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Gąsior-Perczak D, Kowalik A, Kopczyński J, Macek P, Niemyska K, Walczyk A, Gruszczyński K, Siołek M, Dróżdż T, Kosowski M, Pałyga I, Przybycień P, Wabik O, Góźdź S, Kowalska A. Relationship between the Expression of CHK2 and p53 in Tumor Tissue and the Course of Papillary Thyroid Cancer in Patients with CHEK2 Germline Mutations. Cancers (Basel) 2024; 16:815. [PMID: 38398207 PMCID: PMC10886656 DOI: 10.3390/cancers16040815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this study was to determine whether the expression of CHK2 and p53 in tumor tissue in carriers of germline CHEK2 mutations can serve as a prognostic marker for PTC, and whether CHEK2 and TP53 copy numbers correlates with the course of PTC disease. This study included 156 PTC patients previously tested for the presence of CHEK2. Clinicopathological features, treatment response, disease outcome, and germline mutation status of the CHEK2 gene were assessed with respect to CHK2 and p53 expression, and CHEK2 and TP53 gene copy statuses. In patients with and without a germline mutation in CHEK2 and with higher CHK2 expression, the chances of an excellent treatment response and no evidence of disease were lower than in patients without or with lower CHK2 expression. TP53 deletion was associated with angioinvasion. In patients with a truncating mutation, the chance of a CHEK2 deletion was higher than in patients with WT CHEK2 alone or those with WT CHEK2 and with the missense I157T mutation. Higher CHK2 expression was associated with poorer treatment responses and disease outcomes. Higher CHK2 expression and positive p53 together with a TP53 deletion could be a prognostic marker of unfavorable disease outcomes in patients with germline truncating mutations in CHEK2.
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Affiliation(s)
- Danuta Gąsior-Perczak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego St. 3, 25-734 Kielce, Poland;
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (A.K.); (K.G.)
- Division of Medical Biology, Institute of Biology, Jan Kochanowski University, Uniwersytecka 7, 25-406 Kielce, Poland
| | - Janusz Kopczyński
- Surgical Pathology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (J.K.); (K.N.)
| | - Paweł Macek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Department of Epidemiology and Cancer Control, Holycross Cancer Center S. Artwińskiego St. 3, 25-734 Kielce, Poland
| | - Kornelia Niemyska
- Surgical Pathology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (J.K.); (K.N.)
| | - Agnieszka Walczyk
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego St. 3, 25-734 Kielce, Poland;
| | - Krzysztof Gruszczyński
- Department of Molecular Diagnostics, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (A.K.); (K.G.)
| | - Monika Siołek
- Genetic Clinic, Holycross Cancer Centre, 25-734 Kielce, Poland;
| | - Tomasz Dróżdż
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Department of Radiology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland
| | - Marcin Kosowski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
| | - Iwona Pałyga
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego St. 3, 25-734 Kielce, Poland;
| | - Piotr Przybycień
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego St. 3, 25-734 Kielce, Poland;
| | - Olga Wabik
- Surgical Pathology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (J.K.); (K.N.)
| | - Stanisław Góźdź
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Clinical Oncology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland
| | - Aldona Kowalska
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.M.); (A.W.); (T.D.); (M.K.); (I.P.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego St. 3, 25-734 Kielce, Poland;
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Cuéllar DI, De Los Reyes A, Llamas-Olier A. Modified dynamic risk stratification system further predicts individual outcome in patients with intermediate-risk papillary thyroid cancer. ANNALES D'ENDOCRINOLOGIE 2023; 84:242-248. [PMID: 35483449 DOI: 10.1016/j.ando.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/22/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We assessed the contribution of initial treatment response to further refining prediction of individual outcomes in intermediate-risk papillary thyroid cancer (PTC) on the American Thyroid Association (ATA) risk stratification system. Dynamic risk stratification (DRS) as originally proposed by Tuttle et al. in 2010 was modified to also include serum antithyroglobulin antibodies (TgAb) as a surrogate marker of the likelihood of persistent disease, specifically in patients with thyroglobulin assay interference by TgAb. METHODS Three hundred and seventy-three patients with ATA intermediate-risk PTC were enrolled retrospectively upon reviewing medical records. Patients were followed at the National Cancer Institute in Bogota, Colombia after being treated with total thyroidectomy and I-131 therapy between 2009 and 2013. Best response to initial therapy was classified as excellent, indeterminate, biochemically incomplete or structurally incomplete. Final disease status after a median follow-up of 7.1 years was classified as no evidence of disease (NED), indeterminate, or persistent disease (either biochemically or structurally). The rate of recurrence was determined in excellent responders. RESULTS Excellent response was achieved by 164 patients (43.9%). At a median follow-up of 42 months, 19 (11.6%) had experienced recurrence. 87.4% of initially excellent responders available at the final checkpoint were NED, compared to 28% of those with biochemically or structurally incomplete response and to 60.2% of all ATA intermediate-risk PTC patients in our cohort. CONCLUSIONS Modified DRS further predicted individual outcomes in intermediate-risk PTC, potentially allowing ongoing management to be tailored accordingly.
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Affiliation(s)
- Diana Isabel Cuéllar
- Clinical and Epidemiological Cancer Research Unit, Instituto Nacional de Cancerología, Bogotá Calle 1 9-85 Bogotá, Colombia.
