AL, Drilon A, Dogan S. Secretory Carcinoma of the Thyroid in a 49-Year-Old Man Treated with Larotrectinib: Protracted Clinical Course of Disease Despite the High-Grade Histologic Features. Head Neck Pathol 2021; 16:612-620. [PMID: 34655408 PMCID: PMC9187813 DOI: 10.1007/s12105-021-01386-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022]
Abstract
Secretory carcinoma of the thyroid gland is histologically and genetically similar to its mammary and salivary gland counterparts. Unlike differentiated thyroid carcinomas of follicular cell origin, thyroid SC is not a thyroglobulin-producing tumor and would not be amenable to radioactive iodine therapy. Instead, these carcinomas may respond to targeted therapy with TRK inhibitors, which further emphasizes the importance of their recognition among morphologically similar thyroid entities. Based on eleven cases reported to date, most primary thyroid SC tend to present as locally advanced malignancies and are characterized by frequent recurrences and long-term survival. High-grade histologic features, increased mitotic count and necrosis have been described but their impact on clinical course and outcome remains unclear. We hereby report the case of a primary SC with high-grade features arising in the thyroid of a 49-year-old man, who was treated with Larotrectinib for his second recurrence. The patient achieved a durable response that lasted for 18 months but then he continued to progress and died of disease 181 months after the diagnosis.
Collapse
Affiliation(s)
- Maelle Saliba
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| | - Abhinita S. Mohanty
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| | - Alan L. Ho
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065 USA
| | - Alexander Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065 USA
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| |
Collapse
|
13
|
Mackinney EC, Kuchta KM, Winchester DJ, Khokar AM, Holoubek SA, Moo-Young TA, Prinz RA. Overall survival is improved with total thyroidectomy and radiation for male patients and patients older than 55 with T2N0M0 Stage 1 classic papillary thyroid cancer. Surgery 2021; 171:197-202. [PMID: 34666913 DOI: 10.1016/j.surg.2021.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND We examine whether surgery extent and radiation administration affect overall survival for cT2N0M0 classic papillary thyroid cancer according to age and sex. METHODS Patients with cT2N0M0 classic papillary thyroid cancer tumors in the National Cancer Data Base (2004-2016) were selected. Multivariable Cox regression analysis compared patients (combined male + female cohorts) having lobectomy to those having total thyroidectomy with or without radiation (primarily radioactive iodine) for ages: 18 to 45, 46 to 55, and >55 years. In addition, 1:1 propensity score matching and Kaplan-Meier curves with 10-year overall survival estimates, and log-rank test were stratified by age and sex. RESULTS Lobectomy had equivalent overall survival to total thyroidectomy without and with radiation for patients (combined male + female cohorts) aged 18 to 45 and 46 to 55 years on multivariable analysis. On propensity score matching there was overall survival advantage for total thyroidectomy with radiation over both lobectomy and total thyroidectomy for men (ages 18-90+ combined) and overall survival advantage in patients (combined male + female cohort) aged >55 years having total thyroidectomy with radiation versus lobectomy. On propensity score matching there were no overall survival differences in women (ages 18-90+ combined) or patients (combined male + female cohort) aged 18 to 45 and 46 to 55 years having either lobectomy, total thyroidectomy, or total thyroidectomy with radiation. CONCLUSION For cT2N0M0 classic papillary thyroid cancer, total thyroidectomy with radiation improves 10-year overall survival for patients (combined male + female cohort) aged >55 years and men (ages 18-90+ combined).
