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Xu S, Huang H, Xian K, Wang X, Xu Z, Liu S, Liu J. Extent of surgery for unilateral papillary thyroid cancer with nonsuspicious contralateral nodules by ultrasound. Endocrine 2024:10.1007/s12020-024-03850-z. [PMID: 38703328 DOI: 10.1007/s12020-024-03850-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The discussion about surgical treatment of patients with papillary thyroid cancer(PTC) has been an ongoing issue, which is mainly focused on characteristics of tumor, but rarely on nonsuspicious contralateral nodules. We aimed to compare recurrence-free survival(RFS)/progression-free survival(PFS) of unilateral PTC patients with nonsuspicious contralateral nodules after different extents of surgery. METHODS Unilateral PTC patients with nonsuspicious contralateral nodules underwent surgery from 2015 to 2017 were enrolled. The association between surgical extent and RFS/PFS was analyzed by Kaplan-Meier method and Cox proportional hazards model. RESULTS A total of 1293 PTC patients (595[46.0%]TT,523[40.4%]lobectomy+nodule enucleation(LNE),175[13.5%]lobectomy) were analyzed. Patients with a greater surgical extent were more likely to be older, have a greater multifocality of the tumor and contralateral nodules, larger contralateral nodules and primary tumors, and more micro extrathyroidal extension (P < 0.05). After a median follow-up of 45 months, significant growth(>3 mm) was identified in 24 (4.6%) and 19 (10.9%) patients in the LNE and lobectomy group, 7 (1.2%), 14 (2.7%) and 11 (6.3%) structural recurrences and 7 (1.2%), 11 (2.1%) and 7 (4.0%) progression in disease were identified in the TT, LNE and lobectomy groups, respectively. Unadjusted and adjusted RFS/PFS were significantly worse for patients treated with lobectomy than for those who underwent LNE or TT(3-year RFS, 95.5%, 98.2% vs. 99.0%; 3-year PFS, 97.9%, 98.9% vs. 99.0%, P < 0.05), but difference in PFS between LNE and TT lost statistical significance (unadjusted P = 0.226, adjusted P = 0.150). CONCLUSIONS Due to subtle changes in nodules and acceptable prognosis, lobectomy is a considerable option for unilateral PTC patients with nonsuspicious nodules, when a similar prognosis to TT is expected, LNE may be an effective alternative to optimize quality of life.
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Affiliation(s)
- Siyuan Xu
- Department of Otolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hui Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keyao Xian
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolei Wang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhengang Xu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoyan Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Jie Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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do Prado Padovani R, Duarte FB, Nascimento C. Current practice in intermediate risk differentiated thyroid cancer - a review. Rev Endocr Metab Disord 2024; 25:95-108. [PMID: 37995023 DOI: 10.1007/s11154-023-09852-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
Although the overall prognosis for differentiated thyroid cancer (DTC) is excellent, a subset of patients will experience disease recurrence or may not respond to standard treatments. In recent years, DTC management has become more personalized in order to enhance treatment efficacy and avoid unnecessary interventions.In this context, major guidelines recommend post-surgery staging to assess the risk of disease persistence, recurrence, and mortality. Consequently, risk stratification becomes pivotal in determining the necessity of postoperative adjuvant therapy, which may include radioiodine therapy (RIT), the degree of TSH suppression, additional imaging studies, and the frequency of follow-up.However, the intermediate risk of recurrence is a highly heterogeneous category that encompasses various risk criteria, often combined, resulting in varying degrees of aggressiveness and a recurrence risk ranging from 5 to 20%. Furthermore, there is not enough long-term prognosis data for these patients. Unlike low- and high-risk DTC, the available literature is contradictory, and there is no consensus regarding adjuvant therapy.We aim to provide an overview of intermediate-risk differentiated thyroid cancer, focusing on criteria to consider when deciding on adjuvant therapy in the current context of personalized approach, including molecular analysis to enhance the accuracy of patient management.