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Jahanshahi A, Asoodeh Sarshoori A, Rashidi H, Zaman F, Moradi L. Risk Reassessment of Differentiated Thyroid Cancer in Ahvaz, Iran: A Cross-sectional Retrospective Study. Int J Endocrinol Metab 2023; 21:e130434. [PMID: 36945345 PMCID: PMC10024812 DOI: 10.5812/ijem-130434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/03/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Accurate evaluation of response to treatment in differentiated thyroid cancer (DTC) is the sine qua non of preventing over-treatment in low-risk patients and implementing appropriate interventions in high-risk individuals. OBJECTIVES This study aimed to assess the response to therapy in DTC patients based on dynamic stratification method. METHODS In this cross-sectional study, 154 medical records of subjects with DTC (with at least 6 months after total thyroidectomy) and referred to endocrinology clinics in Ahvaz, Iran, from April 2020 to May 2021 were examined. Patients were stratified according to a dynamic risk stratification system (informed by their specific clinical, histopathological, and ultrasonography findings, and other diagnostic imagines) into four groups: Excellent response (ER), indeterminate response (IR), biochemical incomplete response (BIR), and structural incomplete response (SIR). RESULTS For a mean follow-up period of 28.59 months, excellent response to treatment was observed in 92 patients (59.7%), indeterminate response to treatment was found in 32 patients (20.8%), biochemical incomplete response was detected in 2 patients (1.3%), and structural incomplete response was seen in 28 patients (18.2%). In the group with low risk of recurrence, ER and IR were observed in 79.2% and 15.6% of the patients, respectively (P < 0.0001). In the group with an intermediate risk of recurrence, ER was found in 32% of the patients, while IR and SIR + BIR were seen in 34% and 34% of the patients, respectively (P < 0.0001). No cases of ER or IR were observed in the group with high risk (P = 0.001). CONCLUSIONS In sum, response to treatment significantly varied based on dynamic risk stratification, with ER being highest in the low-risk group, less likely in moderate risk group, and undetected in the high-risk group.
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Affiliation(s)
- Alireza Jahanshahi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Asoodeh Sarshoori
- Department of Internal Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homeira Rashidi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Corresponding Author: Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Ferdos Zaman
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Moradi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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van Velsen EFS, Peeters RP, Stegenga MT, van Kemenade FJ, van Ginhoven TM, van Balkum M, Verburg FA, Visser WE. Evaluating Disease Specific Survival Prediction of Risk Stratification and TNM Systems in Differentiated Thyroid Cancer. J Clin Endocrinol Metab 2022; 108:e267-e274. [PMID: 36508298 DOI: 10.1210/clinem/dgac721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Many countries have national guidelines for the management of differentiated thyroid cancer (DTC), including a risk stratification system to predict recurrence of disease. Studies whether these guidelines could also have relevance, beyond their original design, in predicting survival are lacking. Additionally, no studies evaluated these international guidelines in the same population, nor compared them to the TNM system. Therefore, we investigated the prognostic value of six stratification systems employed by ten International guidelines, and the TNM system with respect to predicting disease specific survival (DSS). METHODS We retrospectively studied adult patients with DTC from a Dutch university hospital. Patients were classified using the risk classification described in the British, Dutch, French, Italian, Polish, Spanish, European Society of Medical Oncology, European Thyroid Association, and 2009 and 2015 American Thyroid Association (ATA) guidelines, and the latest TNM system. DSS was analyzed using the Kaplan-Meier method, and the statistical model performance using the C-index, AIC, BIC and PVE. RESULTS We included 857 patients with DTC (79% PTC, 21% FTC). Median follow-up was 9 years, and 67 (7.8%) died due to DTC. The Dutch guideline had the worst statistical model performance, while the 2009 ATA/2014 British guideline had the best. However, the (adapted) TNM system outperformed all stratification systems. CONCLUSIONS In a European population of patients with DTC, out of ten International guidelines employing six risk of recurrence stratification systems and one mortality based stratification system, our optimized age-adjusted TNM system (8th edition) outperformed all other systems.
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Affiliation(s)
| | - Robin P Peeters
- Academic Center for Thyroid Diseases, Department of Internal Medicine
| | - Merel T Stegenga
- Academic Center for Thyroid Diseases, Department of Internal Medicine
| | | | - Tessa M van Ginhoven
- Erasmus MC Cancer Institute, Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE, Rotterdam, The Netherlands
| | - Mathé van Balkum
- Academic Center for Thyroid Diseases, Department of Internal Medicine
| | - Frederik A Verburg
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 CE, Rotterdam, The Netherlands
| | - W Edward Visser
- Academic Center for Thyroid Diseases, Department of Internal Medicine
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Kuchareczko A, Kopczyński J, Kowalik A, Hińcza-Nowak K, Walczyk A, Pałyga I, Trybek T, Szymonek M, Gąsior-Perczak D, Gadawska-Juszczyk K, Mikina E, Płachta I, Suligowska A, Płusa A, Chrapek M, Łopatyński T, Góźdź S, Kowalska A. A Significance of Concomitant BRAF V600E and TERT Mutations in Polish Patients with Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Based on 430 Cases. Thyroid 2022; 32:1372-1381. [PMID: 35950639 DOI: 10.1089/thy.2022.0155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The incidence of papillary thyroid cancer is increasing worldwide due to more frequent pathological detection of papillary thyroid microcarcinomas (PTMC), which are cancers measuring 1 cm or less in diameter. In rare cases, the course of PTMC can be aggressive, with an increased risk of recurrence/persistent disease. The aim of this study of Polish patients diagnosed with PTMC was to assess the impact of concomitant B-type Raf kinas-activating mutation in codon 600 of exon 15 (BRAFV600E) and telomerase reverse transcriptase (TERT) hotspot mutations on clinicopathological features, response to treatment, potential recurrence, and the final outcome. Methods: A retrospective analysis of the 430 PTMC cases diagnosed during 2001-2020 at a single center was performed. All PTMC cases were assessed histopathologically, and analyses of BRAFV600E and TERT promoter were performed based on DNA isolated from tumor blocks. Results: There were 29/430 (6.7% [confidence interval: 4.6-9.5]) patients in whom the TERTC228T and/or TERTC250T mutations coexisted with the BRAFV600E mutation. A statistical comparison between PTMC cases with concomitant BRAFV600E and TERT hotspot mutations and those without any of those mutations revealed no significant differences between the two groups with respect to risk stratification, response to primary treatment, clinical course, or final disease status. Conclusion: Regardless of the molecular background of PTMC, the overall response to therapy is excellent, and long-term disease-free survival rates can be achieved by most patients.