Collapse
Affiliation(s)
- Erin C Mackinney
- Department of Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL
| | - Kristine M Kuchta
- Bioinformatics and Research Core, NorthShore University HealthSystem, Evanston, IL
| | - David J Winchester
- Department of Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL
| | - Amna M Khokar
- Department of Surgery, University of Chicago, Chicago, IL
| | - Simon A Holoubek
- Augusta University, Otolaryngology Department, Head and Neck Surgery, Augusta, GA
| | - Tricia A Moo-Young
- Department of Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL
| | - Richard A Prinz
- Department of Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
| |
Collapse
|
14
|
Shu X, Tang L, Hu D, Wang Y, Yu P, Yang Z, Deng C, Wang D, Su X. Prediction Model of Pathologic Central Lymph Node Negativity in cN0 Papillary Thyroid Carcinoma. Front Oncol 2021; 11:727984. [PMID: 34646771 PMCID: PMC8503674 DOI: 10.3389/fonc.2021.727984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/10/2021] [Indexed: 11/25/2022] Open
Abstract
Background Most patients with papillary thyroid carcinoma (PTC) have an excellent prognosis. Although central lymph node invasion is frequent, management via central lymph node dissection (CLND) remains controversial. The present study retrospectively investigated independent predictors of pathologic central lymph node negativity (pCLN-) and established a prediction model for pCLN- in clinical lymph node negativity (cN0) PTC. Methods A total of 2,687 patients underwent thyroid surgery for cN0 PTC from 2013 to 2018 at the First Affiliated Hospital of Chongqing Medical University, and lobectomy plus ipsilateral CLND was the basic surgical extent. Clinicopathological characteristics were reviewed and analyzed. Univariate and multivariate analyses were performed to identify factors related to pCLN-. A prediction model was established based on the results of multivariate analyses. Results The pCLN- rate was 51.5% (1,383/2,687). Multivariate analysis revealed that sex, age, thyroid stimulating hormone (TSH), size, location, laterality, unifocality and extrathyroidal extension negativity (ETE-) were independent predictors of pCLN-. The nomogram showed good discriminative ability (C-index: 0.784 and 0.787 in derivation and validation groups, respectively) and was well calibrated. We quantified the clinical usefulness of the nomogram by decision curve analysis. The median length of follow-up was 30 (range 12– 83) months, and 190 cases were lost, with a follow-up rate of 92.9% (2,497/2,687). Of the 2,687 patients included, 21 (0.8%) experienced recurrence. Conclusion This nomogram, which integrates available preoperative clinicopathological features and intraoperative frozen biopsy outcomes, is a reliable tool with high accuracy to predict pCLN- in cN0 PTC.
Collapse
Affiliation(s)
- Xiujie Shu
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingfeng Tang
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Daixing Hu
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanyuan Wang
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Yu
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhixin Yang
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chang Deng
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Denghui Wang
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinliang Su
- Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
15
|
Li M, Huang Y, Wang M, Zeng W, Chen S, Zhou W, Wei W, Zhang C, Hu D, Huang J, Liu Z, Guo L. A new proposed tumor-node-metastasis-age staging system for stage IV medullary thyroid carcinoma based on the SEER database. Am J Transl Res 2021; 13:6098-6107. [PMID: 34306348 PMCID: PMC8290818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/08/2021] [Indexed: 06/13/2023]
Abstract
Medullary thyroid carcinoma (MTC) is a rare and lethal cancer. There are currently controversies regarding its staging. This study aimed to verify the significance of the patient's age in the prognosis of MTC and propose its addition to the current staging system. Data on cancer-specific survival (CSS) from the Surveillance, Epidemiology, and End Results database between 2010 and 2015 were used. X-Tile, nomograms, Cox proportional hazards regression analysis, Kaplan-Meier curves, and log-rank tests were used to evaluate mortality rates to create a new staging system. A total of 849 patients were included. Patients were divided into three categories based on their ages at diagnosis: ≤41 years, n = 224 (26.4%); 42-71 years, n = 516 (60.8%); and ≥72 years, n = 109 (12.8%). Independent factors for survival in the multivariate analysis included age (42-71 years, hazard ratio [HR], 2.81, 95% confidence interval [CI], 1.07-7.42; ≥72 years, HR, 8.71, 95% CI, 2.88-26.34), T stage (T2, HR, 3.60, 95% CI, 1.31-9.88), and M stage (M1, HR, 8.43, 95% CI, 4.40-16.16), with P<0.05. The Harrell's concordance index for tumor node metastasis (TNM) nomogram and TNM-age nomogram was 0.904 and 0.908, respectively. The areas under the curve (AUCs) for a 3-year CSS were 0.88 and 0.873, respectively. The corresponding AUCs for a 5-year CSS were 0.892 and 0.888, respectively. A new TNM-age staging system based on cancer-specific mortality rate analysis is proposed. This system provides a more accurate risk stratification and ensures more rational treatment measures for patients with stage IV MTC.