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Affiliation(s)
- Rosalia do Prado Padovani
- Section of Endocrinology and Metabolism, Department of Medicine, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Doutor Cesário Mota Junior, , 61 - SAO PAULO -CEP, São Paulo, 1221020, Brazil.
| | - Fernanda Barbosa Duarte
- Section of Endocrinology and Metabolism, Department of Medicine, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Doutor Cesário Mota Junior, , 61 - SAO PAULO -CEP, São Paulo, 1221020, Brazil
| | - Camila Nascimento
- Nuclear Medicine Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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Parida PK, Pradhan S, Preetam C, Pradhan P, Samal DK, Sarkar S. Prevalence and Predictors of Malignancy in Contralateral Thyroid Lobe in Patients Undergoing Completion Thyroidectomy. Indian J Otolaryngol Head Neck Surg 2022; 74:2053-2060. [PMID: 36452700 PMCID: PMC9702099 DOI: 10.1007/s12070-020-02009-2] [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: 06/11/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
Abstract
(1) To determine prevalence of malignancy in contralateral lobe (CL) in patients undergoing completion thyroidectomy (CT) and to study complications of CT. (2) To analyze clinical, ultrasonography(USG) findings and histopathological features of the tumor in ipsilateral lobe (IL) that could predict malignancy in CL. Retrospective chart review of 40-patients who first underwent hemi-thyroidectomy for fine-needle-aspiration (FNA) diagnosed benign lesions followed by CT between September-2017 and November-2019. Histopathology reports from both surgeries, along with patient characteristics and USGfeatures of initial hemi-thyroid lobe were reviewed. Thirty-two (80%) of the 40 patients were female. Mean age of presentation was 38.2 years (Range = 19-61years). Malignancy was found in 22(55%) contralateral-lobes of 40 completion thyroidectomies performed. Multi-focality of tumor in first surgery was only factor with significant association with presence of malignancy in CL (OR = 5.53, 95% CI 1.01-30.35, p = 0.048).In terms of USG-findings, most common suspicious feature in IL was peripheral/rim calcification, with TIRADS ≥ 4 was present in 19 patients but none of features could significantly predict bilateral disease. Three (7.5%) patients developed permanent unilateral recurrent-laryngeal-nerve (RLN) palsy (2-following initial surgery and 1-following CT). Fourteen (35%) patients developed hypoparathyroidism following CT of whom 12 were symptomatic and 4(10%) proceeded to permanent hypoparathyroidism. There were no other major complication following CT. Multifocality in initial hemithyroidectomy specimen was most frequently associated with malignancy in CL. Preoperative TIRADS ≥ 4 of IL may be considered a risk factor for bilateral malignancy. CT may be performed in FNA misdiagnosed thyroid cancers as there is high prevalence(56%) of disease in CL. CT is safe and it eradicates disease in CL.
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Affiliation(s)
- Pradipta Kumar Parida
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
| | - Siddhartha Pradhan
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
| | - Chapity Preetam
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
| | - Pradeep Pradhan
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
| | - Dillip Kumar Samal
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
| | - Saurav Sarkar
- Department of ENT & Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapara, Bhubaneswar, Odisha 751020 India
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Wang N, Qian LX. Predictive Factors for Occult Bilateral Papillary Thyroid Carcinoma. Acad Radiol 2021; 28:328-332. [PMID: 32253114 DOI: 10.1016/j.acra.2020.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Bilateral papillary thyroid carcinoma (PTC) requires aggressive treatment, such as total thyroidectomy (TT). If there is only an isolated PTC focus in one lobe that can be diagnosed preoperatively, and it is unknown whether there are foci in the contralateral lobe that are too small to be detected, it is difficult to know whether to perform TT or to remove only the lobe with the isolated PTC focus. Here, we investigated the prevalence of and predictive factors for occult bilateral PTC that was only diagnosed unilaterally before surgery. METHODS This retrospective study involved 586 patients with unilateral PTC who were diagnosed preoperatively by ultrasound. They underwent TT and cervical lymph node dissection. According to the pathology, they were divided into unilateral PTC and bilateral (Bil)-PTC groups. Student's t test, chi-squared test, and multivariate analysis were performed to identify features of the malignant tumor that increased the likelihood of malignancy in the contralateral lobe. The prevalence of occult Bil-PTC was calculated. RESULTS Bil-PTC was found in 70 of 586 (11.95%) PTC patients. Multivariate analysis showed that vascularity (odds ratio[OR]: 2.180, 95% confidence interval [CI]: 1.142-4.162, p = 0.018) and ultrasound diagnosis of lymph node metastasis (USLNM) (OR: 2.056, 95% CI: 1.056-4.004, p = 0.034) were independent predictors of occult Bil-PTC. CONCLUSION The prevalence of occult PTC in the contralateral lobe was only 11.95%. Vascularity and USLNM were risk factors for Bil-PTC. In terms of these preoperative risk factors for PTC, TT should be cautiously performed in patients with preoperative diagnosis of PTC with isolated focus.