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Affiliation(s)
- Artur Kuchareczko
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Artur Kowalik
- Division of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | - Kinga Hińcza-Nowak
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | - Agnieszka Walczyk
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Iwona Pałyga
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Tomasz Trybek
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Monika Szymonek
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Danuta Gąsior-Perczak
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Estera Mikina
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Izabela Płachta
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Agnieszka Płusa
- Department of Pathology, Holycross Cancer Centre, Kielce, Poland
| | - Magdalena Chrapek
- Department of Mathematics, Faculty of Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Tomasz Łopatyński
- Department of General, Oncologic and Metabolic Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Stanisław Góźdź
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Clinical Oncology, Holycross Cancer Centre, Kielce, Poland
| | - Aldona Kowalska
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
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Munagala K, Vijay Praveen S, Maadam K, Chopra S, Kishve S. Applicability of Dynamic Risk Stratification for Differentiated Thyroid Cancer (DTC) in a Resource Limited Setting. Indian J Otolaryngol Head Neck Surg 2022; 74:2217-2221. [PMID: 36452843 PMCID: PMC9702158 DOI: 10.1007/s12070-020-02069-4] [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: 05/14/2020] [Accepted: 08/12/2020] [Indexed: 11/27/2022] Open
Abstract
Dynamic risk stratification (DRS) in DTC has been considered necessary to deliver correct follow-up (FU) treatment, avoiding overtreatment of low risk/intermediate risk patients as well as inadequate treatment of high risk patients. However, it's clinical applicability has been questioned in comparison with more conventional FU protocols. We aimed to know the predictive reliability of DRS in monitoring FU of DTC in a resource-constrained setting across various risk groups, especially when compared with clinical examination alone.
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Affiliation(s)
- Karthik Munagala
- Department of ENT, ESIC Medical College Hospital, Hyderabad, Telangana India
| | - S. Vijay Praveen
- Department of ENT, ESIC Medical College Hospital, Hyderabad, Telangana India
| | | | - Shamit Chopra
- Department of HNS, Patel Hospital, Jalandhar, Punjab India
| | - Sanjay Kishve
- Department of ENT, ESIC Medical College Hospital, Hyderabad, Telangana India
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Nordell F, Hallal G, Asp P, Almquist M. Optimization of follow-up in patients with papillary thyroid cancer who show no evidence of disease 9-12 months after treatment. BJS Open 2021; 5:6457395. [PMID: 34882764 PMCID: PMC8659350 DOI: 10.1093/bjsopen/zrab119] [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: 03/11/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Papillary thyroid cancer (PTC) has an excellent prognosis, and recurrence is rare in patients with no evidence of disease (NED) after initial treatment. Despite this, several guidelines recommend long and costly follow-up, with limited evidence of improved patient outcomes. This study aims to examine the value of follow-up in patients with NED after treatment for PTC, by determining the rate of recurrence, recurrence-associated morbidity, and death, and whether any recurrence was diagnosed through the follow-up programme. METHODS Patients operated for PTC at Lund University Hospital between January 2004 and December 2016 were eligible. Patients with T1a N0/NX were excluded as well as patients with any other thyroid malignancy. Data were collected retrospectively by searching the patients' medical records. NED was defined as thyroglobulin less than 1 ng/ml, thyroglobulin antibodies less than 20 kIU/l, and negative imaging. Biochemical recurrence was defined as thyroglobulin greater than 1 ng/ml, and/or thyroglobulin antibodies greater than 20 kIU/l. Structural recurrence was defined as a strong suspicion of recurrence on imaging and/or histological proof of recurrence. RESULTS Out of a cohort of 187 patients, there were 90 patients with NED who were followed for a median of 6.3 years. Three patients had biochemical recurrence; none of them had symptoms, nor were they treated for their recurrence. Three had structural recurrence; all were above 75 years old and only one was diagnosed through the follow-up programme. No patient died of PTC; five patients died during the follow-up. CONCLUSION Follow-up as it is designed today cannot identify recurrences accurately and seems to be of questionable benefit in younger patients with NED after treatment for PTC.