Collapse
Affiliation(s)
- Man Li
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Yihui Huang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Min Wang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Wen Zeng
- Department of Ophthalmology, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Sichao Chen
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Wei Zhou
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Wei Wei
- Department of Pediatrics, St. John Hospital and Medical CenterDetroit, MI, USA
| | - Chao Zhang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, Hubei Province, China
| | - Di Hu
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Jianglong Huang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| | - Zeming Liu
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, Hubei Province, China
| | - Liang Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan UniversityWuhan 430071, Hubei Province, China
| |
Collapse
|
16
|
Improvement of Overall Survival Using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience. J Clin Med 2021; 10:jcm10030384. [PMID: 33498404 PMCID: PMC7864191 DOI: 10.3390/jcm10030384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Tyrosine kinase inhibitors (TKIs) have improved progression-free survival in patients with advanced thyroid cancer. So far, few studies have investigated the efficacy of TKIs in a second-line setting. The purpose of our study was to explore the salvage therapy efficacy in patients with advanced thyroid cancer. Methods: We retrospectively evaluated 63 patients with progressive advanced thyroid carcinoma treated with TKIs divided into a Study group (23 patients) treated with salvage therapy, and a Control group (40 patients) treated with only one TKI. Results: Similar clinical benefits (stable disease + partial response) and progression free survival between the first and the second line TKI were observed in the Study group (p > 0.99 and p = 0.5, respectively). Median overall survival (OS) was 67.7 months in the Study group and 22.6 months in the Control group (HR 2.46; 95% CI 1.34–4.52, p = 0.004). After stratifying the whole population by age (<65 and ≥65 years), OS was significantly different (p < 0.001) with the best survival curve in younger patients, treated with salvage therapy and the worst in older subjects, treated with only one TKI. Conclusions: Salvage therapy showed a significant improvement of OS in patients with advanced thyroid cancer who experienced disease progression during prior TKI therapies.
Collapse
|
17
|
Chatchomchuan W, Thewjitcharoen Y, Karndumri K, Porramatikul S, Krittiyawong S, Wanothayaroj E, Vongterapak S, Butadej S, Veerasomboonsin V, Kanchanapitak A, Rajatanavin R, Himathongkam T. Recurrence Factors and Characteristic Trends of Papillary Thyroid Cancer over Three Decades. Int J Endocrinol 2021; 2021:9989757. [PMID: 34054949 PMCID: PMC8131146 DOI: 10.1155/2021/9989757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. The present study aimed to examine the trend of incidence and factors associated with recurrence and outcomes of papillary thyroid cancer (PTC) in Thai patients over the last 30 years. METHODS We reviewed the clinical data of all patients with PTC who were treated between 1987 and 2019 at Theptarin Hospital. Clinical characteristics, epidemic trend, factors associated with the persistence/recurrence of the disease, overall disease-specific survival rate, and overall disease-free survival rate were analysed. RESULTS A total of 235 patients with PTC who were registered between 1987 and 2019 were reviewed. The mean age was 42.5 ± 14.3 years, with a mean follow-up of 9.5 years. Papillary thyroid microcarcinoma (PTMC) was consistently increased and accounted for 21.4% (50/235) of total cases. The American Thyroid Association (ATA) risk stratification was high in 24% of all PTMCs in the last decade, and 16.0% of these patients experienced local recurrence during the follow-up period. Coexistence with Hashimoto's thyroiditis (HT) was found in one-fifth