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Affiliation(s)
- Ning Wang
- Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, 95 Yong an Street, Xicheng District, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, 95 Yong an Street, Xicheng District, Beijing, China.
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5
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Ma T, Wang H, Liu J, Zou J, Liu S. Should Contralateral Nodules Be an Indication of Total or Completion Thyroidectomy for Patients With Unilateral Papillary Thyroid Carcinoma? Front Endocrinol (Lausanne) 2021; 12:723631. [PMID: 34434171 PMCID: PMC8380921 DOI: 10.3389/fendo.2021.723631] [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: 06/11/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine whether papillary thyroid carcinoma (PTC) patients with benign or nonsuspicious nodules in the contralateral lobe have a higher rate of recurrence or worse survival after lobectomy compared to those without nodules in the contralateral lobe. METHODS Adult patients who underwent lobectomy and were diagnosed with unilateral PTC (2013-2015), were identified from an institutional database. Patients who previously had cytologically benign nodules or nonsuspicious nodules in the contralateral lobe comprised the contralateral nodule (CN) group. Patients who did not have nodules in the contralateral lobe comprised the unilateral nodule (UN) group. RESULTS 370 patients were included: 242 in the UN group and 128 in the CN group. After a median follow-up of 62 months (range, 16-85 months), recurrence was confirmed in 4.1% patients in the UN group and 5.5% patients in the CN group (p = 0.559). Clinical contralateral lobe PTC was detected in 2.9% (7/242) of patients from the UN group and 3.9% (5/128) of patients from the CN group (p = 0.601). The 5-year contralateral lobe recurrence-free survival (RFS) rates were 96.8% in the UN group and 97.4% in the CN group (p = 0.396). The 5-year loco-regional RFS rates were 98.4% in the UN group and 97.8% in the CN group (p = 0.690). The 5-year disease-specific survival rates were both 100%. CONCLUSION PTC patients with benign or nonsuspicious CNs have similar recurrence and survival rates after lobectomy compared to those without CNs. CNs alone should not be an indication for total or completion thyroidectomy.
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Ronen O, Robbins KT, Olsen KD, Shaha AR, Randolph GW, Nixon IJ, Zafereo ME, Hartl DM, Kowalski LP, Rodrigo JP, Coca-Pelaz A, Mäkitie AA, Vander Poorten V, Sanabria A, Angelos P, Rinaldo A, Ferlito A. Case for staged thyroidectomy. Head Neck 2020; 42:3061-3071. [PMID: 32761849 DOI: 10.1002/hed.26393] [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: 04/28/2020] [Revised: 06/01/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022] Open
Abstract
Recent modifications in the management of well-differentiated thyroid cancer have resulted in significant alterations in clinical approach. Utilizing a series of preoperative and postoperative risk factors involving both the patient and the disease pathology, we offer the term "staged thyroidectomy" to help organize these risk factors for patients and the endocrine team to optimize management. This approach is intended to incorporate our latest nuanced understanding of certain endocrine pathology and may serve to optimize patient outcomes.