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Affiliation(s)
| | | | - Pernilla Asp
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Martin Almquist
- Department of Surgery, Lund University Hospital, Lund, Sweden
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Abelleira E, Peñaloza MA, Jerkovich F, Bueno F, Pitoia F. Dynamic risk allows us to adequately select patients with differentiated thyroid cancer who do not require radioiodine treatment. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:315-321. [PMID: 34731559 PMCID: PMC10065346 DOI: 10.20945/2359-3997000000374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective The treatment of patients with differentiated thyroid cancer (DTC) was modified in the last decade towards a more individualized approach according to the risk of recurrence (RR). We compared the outcomes of patients with low and intermediate RR (LRR and IRR) who received or did not receive radioiodine remnant ablation (RRA) after assessing the dynamic risk. Methods We included 307 DTC patients with LRR and IRR submitted to total thyroidectomy. All patients were reclassified according to the dynamic risk stratification (low or high). Patients with high dynamic risk received RRA (141 patients). Results LRR patients who received RRA presented a frequency of structural incomplete response (SIR) of 5% at the end of the follow-up, compared to 2% in those who did not receive it (p=0.353). IRR patients treated with RRA had a frequency of SIR of 22%, compared to 5% in patients without RRA (p=0.008). Conclusion This study demonstrates the usefulness of dynamic risk assessment to decide RRA in a cohort with a long-term follow-up. The lower prevalence of SIR at the end of the follow-up in patients who did not receive RRA highlights the adequate selection of those who would not benefit from RRA, even with an intermediate risk of recurrence.
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Affiliation(s)
- Erika Abelleira
- Division of Endocrinology, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Fernando Jerkovich
- Division of Endocrinology, University of Buenos Aires, Buenos Aires, Argentina
| | - Fernanda Bueno
- Division of Endocrinology, University of Buenos Aires, Buenos Aires, Argentina
| | - Fabián Pitoia
- Division of Endocrinology, University of Buenos Aires, Buenos Aires, Argentina,
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Gajowiec A, Chromik A, Furga K, Skuza A, Gąsior-Perczak D, Walczyk A, Pałyga I, Trybek T, Mikina E, Szymonek M, Gadawska-Juszczyk K, Kuchareczko A, Suligowska A, Jaskulski J, Orłowski P, Chrapek M, Góźdź S, Kowalska A. Is Male Sex A Prognostic Factor in Papillary Thyroid Cancer? J Clin Med 2021; 10:jcm10112438. [PMID: 34072690 PMCID: PMC8199349 DOI: 10.3390/jcm10112438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 12/30/2022] Open
Abstract
Identifying risk factors is crucial for predicting papillary thyroid cancer (PTC) with severe course, which causes a clinical problem. The purpose of this study was to assess whether male sex can be such a predictive factor and to verify whether including it as a predictive factor of high initial risk of recurrence/persistence would help to enhance the value of the American Thyroid Association initial risk stratification system (ATA). We retrospectively analyzed 1547 PTC patients (1358 females and 189 males), treated from 1986 to 2018. The relationship between sex and clinicopathological features, response to therapy, and disease status was assessed. Men with PTC showed some adverse clinicopathological features more often than women, including angioinvasion, lymph node metastases, and tumor size > 40 mm. There were sex-related disparities with respect to response to initial therapy and final follow-up. Male sex is associated with some unfavorable clinicopathological features of PTC, which may affect response to initial therapy or final disease status. In our study, modification of the ATA system by including male sex as a risk factor does not enhance its value. Thus, further studies are needed to assess whether males require treatment modalities or oncological follow-up protocols that are different from those of females.
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Affiliation(s)
- Aleksandra Gajowiec
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
- Correspondence: ; Tel.: +48-663-961-210
| | - Anna Chromik
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Kinga Furga
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Alicja Skuza
- ESKULAP Student Scientific Organization, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.C.); (K.F.); (A.S.)
| | - Danuta Gąsior-Perczak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Agnieszka Walczyk
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Iwona Pałyga
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Klaudia Gadawska-Juszczyk
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Artur Kuchareczko
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Agnieszka Suligowska
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
| | - Jarosław Jaskulski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Paweł Orłowski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Magdalena Chrapek
- Faculty of Natural Sciences, Jan Kochanowski University, 25-406 Kielce, Poland;
| | - Stanisław Góźdź
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Clinical Oncology, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland
| | - Aldona Kowalska
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (D.G.-P.); (A.W.); (I.P.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Centre, S. Artwińskiego Str. 3, 25-734 Kielce, Poland; (T.T.); (E.M.); (M.S.); (K.G.-J.); (A.K.); (A.S.)
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10
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Therapeutic Outcomes of Recurrent Well-Differentiated Thyroid Carcinomas. Int Surg 2021. [DOI: 10.9738/intsurg-d-17-00132.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective
The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed.
Summary of Background Data
Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques.
Methods
The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients.
Results
The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse.
Conclusions
These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.
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11
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Gąsior-Perczak D, Kowalik A, Gruszczyński K, Walczyk A, Siołek M, Pałyga I, Trepka S, Mikina E, Trybek T, Kopczyński J, Suligowska A, Ślusarczyk R, Gonet A, Jaskulski J, Orłowski P, Chrapek M, Góźdź S, Kowalska A. Incidence of the CHEK2 Germline Mutation and Its Impact on Clinicopathological Features, Treatment Responses, and Disease Course in Patients with Papillary Thyroid Carcinoma. Cancers (Basel) 2021; 13:cancers13030470. [PMID: 33530461 PMCID: PMC7865996 DOI: 10.3390/cancers13030470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/16/2021] [Accepted: 01/22/2021] [Indexed: 01/23/2023] Open
Abstract
Simple Summary The aim of our study was to evaluate whether the CHEK2 mutation was a predictor of poorer clinical course in patients with papillary thyroid cancer. The study included 1547 patients from a single center in Poland, in whom the presence and variant of the CHEK2 mutation were determined. Two hundred and forty patients were found to carry this mutation. We found significant association of the CHEK2 truncating variant with vascular invasion and intermediate or high initial risk of recurrence/persistence, whereas this relationship was not found in case of the missense CHEK2 variant. Neither the truncating nor the missense mutations were associated with worse primary treatment response and outcome of the disease. Abstract The CHEK2 gene is involved in the repair of damaged DNA. CHEK2 germline mutations impair this repair mechanism, causing genomic instability and increasing the risk of various cancers, including papillary thyroid carcinoma (PTC). Here, we asked whether CHEK2 germline mutations predict a worse clinical course for PTC. The study included 1547 unselected PTC patients (1358 women and 189 men) treated at a single center. The relationship between mutation status and clinicopathological characteristics, treatment responses, and disease outcome was assessed. CHEK2 mutations were found in 240 (15.5%) of patients. A CHEK2 I157T missense mutation was found in 12.3%, and CHEK2 truncating mutations (IVS2 + 1G > A, del5395, 1100delC) were found in 2.8%. The truncating mutations were more common in women (p = 0.038), and were associated with vascular invasion (OR, 6.91; p < 0.0001) and intermediate or high initial risk (OR, 1.92; p = 0.0481) in multivariate analysis. No significant differences in these parameters were observed in patients with the I157T missense mutation. In conclusion, the CHEK2 truncating mutations were associated with vascular invasion and with intermediate and high initial risk of recurrence/persistence. Neither the truncating nor the missense mutations were associated with worse primary treatment response and outcome of the disease.