of the patients with PTC and was correlated with a low recurrence rate (HR: 0.16, P=0.013). Only age ≥55 years associated with the persistence/recurrence of the disease. The overall disease-free survival and disease-specific survival rates were 77.4% and 98.3%, respectively. CONCLUSIONS The prognosis of PTC is generally considered favorable. However, approximately one-fourth of patients with PTMC demonstrated more aggressive clinical behavior, particularly in the last decade of the study. Coexistence of HT contributed to a better prognosis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Siriwan Butadej
- Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand
| | | | | | | | | |
Collapse
|
18
|
Colonna M, Borson-Chazot F, Delafosse P, Schvartz C, Guizard AV. Progression of incidence and estimate of net survival from papillary thyroid cancers diagnosed between 2008 and 2016 in France. ANNALES D'ENDOCRINOLOGIE 2020; 81:530-538. [PMID: 33290751 DOI: 10.1016/j.ando.2020.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/01/2020] [Accepted: 11/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND After several decades of increasing incidence of papillary thyroid cancer (PTC), a change in this trend has been recently observed, particularly in the United States. This is attributed to the impact of new guidelines for the management of thyroid disease. The objective of this study was to describe the recent situation in France in terms of incidence and survival, taking account of tumor size. METHODS Data from the FRANCIM network cancer registries, covering around 25% of the French metropolitan population, were analyzed. Distribution according to tumor size was determined in terms of frequency, trends in incidence and spatial distribution for the period 2008-2016. Analysis of net survival considered gender, age and tumor size. RESULTS Cancers of size≤5mm were predominant in patients diagnosed between 55 and 74 years of age. Incidence of≤5mm tumors in women and of 5-10mm tumors in men began declining in the early 2010s. Incidence of 10-20mm and 20-40mm tumors in men increased significantly throughout the period 2008-2016. For both men and women, the incidence of the largest tumors (>40mm) also increased, but not significantly. The spatial distribution of incidence showed great heterogeneity. Net survival was generally high, although decreasing with age and tumor size. CONCLUSION The recent epidemiological situation in France is consistent with the hypothesis of recent progress in medical management of thyroid pathologies. Variations in incidence should be monitored for both small (<10mm) and larger tumors, and notably>40mm tumors. Net survival is generally high, although decreasing with age and tumor size.
Collapse
Affiliation(s)
- Marc Colonna
- Registre du cancer de l'Isère, Pavillon E, CHU Grenoble-Alpes, 38043 Grenoble, France; FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France.
| | - Françoise Borson-Chazot
- FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France; Registre Rhône Alpin des Cancers Thyroïdiens - Centre de médecine nucléaire et fédération d'endocrinologie, groupement hospitalier Est, hospices civils de Lyon, 69677 Lyon, France; Pôle d'information médicale évaluation recherche, hospices civils de Lyon, 69424 Lyon, France
| | - Patricia Delafosse
- Registre du cancer de l'Isère, Pavillon E, CHU Grenoble-Alpes, 38043 Grenoble, France; FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - Claire Schvartz
- FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France; Thyroid Cancer Registry of Marne-Ardennes, Institut Jean-Godinot, 1, rue du Général-Kœnig, 51100 Reims, France
| | - Anne-Valérie Guizard
- FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France; Registre des tumeurs du Calvados, Centre François Baclesse, 14076 Caen, France
| | -
- FRANCIM, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| |
Collapse
|
19
|