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Affiliation(s)
- Ohad Ronen
- Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - K Thomas Robbins
- Department of Otolaryngology Head and Neck Surgery, Southern Illinois University Medical School, Springfield, Illinois, USA
| | - Kerry D Olsen
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Iain J Nixon
- Department of Otorhinolaryngology Head and Neck Surgery, Edinburgh Royal Infirmary, Edinburgh, UK
| | - Mark E Zafereo
- Head and Neck Endocrine Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dana M Hartl
- Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.,Laboratoire de Phonétique et de Phonologie, Paris, France
| | - Luiz P Kowalski
- Department of Otorhinolaryngology-Head and Neck Surgery, A.C. Camargo Cancer Center, São Paulo, Brazil.,Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-ISPA, Oviedo, Spain.,Department of Otolaryngology, University of Oviedo-IUOPA, Oviedo, Spain.,Head and Neck Cancer Unit, CIBERONC, Madrid, Spain
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias-ISPA, Oviedo, Spain.,Department of Otolaryngology, University of Oviedo-IUOPA, Oviedo, Spain.,Head and Neck Cancer Unit, CIBERONC, Madrid, Spain
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, Medellín, Colombia.,Department of Surgery, CEXCA-Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois, USA
| | - Alessandra Rinaldo
- Department of Otolaryngology, University of Udine School of Medicine, Udine, Italy
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Bahat Dinur A, Quint E, Lupo L, Fraenkel M, El-Saied S, Joshua BZ. Limitations of ultrasound in predicting bilaterality vs unilaterality of well-differentiated carcinoma of the thyroid. Am J Otolaryngol 2020; 41:102543. [PMID: 32474327 DOI: 10.1016/j.amjoto.2020.102543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/24/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study is to assess the efficacy of ultrasonography in the differentiation of a bilateral and a unilateral WDTC to help physicians decide on performing a total or a partial thyroidectomy. MATERIALS AND METHODS Retrospective chart review of all patients diagnosed with papillary thyroid carcinoma following a total thyroidectomy or a complete thyroidectomy between January 2013 and December 2015 at the Department of Otorhinolaryngology and Head and Neck Surgery in Soroka University Medical Center in southern Israel. The preoperative ultrasound images of the thyroid were compared to the final pathology in the contralateral lobe. RESULTS Seventy seven patients (77) were included in this study, There was no correlation between the sonography in the contralateral lobe and the malignancy on that side (p = 0.479). US had a 39% false negative rate and 69% false positive rate. CONCLUSION The patients with a well-differentiated carcinoma of the thyroid, a benign nodule detected sonographically in the contralateral lobe should not bear a high weight in decision making regarding the extent of surgery.
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Affiliation(s)
- Anat Bahat Dinur
- Department of Otolaryngology and Head and Neck Surgery, Soroka Medical Center, Israel
| | - Elhanan Quint
- Department of Surgery B, Soroka Medical Center, Beer Sheva, Israel
| | - Liliana Lupo
- Department of Radiology, Soroka Medical Center, Beer Sheva, Israel
| | - Merav Fraenkel
- Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka Medical Center, Israel; Endocrinology Unit, Soroka Medical Center, Beer Sheva, Israel
| | - Sabri El-Saied
- Department of Otolaryngology and Head and Neck Surgery, Soroka Medical Center, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka Medical Center, Israel.
| | - Ben-Zion Joshua
- Department of Otolaryngology and Head and Neck Surgery, Soroka Medical Center, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka Medical Center, Israel
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Baumgarten H, Jenks CM, Isaza A, Bhatti T, Mostoufi-Moab S, Kazahaya K, Adzick NS, Bauer AJ. Bilateral papillary thyroid cancer in children: Risk factors and frequency of postoperative diagnosis. J Pediatr Surg 2020; 55:1117-1122. [PMID: 32171533 DOI: 10.1016/j.jpedsurg.2020.02.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 02/20/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The recommendation for children with papillary thyroid cancer (PTC) is total thyroidectomy (TT) based on the incidence of bilateral disease. Evaluating this assumption, we reviewed the characteristics of bilateral PTC in a large cohort of children. METHODS A retrospective chart review for patients surgically treated for PTC from 2009 to 2018 analyzing preoperative risk factors, ultrasound findings, and pathology results was performed. Bilateral disease was defined as pathologic PTC in the contralateral lobe, including microscopic disease. RESULTS Of the 172 patients included, 38.4% had bilateral disease with 23% diagnosed postoperatively. Multifocal disease on ultrasound was associated with bilateral disease (OR 2.9, 95% CI 1.5-5.9, p = 0.002). Nodule dimension >2 cm was associated with increased risk for postoperative bilateral disease (OR 3.5, 95% CI 1.6-7.4, p = 0.001). Patients with bilateral disease were more likely to have extrathyroidal extension, lymphovascular invasion, positive central lymph nodes, and extranodal extension (p < 0.001 for all). Diffuse-sclerosing variant PTC was also associated with bilateral disease. CONCLUSION Thirty-eight percent of children were diagnosed with PTC demonstrate bilateral disease. Nearly one in four have occult bilateral disease. The features that predicted bilateral disease were multifocality, widely invasive PTC on ultrasound, and the presence of lymphadenopathy. Thus, TT is the appropriate surgical approach for pediatric patients with PTC. TYPE OF STUDY Clinical Research, Retrospective Review. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Heron Baumgarten
- Department of Surgery, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Carolyn M Jenks
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Amber Isaza
- Department of Pediatrics, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Tricia Bhatti
- Department of Pediatrics, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Sogol Mostoufi-Moab
- Department of Pediatrics, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Ken Kazahaya
- Department of Pediatric Otolaryngology, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - N Scott Adzick
- Department of Surgery, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA
| | - Andrew J Bauer
- Department of Pediatrics, Pediatric Thyroid Center, Children's Hospital of Philadelphia and Perelman School of Medicine University of Pennsylvania, Philadelphia, PA.