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Affiliation(s)
- Danuta Gąsior-Perczak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
- Correspondence:
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (A.K.); (K.G.)
- Division of Medical Biology, Institute of Biology Jan Kochanowski University, Uniwersytecka 7, 25-406 Kielce, Poland
| | - Krzysztof Gruszczyński
- Department of Molecular Diagnostics, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (A.K.); (K.G.)
| | - Agnieszka Walczyk
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
| | - Monika Siołek
- Genetic Clinic, Holycross Cancer Center, 25-734 Kielce, Poland;
| | - Iwona Pałyga
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
| | - Sławomir Trepka
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Department of Surgical Oncology, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
| | - Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
| | - Janusz Kopczyński
- Surgical Pathology, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland;
| | - Agnieszka Suligowska
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
| | - Rafał Ślusarczyk
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Agnieszka Gonet
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Jarosław Jaskulski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Paweł Orłowski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
| | - Magdalena Chrapek
- Faculty of Natural Sciences, Jan Kochanowski University, 25-406 Kielce, Poland;
| | - Stanisław Góźdź
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Clinical Oncology, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland
| | - Aldona Kowalska
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (A.W.); (I.P.); (S.T.); (R.Ś.); (A.G.); (J.J.); (P.O.); (S.G.); (A.K.)
- Endocrinology Clinic, Holycross Cancer Center, Artwińskiego 3, 25-734 Kielce, Poland; (E.M.); (T.T.); (A.S.)
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Coexisting Germline CHEK2 and Somatic BRAFV600E Mutations in Papillary Thyroid Cancer and Their Association with Clinicopathological Features and Disease Course. Cancers (Basel) 2019; 11:cancers11111744. [PMID: 31703344 PMCID: PMC6896084 DOI: 10.3390/cancers11111744] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 01/26/2023] Open
Abstract
BRAFV600E is the most common somatic mutation in papillary thyroid carcinoma (PTC) and the majority of evidence indicates that it is associated with an aggressive clinical course. Germline mutations of the CHEK2 gene impair the DNA damage repair process and increase the risk of PTC. Coexistence of both mutations is expected to be associated with poorer clinical course. We evaluated the prevalence of concomitant CHEK2 and BRAFV600E mutations and their associations with clinicopathological features, treatment response, and disease course in PTC patients. The study included 427 unselected PTC patients (377 women and 50 men) from one center. Relationships among clinicopathological features, mutation status, treatment response, and disease outcomes were assessed. Mean follow-up was 10 years. CHEK2 mutations were detected in 15.2% and BRAFV600E mutations in 64.2% patients. Neither mutation was present in 31.4% cases and both BRAFV600E and CHEK2 mutations coexisted in 10.8% patients. No significant differences in clinicopathological features, initial risk, treatment response, or disease outcome were detected among these patient groups. CHEK2 mutations were significantly associated with older age, while BRAFV600E was significantly associated with older age and extrathyroidal extension. The coexistence of both mutations was not associated with more aggressive clinicopathological features of PTC, poorer treatment response, or disease outcome.
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13
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Trybek T, Walczyk A, Gąsior-Perczak D, Pałyga I, Mikina E, Kowalik A, Hińcza K, Kopczyński J, Chrapek M, Góźdź S, Kowalska A. Impact of BRAF V600E and TERT Promoter Mutations on Response to Therapy in Papillary Thyroid Cancer. Endocrinology 2019; 160:2328-2338. [PMID: 31305897 DOI: 10.1210/en.2019-00315] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/08/2019] [Indexed: 11/19/2022]
Abstract
In this study, we examined the relationship between coexisting BRAF V600E and TERT promoter mutations in papillary thyroid cancer (PTC) and response to therapy. PTC cases (n = 568) with known BRAF and TERT status, diagnosed from 2000 to 2012 and actively monitored at one institution, were reviewed retrospectively. Associations between BRAF V600E and TERT promoter mutations and clinicopathological features, Tumor-Node-Metastasis stage, initial risk, response to therapy, follow-up, and final disease outcome were assessed according to American Thyroid Association 2015 criteria and the American Joint Committee on Cancer/Tumor-Node-Metastasis (8th edition) staging system. Median follow-up was 120 months. TERT promoter mutations (any type) were detected in 13.5% (77/568) of PTC cases with known BRAF status. The C228T and C250T TERT hotspot mutations were found in 54 (9.5%) and 23 (4%) patients, respectively, and 22 other TERT promoter alterations were identified. Coexisting BRAF V600E and TERT hotspot promoter mutations were detected in 9.5% (54/568) of patients, and significantly associated with older patient age (P = 0.001), gross extrathyroidal extension (P = 0.003), tumor stage pT3-4 (P = 0.005), stage II to IV (P = 0.019), intermediate or high initial risk (P = 0.003), worse than excellent response to primary therapy (P = 0.045), recurrence (P = 0.015), and final outcome of no remission (P = 0.014). We conclude that coexisting BRAF V600E and TERT mutations in patients with PTC are associated with poor initial prognostic factors and clinical course and may be useful for predicting a worse response to therapy, recurrence, and poorer outcome than in patients without the above mutations.