Jiang G, Zhang W, Wang T, Ding S, Shi X, Zhang S, Shi W, Liu A, Zheng S. Characteristics of genomic alterations in Chinese cholangiocarcinoma patients. Jpn J Clin Oncol 2020; 50:1117-1125. [PMID: 32533190 DOI: 10.1093/jjco/hyaa088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/21/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Cholangiocarcinoma (CCA) is a primary malignancy, which is often diagnosed as advanced and inoperable due to the lack of effective biomarkers and poor sensitivity of clinical diagnosis. Here, we aimed to identify the genomic profile of CCA and provided molecular evidence for further biomarker development. METHODS The formalin-fixed paraffin-embedded and matching blood samples were sequenced by deep sequencing targeting 450 cancer genes and genomic alteration analysis was performed. Tumor mutational burden (TMB) was measured by an algorithm developed in-house. Correlation analysis was performed by Fisher's exact test. RESULTS The most commonly altered genes in this cohort were TP53 (41.27%, 26/63), KRAS (31.75%, 20/63), ARID1A and IDH1 (15.87%, 10/63, for both), SMAD4 (14.29%, 9/63), FGFR2 and BAP1 (12.70%, 8/63, for both), and CDKN2A (11.11%, 7/63). BAP1 mutations were significantly correlated with the CCA subtype. LRP2 mutations were significantly associated with the younger intrahepatic CCA (iCCA) patients, while BAP1 was associated with iCCA patients aged 55-65 years old. BAP1 and LRP2 mutations were associated with TMB. CONCLUSIONS Most Chinese CCA patients were 50-70 years old. BAP1 and LRP2 mutations were associated with the age of iCCA patients.
Collapse
Affiliation(s)
- Guoping Jiang
- The Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, P.R. China
| | - Wu Zhang
- The Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, P.R. China
| | - Ting Wang
- The Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, P.R. China
| | - Songming Ding
- The Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, P.R. China
| | | | | | | | - Angen Liu
- OrigiMed Co. Ltd, Shanghai, P.R. China
| | - Shusen Zheng
- The Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| |
Collapse
|
20
|
Mourato FA, Almeida MA, Brito AET, Leal ALG, Almeida Filho P, Etchebehere E. FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta-analysis. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00390-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
21
|
Wang Y, Wang S, Zhang B. A Population-Based Analysis of Mucoepidermoid Carcinoma of the Oral Cavity. Laryngoscope 2020; 131:E857-E863. [PMID: 32692861 DOI: 10.1002/lary.28905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To identify survival outcomes for patients with mucoepidermoid carcinoma (MEC) of the oral cavity and the effects of different prognostic factors on survival. STUDY DESIGN Retrospective cohort study using a national database. METHODS Retrospective, population-based cohort study of patients in the Surveillance, Epidemiology and End Results (SEER) database who were diagnosed with MEC of the oral cavity from 1973 to 2016. Overall survival (OS) and disease-specific survival (DSS) were calculated. RESULTS A total of 1693 patients with MEC of the oral cavity were included. Of those, there are 696 males and 997 females, the average age at diagnosis being 52.4 years. The vast majority of cases (86.4%) presented with stage I and stage II disease. A total of 206 patients had received both surgical and radiation therapy (RT), while 1338 patients just had undergone only surgery and 149 with no treatment. On multivariate analysis, advanced age, stage, and histologic grade were associated with worse OS and DSS. Surgical therapy was an independent favorable predictor of OS and DSS. For radiotherapy, multivariate analysis showed that it was associated with worse DSS, whereas there was no significant difference in OS. CONCLUSION MEC of the oral cavity is associated with a generally favorable prognosis. Advanced age, stage, and histologic grade were independent negative prognostic factors for survival, and surgery was the main treatment to improve survival. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E857-E863, 2021.