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9
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Total thyroidectomy vs completion thyroidectomy for thyroid nodules with indeterminate cytology/follicular proliferation: a single-centre experience. BMC Surg 2019; 19:87. [PMID: 31291921 PMCID: PMC6617582 DOI: 10.1186/s12893-019-0552-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Despite total thyroidectomy (TT) is the most practiced procedure for a preoperatively diagnosed neoplastic lesion, according to the ATA guidelines, many surgeons perform completion thyroidectomy (CT) after hemithyroidectomy for patients with preoperative follicular proliferation/indeterminate cytology who are diagnosed with malignancy. CT has a higher complication rate than the primary procedure. The primary endpoint of our study is to compare the morbidity rate after CT with that after primary TT in patients with follicular proliferation/indeterminate cytology. Methods We retrospectively reviewed 237 patients who underwent thyroid surgery from 2009 to 2018 at our institution. We recruited only patients with follicular proliferation/indeterminate cytology and excluded those undergoing lymphadenectomies and thyroidectomies for benign pathology and staged thyroidectomies after intraoperative documentation of a RLN lesion. One hundred eighty-six of these patients underwent TT, and fifty-one underwent CT for the detection of differentiated thyroid cancer at the histological exam. Results No differences were found in the total complication rates between the two groups (OR 0,76, 95% CI 0.35–1.65, P = 0.49). We did not find any significant differences in the subgroup analysis. In particular, no significant differences were identified for transient hypocalcaemia (OR 1.17, 95% CI 0.44–3.11; P = 0,74), permanent hypocalcaemia (OR 1.04, 95% CI 0.21–5.18; P = 0,95), transient unilateral recurrent laryngeal nerve palsy (OR 0.78, 95% CI 0.21–2.81; P = 0,16), permanent unilateral recurrent laryngeal nerve palsy (OR 1.48, 95% CI 0.28–7.85; P = 0,61), and haematoma (OR 1,84, 95% CI 0,16-20,71; P = 0,61). Conclusions CT following hemithyroidectomy can be performed with acceptable morbidity in patients with thyroid nodules with preoperative indeterminate cytology/follicular proliferation.
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Completion Thyroidectomy in Differentiated Thyroid Malignancy-A Prospective Analysis. Indian J Surg Oncol 2019; 10:130-134. [PMID: 30948887 DOI: 10.1007/s13193-018-0845-4] [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: 07/18/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022] Open
Abstract
Completion thyroidectomy, being a surgically challenging procedure, choice of doing such procedure in differentiated thyroid cancer (DTC), remains unclear due to the complications involved following the procedure. So this study is intended to look into risk factors that will prompt completion thyroidectomy and surgery-related complications. A prospective analysis was done in 48 patients diagnosed with DTC during the year 2017. Completion thyroidectomy with or without neck dissection was performed as per institutional protocol. Clinico-radiological features were compared with histopathology in completion thyroidectomy specimen. The incidence of malignancy in completion thyroidectomy specimen and complications during the procedure were noted. Risk factors associated with malignancy were statistically analyzed. The incidence of malignancy in completion thyroidectomy specimen was 56.25%. Papillary carcinoma thyroid (PCT) had a statistically significant risk compared to follicular carcinoma thyroid (p = 0.042). Also, capsular invasion in primary specimen had a significant impact (p = 0.021) with odds of 7.20 times increase in incidence of malignancy and patients with age more than 55 years had a significantly increased risk of malignancy (p = 0.05). There was no statistically significant increase in complications following procedure, with respect to duration between surgeries or type of surgeries performed. Incidence of malignancy in completion thyroidectomy specimen was high. Completion thyroidectomy can be safely performed under experienced hands with an acceptable level of complications. It should be considered in places where patients are non-compliant and in those with PCT, tumor with capsular invasion and elderly patients.