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Affiliation(s)
- Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | | | | | - Iwona Pałyga
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Kinga Hińcza
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Góźdź
- Oncology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Endocrinology Clinic, Holycross Cancer Center, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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14
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Walczyk A, Kopczyński J, Gąsior-Perczak D, Pałyga I, Kowalik A, Chrapek M, Hejnold M, Góźdź S, Kowalska A. Poorly differentiated thyroid cancer in the context of the revised 2015 American Thyroid Association Guidelines and the Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System (eighth edition). Clin Endocrinol (Oxf) 2019; 91:331-339. [PMID: 30525210 DOI: 10.1111/cen.13910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/06/2018] [Accepted: 12/02/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Poorly differentiated thyroid cancer (PDTC) is a rare, but aggressive thyroid cancer (TC) and a main cause of death from non-anaplastic follicular cell-derived TC. Assessing the risk of PDTC-related death and the risk of recurrence is important for clinicians. The recent American Thyroid Association (ATA) 2015 guidelines and the updated 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system should support clinicians in the management approach to PDTC patients. PATIENTS Forty-six consecutive PDTC patients treated in a single oncologic centre, 2000-2017. MEASUREMENTS Retrospective analysis of TNM stage, initial risk, response-to-therapy categories, follow-up and final disease status incorporating the ATA 2015 criteria and the 8th AJCC/TNM staging system. Disease-specific survival (DSS) using the Kaplan-Meier method. RESULTS Of the 46 PDTC 21 (45.6%) were ATA high risk (HR), 22 (47.8%), 17 (37%) and seven (15.2%) were TNM stages I, II, and III-IV, respectively. During a median follow-up of 55.5 months, two (4.3%) patients were recurrent, 18 (39.1%) died of PDTC. The 5-/10-year DSS were 65/57%, respectively. According to the AJCC/TNM, the 5-/10-year DSS of I, II, and III-IV stage were 83/83%; 77/55%, and 0/0%, respectively. According to the 2015 ATA initial risk, the 5-/10-year DSS were 91/72% for ATA intermediate risk and 38/38% for ATA HR patients. CONCLUSIONS In PDTC patients, the updated AJCC/TNM staging system accurately predicts a high risk of death in stage III-IV, whereas it seems to be inadequate for predicting a very low or low risk of death expected for differentiated TC in stage I-II. The ATA initial HR may be also used to predict a high risk of PDTC-related death.
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Affiliation(s)
- Agnieszka Walczyk
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
| | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | | | - Iwona Pałyga
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Magdalena Chrapek
- Faculty of Mathematics and Natural Sciences, Department of Probability Theory and Statistics Institute of Mathematics, Jan Kochanowski University, Kielce, Poland
| | - Maria Hejnold
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | - Stanisław Góźdź
- Department of Clinical Oncology, Holycross Cancer Center, Kielce, Poland
- The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
- The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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15
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Gąsior-Perczak D, Pałyga I, Szymonek M, Kowalik A, Walczyk A, Kopczyński J, Lizis-Kolus K, Trybek T, Mikina E, Szyska-Skrobot D, Gadawska-Juszczyk K, Hurej S, Szczodry A, Słuszniak A, Słuszniak J, Mężyk R, Góźdź S, Kowalska A. The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer. PLoS One 2018; 13:e0204668. [PMID: 30273371 PMCID: PMC6166948 DOI: 10.1371/journal.pone.0204668] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 09/12/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Obesity is a serious health problem worldwide, particularly in developed countries. It is a risk factor for many diseases, including thyroid cancer. The relationship between obesity and prognostic factors of thyroid cancer is unclear. Aims We sought to ascertain the relationship between body mass index (BMI) and clinicopathological features increasing the risk of poor clinical course, treatment response, and clinical outcome in patients with differentiated thyroid cancer (DTC). Subjects & methods The study included 1181 patients with DTC (88% women and 12% men) treated at a single center from 2000 to 2016. BMI before surgery and aggressive clinicopathological features, according to the American Thyroid Initial Risk stratification system, were analyzed. The relationship between BMI and initial risk, treatment response, and final status of the disease was evaluated, incorporating the revised 2015 American Thyroid Association guidelines and the 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system. Patients were stratified according to the World Health Organization classification of BMI. Statistical analysis was performed using univariate and multivariate logistic regression analysis. Results Median follow-up was 7.7 years (1–16 years). There were no significant associations between BMI and extrathyroidal extension (microscopic and gross), cervical lymph node metastasis, or distant metastasis in univariate and multivariate analyses. BMI did not affect initial risk, treatment response or disease outcome. Obesity was more prevalent in men (p = 0.035) and in patients ≥55 years old (p = 0.001). There was no statistically significant relationship between BMI and more advanced TNM stage in patients ≤55 years old (stage I vs. stage II) (p = 0.266) or in patients >55 years old (stage I–II vs. III–IV) (p = 0.877). Conclusions Obesity is not associated with more aggressive clinicopathological features of thyroid cancer. Obesity is not a risk factor for progression to more advanced stages of disease, nor is it a prognostic factor for poorer treatment response and clinical outcome.