Collapse
Affiliation(s)
- Yiting Wang
- Department of Stomatology, People's Hospital of Zhengzhou, Zhengzhou, China
| | - Shijie Wang
- Department of Hepatobiliary & Pancreatovascular Surgery, First affiliated Hospital of Xiamen University, Xiamen, China
| | - Bingyang Zhang
- Department of Hemangioma and Vascular Malformation Surgery, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China
| |
Collapse
|
22
|
Qiu ZL, Shen CT, Sun ZK, Song HJ, Xi C, Zhang GQ, Wang Y, Luo QY. Long-Term Outcomes and Prognoses of Elderly Patients (≥65-Years-Old) With Distant Metastases From Well-Differentiated Thyroid Cancer During Radioiodine Therapy and Follow-Up. Front Endocrinol (Lausanne) 2020; 11:588024. [PMID: 33716950 PMCID: PMC7947854 DOI: 10.3389/fendo.2020.588024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the clinicopathological characteristics, long-term outcomes, and prognostic factors of elderly patients with distant metastases at initial diagnosis from well-differentiated thyroid cancer (WDTC) during radioactive iodine (131I) treatment and follow-up. METHODS A retrospective review of medical records identified 183 elderly patients with DTC who underwent 131I treatment at our institution between 2006 and 2019. RESULTS In total, 57 elderly WDTC patients with distant metastases were enrolled in this study. After 131I treatment, 32 (56.14%) patients had 131I avidity and 25 (43.86%) had non-131I avidity; 35 (61.40%) cases were classified as radioiodine refractory (RR)-WDTC and 22 (38.60%) as non-RR-WDTC. At the end of follow-up, 25 (43.86%) patients had died and 32 (56.14%) were alive. The 5- and 10-year overall survival (OS) rates were 71.50% and 30.49%, respectively, while the 5- and 10-year disease-specific survival (DSS) rates were 76.89% and 48.71%, respectively. Multivariate analyses showed that gross extrathyroidal extension and RR-DTC were independent prognostic factors for poor OS (P=0.04 and P=0.03, respectively), while gross extrathyroidal extension, extrapulmonary distant metastases, and RR-WDTC were independent prognostic factors for poor DSS at the end of follow-up (P=0.02, P=0.03, and P=0.02, respectively). CONCLUSIONS WDTC with distant metastases at initial diagnosis accounted for 31.15% of all elderly patients with DTC. Gross extrathyroidal extension and RR-DTC were the major factors associated with poor OS; gross extrathyroidal extension, extrapulmonary distant metastases, and RR-DTC were independent prognostic factors for poor DSS in elderly DTC patients with distant metastases.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Yang Wang
- *Correspondence: Quan-Yong Luo, ; Yang Wang,
| | | |
Collapse
|
23
|
He Q, Huang Y, Wan G, Feng M, Zeng H, Liu M, Luo H, Yang Y, Song X, Zhang L, Lang J. A novel prognostic marker based on risk stratification with prognostic nutritional index and age for nasopharyngeal carcinoma patients who received neoadjuvant chemotherapy. Biomark Med 2019; 13:1013-1023. [PMID: 31385518 DOI: 10.2217/bmm-2018-0401] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: To evaluate the prognostic value of pretreatment prognostic nutritional index (PNI) in nasopharyngeal carcinoma (NPC) patients treated with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy. Materials & methods: We conducted a retrospective study on prognostic value of PNI in NPC patients. A new prognostic marker was explored based on risk stratification with PNI and age. Results: PNI and age were two independent prognostic factors for overall survival (OS) and progression free survival besides node stage and clinical stage. Low prognostic nutritional index and high age (LPNI-HAge) was identified as an independent prognostic factor for both OS (p < 0.001) and progression free survival (p = 0.008), which has a better predict value than sole PNI or age. Conclusion: The novel prognosis index LPNI-HAge provides prognostication of OS and progression free survival for NPC patients treated with neoadjuvant chemotherapy plus concurrent chemoradiotherapy.
Collapse
Affiliation(s)
- Qiao He
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Yecai Huang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Gang Wan
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Mei Feng
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Huamin Zeng
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Mengru Liu
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Huaichao Luo
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Yuanyuan Yang
- Department of Medical information, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Xiaoyu Song
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Li Zhang
- Department of Clinical Laboratory, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| | - Jinyi Lang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu, PR China
| |
Collapse
|