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11
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Canberk S, Montezuma D, Taştekin E, Grangeia D, Demirhas MP, Akbas M, Tokat F, Ince U, Soares P, Schmitt F. “The other side of the coin”: understanding noninvasive follicular tumor with papillary-like nuclear features in unifocal and multifocal settings. Hum Pathol 2019; 86:136-142. [DOI: 10.1016/j.humpath.2018.10.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/28/2018] [Accepted: 10/04/2018] [Indexed: 12/13/2022]
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12
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Polat SB, Cakir B, Evranos B, Baser H, Cuhaci N, Aydin C, Ersoy R. Preoperative predictors and prognosis of bilateral multifocal papillary thyroid carcinomas. Surg Oncol 2019; 28:145-149. [DOI: 10.1016/j.suronc.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/29/2018] [Accepted: 12/30/2018] [Indexed: 01/08/2023]
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Ratnagiri R, Uppin M, Jena S, Patil RS, Raju GSN. Completion Thyroidectomy for Differentiated Thyroid Cancers: Predicting Contralateral Disease. Indian J Surg 2019. [DOI: 10.1007/s12262-017-1704-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Completion Thyroidectomy in Patients Diagnosed with Papillary Thyroid Cancer: Is There a Predictive Factor for Contralateral Lobe Tumor? MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2018; 52:262-267. [PMID: 32774088 PMCID: PMC7406558 DOI: 10.14744/semb.2018.83713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/05/2018] [Indexed: 11/20/2022]
Abstract
Objectives: Completion thyroidectomy (CT) is defined as the removal of the residual thyroid tissue in the case of detected malignancy after lobectomy for an indeterminate or non-diagnostic biopsy. Factors such as tumor diameter, aggressive histology, extrathyroidal spread, and positive surgical margin in papillary thyroid cancer (PTC) constitute CT indications. However, the type of surgery is controversial especially in patients with a tumor diameter of 1-4 cm. Determination of predictive factors for contralateral lobe tumors (CLTs) in PTC may be helpful for rough or excessive treatment of patients with this common thyroid pathology. The aim of the present study was to determine the predictive factors and rate of detection of CLTs after CT in patients with papillary thyroid carcinoma after lobectomy. Methods: Medical records of patients who underwent lobectomy with the final histological diagnosis of papillary thyroid carcinoma for the study period 2011 to 2016 were reviewed. Demographic data of the patients, diameter, multicentricity and subtype of tumor, extrathyroidal spread, and vascular invasion rate were obtained. Patients were divided into 2 groups as final histological examination after CT revealed benign (Group 1) and malignant (Group 2). Results: Data of 49 patients were retrospectively analyzed during the study period. The female-to-male ratio was 33/16. The mean age of the patients was 47.59 (23–77) years. Groups 1 and 2 consisted of 30 and 19 patients, respectively. No significant difference was found between the two groups regarding demographic data and tumor characteristics. Conclusion: Despite the fact that we have not been detecting any predictive factor in predicting the presence of tumor on the contralateral lobe in our study, the detection of a tumor on the contralateral lobe is frequent.
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Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature. Cancers (Basel) 2018; 11:cancers11010026. [PMID: 30591680 PMCID: PMC6356549 DOI: 10.3390/cancers11010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/09/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022] Open
Abstract
Background: The extent of surgery for differentiated thyroid cancer (DTC) remains a controversial issue. Since a less aggressive approach is becoming more predominant, we aim here to study the short- and long-term outcomes of DTC patients after hemithyroidectomy. Methods: From a total of 1252 consecutive papillary thyroid cancer (PTC) patients, 109 treated with hemithyroidectomy and 50 with total thyroidectomy but no I131 were included. Persistent or recurrent disease was defined based on histopathology, imaging studies, and thyroglobulin levels. Results: Our hemithyroidectomy cohort included females (84.4%), microcarcinomas (81.9%), TNM stage I (95.4%), and a low American Thyroid Association (ATA) recurrence risk (94.5%). At one-year post-treatment, 3.7% had persistent disease (all female, median age 55 years, tumor size 7.5 mm). Recurrent disease was detected in 7.5% of those with excellent response at 1-year. With a follow-up of 8.6 years (1–48), all 109 patients were disease free at last visit, including the 11 patients (10.1%) who received additional treatment. Also, when comparing the hemi- and total thyroidectomy groups no significant differences were found in the rate of persistent and recurrent disease, overall mortality, and disease status at last visit. Conclusions: For properly selected low-risk PTC patients, hemithyroidectomy is a safe treatment option with a favorable long-term outcome.