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Affiliation(s)
| | - Iwona Pałyga
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | | | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Centre, Kielce, Poland
| | | | - Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | | | | | - Stefan Hurej
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Artur Szczodry
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Anna Słuszniak
- Laboratory of Tumor Markers, Holycross Cancer Centre, Kielce, Poland
| | - Janusz Słuszniak
- Department of Surgical Oncology, Holycross Cancer Centre, Kielce, Poland
| | - Ryszard Mężyk
- Cancer Epidemiology, Holycross Cancer Centre, Kielce, Poland
| | - Stanisław Góźdź
- Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
- Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
- Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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16
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Dynamic risk stratification for predicting the recurrence in differentiated thyroid cancer. Nucl Med Commun 2018; 38:1055-1059. [PMID: 28957841 DOI: 10.1097/mnm.0000000000000766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To analyze the predictive value of the dynamic risk stratification (DRS) system for assessing the risk of recurrent/persistent disease in our large group of differentiated thyroid carcinoma (DTC) patients. PATIENTS AND METHODS We retrospectively included 2184 consecutive patients who received radioiodine ablation therapy following a total or near total thyroidectomy in our department between 1998 and 2014. The American Thyroid Association (ATA) classification was used for initial risk classification. At the second year of follow-up period after radioiodine ablation therapy, DRS was performed also. The ATA and DRS risk classification results were compared with clinical outcome. RESULTS According to DRS, more than half of the ATA high-risk patients (73.2%) moved to the DRS low-risk category and the 6.4% of ATA low-risk patients comprised the DRS high-risk category. In comparison of variables within the ATA and the DRS risk groups with clinical outcome, combined use of the ATA and the DRS systems was statistically significant to predict the recurrent/persistent disease (P<0.005). CONCLUSION The present study revealed that the DRS system is a necessary stratification system in addition to the initial risk evaluation. The DRS can discriminate those patients who does not require closer follow-up in the long-term period.
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Kowalska A, Walczyk A, Kowalik A, Pałyga I, Gąsior-Perczak D, Trybek T, Kopczyński J, Kajor M, Mikina E, Szymonek M, Gadawska-Juszczyk K, Szyska-Skrobot D, Lizis-Kolus K, Hurej S, Chrapek M, Chłopek M, Góźdź S. Response to therapy of papillary thyroid cancer of known BRAF status. Clin Endocrinol (Oxf) 2017; 87:815-824. [PMID: 28718951 DOI: 10.1111/cen.13423] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 05/28/2017] [Accepted: 07/14/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A dynamic risk stratification with modified initial estimated risk based on response to therapy and disease course is one of the crucial changes adopted recently by the American Thyroid Association (ATA). This approach focuses on an individualized risk-adapted approach to the management of differentiated thyroid cancer. The BRAF V600E mutation is the most common genetic alteration in papillary thyroid cancer (PTC). However, the prognostic value of this mutation remains unclear. The aim of this study was to examine the relation between the BRAF V600E status in PTC and all ATA response-to-therapy categories, as well as the recurrence and persistence of both biochemical disease and structural disease. PATIENTS Unselected PTC cases with known BRAF status diagnosed from 2000 to 2013 and actively monitored at one institution (n=723) were reviewed retrospectively. The association between the BRAF V600E mutation and clinicopathological characteristics, ATA 2015 response-to-therapy category, recurrence after a period of no evidence of disease (NED) and persistent biochemical or structural disease, was analysed. RESULTS BRAF V600E was found in 65.7% (475/723) of PTC cases. Although BRAF mutation status correlated significantly with certain clinicopathological prognostic factors, there was no correlation with any of the response-to-therapy categories. Recurrences and persistent biochemical or structural disease were not associated with BRAF status. CONCLUSIONS Our data are consistent with those of other studies reporting a positive relation between BRAF V600E mutation and poor prognostic factors in PTC; however, the BRAF status did not significantly correlate with a response to therapy.
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Affiliation(s)
- Aldona Kowalska
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
- The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Agnieszka Walczyk
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | - Artur Kowalik
- Departments of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Iwona Pałyga
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | | | - Tomasz Trybek
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | - Janusz Kopczyński
- Departments of Surgical Pathology, Holycross Cancer Centre, Kielce, Poland
| | - Maciej Kajor
- Department of Surgical Pathology, Medical University of Silesia, Katowice, Poland
| | - Estera Mikina
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | - Monika Szymonek
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | | | | | | | - Stefan Hurej
- Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Science, Jan Kochanowski University, Kielce, Poland
| | - Małgorzata Chłopek
- Departments of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | - Stanisław Góźdź
- The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
- Departments of Clinical Oncology, Holycross Cancer Centre, Kielce, Poland
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18
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Krajewska J, Chmielik E, Jarząb B. Dynamic risk stratification in the follow-up of thyroid cancer: what is still to be discovered in 2017? Endocr Relat Cancer 2017; 24:R387-R402. [PMID: 28821573 DOI: 10.1530/erc-17-0270] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/18/2017] [Indexed: 12/12/2022]
Abstract
The adequate risk stratification in thyroid carcinoma is crucial to avoid on one hand the overtreatment of low-risk and on the other hand the undertreatment of high-risk patients. The question how to properly assess the risk of relapse has been discussed during recent years and resulted in a substantial change in our approach to risk stratification in differentiated thyroid cancer, proposed by the newest ATA guidelines. First initial risk stratification, based on histopathological data is carried out just after primary surgery. It should be emphasized, that a high quality of histopathological report is crucial for proper risk stratification. Next, during the follow-up, patients are restratified considering their response to treatment applied and classified to one of the following categories: excellent response, biochemical incomplete response, structural incomplete or indeterminate response. This new approach is called dynamic risk stratification as, in contrary to the previous rigid evaluation performed at diagnosis, reflects a real-time prognosis and thereby substantially influences and personalizes disease management. In this review, we raise some unresolved questions, among them the lack of prospective studies, fulfilling evidence-based criteria, necessary to validate this model of risk stratification. We also provided some data concerning the use of dynamic risk stratification in medullary thyroid cancer, not yet reflected in ATA guidelines. In conclusion, dynamic risk stratification allows for better prediction of the risk of recurrence in thyroid carcinoma, what has been demonstrated in numerous retrospective analyses. However, the validation of this approach in prospective studies seems to be our task for near future.