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Gulcelik MA, Dogan L, Akgul GG, Güven EH, Ersöz Gulcelik N. Completion Thyroidectomy: Safer than Thought. Oncol Res Treat 2018; 41:386-390. [PMID: 29734197 DOI: 10.1159/000487083] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 01/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to find out whether a substantial difference in terms of complication rates exists between primary and completion thyroidectomies following initial bilateral subtotal thyroidectomy in the light of current literature and our series. PATIENTS AND METHODS Total number of 696 patients who received completion thyroidectomy (Group 1, n = 289) and total thyroidectomy for differentiated thyroid cancer (Group 2, n = 407) and their data were reviewed and postoperative complications were compared between the groups and with the literature. RESULTS Transient and permanent hypocalcaemia rates were 20% and 5.8% in Group 1 and 10.5% and 5.1% for Group 2 respectively. Unilateral transient, bilateral transient and unilateral permanent recurrent laryngeal nerve palsy rates were 6.2%, 1.3% and 4.4% for patients in Group 1 whereas same complications were seen in 4.6%, 0.7% and 3.6% of patients in Group 2. When groups were compared for complications; temporary hypocalcaemia, unilateral temporary nerve palsy, and minor wound infection rates were statistically higher in Group 1, with no significant difference in permanent complications. CONCLUSION When complication rates of re-operation after bilateral subtotal thyroidectomy and primary total thyroidectomy for differentiated thyroid cancer were compared in an unbiased fashion, completion thyroidectomy was shown to be as safe as a primary operation with regard to permanent complications.
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Ritter A, Bachar G, Hirsch D, Benbassat C, Katz O, Kochen N, Diker-Cohen T, Akirov A, Shimon I, Robenshtok E. Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma. J Clin Endocrinol Metab 2018; 103:407-414. [PMID: 29240898 DOI: 10.1210/jc.2017-01616] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 12/01/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bilateral thyroid nodularity is considered an indication for total thyroidectomy in papillary thyroid carcinoma (PTC). However, the natural history and outcome of contralateral nodules have never been studied. OBJECTIVE To investigate the natural history of nonsuspicious contralateral nodules after lobectomy for PTC. METHODS We included patients who had one or more solid nodules (≥3 mm) in the contralateral lobe with benign cytology before surgery or small nonsuspicious nodules per ultrasonography. RESULTS One hundred and twelve patients were included. Median age was 57 years, and median size of the PTC (initial lobectomy) was 8 mm (range, 0.5 to 28 mm). On the contralateral side, the median size of nodules was 7 mm (range, 3 to 30 mm). Thirty-three nodules (29%) had fine-needle aspiration (FNA) before surgery, and all were benign. After a median follow-up of 6 years, median growth was zero (range, -20 to 19 mm). Twenty-six nodules (23%) increased ≥3 mm in size (median, 6 mm; range, 4 to 19 mm). Twenty patients (18%) developed new nodules. Twelve patients (11%) underwent completion thyroidectomy for growth (three), suspicious FNA (seven; Bethesda III to V), malignancy (one), or unknown reason (one). Overall, according to the completion thyroidectomy specimen, six patients (5%) were diagnosed with contralateral PTC (five micro-PTCs, one 20 mm), and all were without evidence of disease at the end of follow-up. There were no surgical difficulties or local complications during completion surgery. CONCLUSIONS Lobectomy for low-risk patients with a small PTC and nonsuspicious contralateral thyroid nodule(s) is a reliable and safe initial treatment option. In the few patients who required completion thyroidectomy, treatment with surgery and radioiodine was effective.
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Affiliation(s)
- Amit Ritter
- Department of Otorhinolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Bachar
- Department of Otorhinolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dania Hirsch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Carlos Benbassat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Assaf Harofeh Medical Center, Zriffin, Israel
| | - Orna Katz
- Department of Otorhinolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Kochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Talia Diker-Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Internal Medicine A, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Amit Akirov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Ilan Shimon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Eyal Robenshtok
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
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Cox C, Bosley M, Southerland LB, Ahmadi S, Perkins J, Roman S, Sosa JA, Carneiro-Pla D. Lobectomy for treatment of differentiated thyroid cancer: can patients avoid postoperative thyroid hormone supplementation and be compliant with the American Thyroid Association guidelines? Surgery 2018; 163:75-80. [DOI: 10.1016/j.surg.2017.04.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/14/2017] [Accepted: 04/27/2017] [Indexed: 12/16/2022]
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Lodewijk L, Kluijfhout WP, Kist JW, Stegeman I, Plukker JTM, Nieveen van Dijkum EJ, Bonjer HJ, Bouvy ND, Schepers A, de Wilt JHW, Netea-Maier RT, van der Hage JA, Burger JWA, Ho G, Lee WS, Shen WT, Aronova A, Zarnegar R, Benay C, Mitmaker EJ, Sywak MS, Aniss AM, Kruijff S, James B, Grogan RH, Brunaud L, Hoch G, Pandolfi C, Ruan DT, Jones MD, Guerrero MA, Valk GD, Borel Rinkes IHM, Vriens MR. Characteristics of contralateral carcinomas in patients with differentiated thyroid cancer larger than 1 cm. Langenbecks Arch Surg 2016; 401:365-73. [PMID: 27013326 PMCID: PMC4851685 DOI: 10.1007/s00423-016-1393-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/26/2016] [Indexed: 01/11/2023]
Abstract
Purpose Traditionally, total thyroidectomy has been advocated for patients with tumors larger than 1 cm. However, according to the ATA and NCCN guidelines (2015, USA), patients with tumors up to 4 cm are now eligible for lobectomy. A rationale for adhering to total thyroidectomy might be the presence of contralateral carcinomas. The purpose of this study was to describe the characteristics of contralateral carcinomas in patients with differentiated thyroid cancer (DTC) larger than 1 cm. Methods A retrospective study was performed including patients from 17 centers in 5 countries. Adults diagnosed with DTC stage T1b-T3 N0-1a M0 who all underwent a total thyroidectomy were included. The primary endpoint was the presence of a contralateral carcinoma. Results A total of 1313 patients were included, of whom 426 (32 %) had a contralateral carcinoma. The contralateral carcinomas consisted of 288 (67 %) papillary thyroid carcinomas (PTC), 124 (30 %) follicular variant of a papillary thyroid carcinoma (FvPTC), 5 (1 %) follicular thyroid carcinomas (FTC), and 3 (1 %) Hürthle cell carcinomas (HTC). Ipsilateral multifocality was strongly associated with the presence of contralateral carcinomas (OR 2.62). Of all contralateral carcinomas, 82 % were ≤10 mm and of those 99 % were PTC or FvPTC. Even if the primary tumor was a FTC or HTC, the contralateral carcinoma was (Fv)PTC in 92 % of cases. Conclusions This international multicenter study performed on patients with DTC larger than 1 cm shows that contralateral carcinomas occur in one third of patients and, independently of primary tumor subtype, predominantly consist of microPTC.
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Affiliation(s)
- Lutske Lodewijk
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Wouter P Kluijfhout
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jakob W Kist
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Inge Stegeman
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - John T M Plukker
- University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | | | - H Jaap Bonjer
- VU Medical Center, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands
| | - Nicole D Bouvy
- Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Abbey Schepers
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Johannes H W de Wilt
- Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Romana T Netea-Maier
- Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Jos A van der Hage
- Netherlands Cancer Institute, Plesmanlaan 121 - 123, 1066 CX, Amsterdam, The Netherlands
| | - Jacobus W A Burger
- Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Gavin Ho
- University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Wayne S Lee
- University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Wen T Shen
- University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Anna Aronova
- Weill Cornell Medical Center, 525 E 68th St, New York, NY, 10065, USA
| | - Rasa Zarnegar
- Weill Cornell Medical Center, 525 E 68th St, New York, NY, 10065, USA
| | - Cassandre Benay
- McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada
| | - Elliot J Mitmaker
- McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada
| | - Mark S Sywak
- Endocrine Surgery Unit, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Ahmad M Aniss
- Endocrine Surgery Unit, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Schelto Kruijff
- Endocrine Surgery Unit, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Benjamin James
- The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Raymon H Grogan
- The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Laurent Brunaud
- Centre Hospitalier Universitaire de Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
| | - Guillaume Hoch
- Centre Hospitalier Universitaire de Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France
| | - Chiara Pandolfi
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Daniel T Ruan
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Michael D Jones
- The University of Arizona Medical Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
| | - Marlon A Guerrero
- The University of Arizona Medical Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
| | - Gerlof D Valk
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Inne H M Borel Rinkes
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Menno R Vriens
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. .,Department of Surgery (G.04.228), University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
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