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Affiliation(s)
- Jolanta Krajewska
- Nuclear Medicine and Endocrine Oncology DepartmentM. Sklodowska-Curie Memorial Institute - Cancer Center, Gliwice, Poland
| | - Ewa Chmielik
- Tumor Pathology DepartmentM. Sklodowska-Curie Memorial Institute - Cancer Center, Gliwice, Poland
| | - Barbara Jarząb
- Nuclear Medicine and Endocrine Oncology DepartmentM. Sklodowska-Curie Memorial Institute - Cancer Center, Gliwice, Poland
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19
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Muller S, Senne M, Kirschniak A, Königsrainer A, Bares R, Falch C. Impact of surgical resection extension on outcome for primary well-differentiated thyroid cancer-a retrospective analysis. World J Surg Oncol 2017; 15:190. [PMID: 29065879 PMCID: PMC5655869 DOI: 10.1186/s12957-017-1261-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The surgical resection extension in well-differentiated thyroid cancer is controversially discussed with the possibility of an overtreatment on the one hand against the risk of local disease recurrence. The aim of this study is to evaluate how the surgical resection extension with the adjunction of radioiodine therapy affects postoperative morbidity and the oncologic outcome of patients primarily treated for well-differentiated thyroid cancer. METHODS All patients undergoing primary surgery for a well-differentiated, non-recurrent thyroid cancer from January 2005 to April 2013 at Tuebingen University Hospital were retrospectively analyzed. RESULTS Papillary thyroid cancer (PTC) was present in 73 patients (including 27 papillary microcarinoma) and follicular thyroid cancer in 14 patients. Fifty-six of 87 patients (64%) underwent one-stage surgery, of which 26 patients (30%) received simultaneous lymph node dissection (LND). The remaining 31 patients (36%) underwent a two-stage completion surgery (29 patients with LND). Only in three patients a single lymph node metastasis was newly detected during two-stage completion surgery. Patients with LND at either one-stage and two-stage completion surgery had a significant higher rate of transient postoperative hypocalcemia. Postoperative adjuvant radioiodine therapy was performed in 68 of 87 patients (78%). After a median follow-up of 69 months [range 9-104], one local recurrence was documented in a patient suffering from PTC 23 months after surgery. CONCLUSION No prophylactic two-stage lymphadenectomy should be performed in case of well-differentiated thyroid cancer to avoid unnecessary complication without any proven oncologic benefit.
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Affiliation(s)
- S Muller
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany.
| | - M Senne
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany
| | - A Kirschniak
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany
| | - R Bares
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - C Falch
- Department of General, Visceral and Transplant Surgery, Tuebingen University Hospital, Hoppe-Seyler Str. 3, 72076, Tuebingen, Germany
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20
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Gąsior-Perczak D, Pałyga I, Szymonek M, Kowalik A, Walczyk A, Kopczyński J, Lizis-Kolus K, Słuszniak A, Słuszniak J, Łopatyński T, Mężyk R, Góźdź S, Kowalska A. Delayed risk stratification system in pT1aN0/Nx DTC patients treated without radioactive iodine. Endocr Connect 2017; 6:522-527. [PMID: 28821486 PMCID: PMC5597973 DOI: 10.1530/ec-17-0135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/18/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE Delayed risk stratification (DRS) system by Momesso and coworkers was accepted by the American Thyroid Association as a diagnostic tool for the risk stratification of unfavorable clinical outcomes and to monitor the clinical outcomes of differentiated thyroid cancer (DTC) patients treated without radioactive iodine (RAI). The aim of this study was to evaluate the DRS system in patients with pT1aN0/Nx stage. METHODS The study included 304 low-risk patients after thyroidectomy (n = 202) or lobectomy (n = 102) without RAI and were treated at a single center. The median age was 50.5 years, 91.1% were women and the median follow-up was 4 years. DRS of the treatment response was performed based on medical records and according to the criteria of Momesso and coworkers. Disease course (recurrence, death) and status (remission, persistent disease) on December 31, 2016 were evaluated. The relationship between unfavorable outcomes and the DRS system was evaluated. RESULTS Response to initial therapy was excellent in 272 patients (89.5%), indeterminate in 31 (10.2%) and biochemical incomplete (increased TgAb levels) in one (0.3%). Two patients in the excellent response group experienced recurrence at 6 and 7 years of follow-up (after lobectomy). None of the patients with indeterminate and biochemical incomplete response developed structural disease, and none of the patients died during the follow-up. CONCLUSIONS The DRS system was not useful for predicting the risk of unfavorable clinical outcomes and cannot be used to personalize the monitoring method of the disease in patients at pT1aN0/Nx stage who are not treated with RAI.
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Affiliation(s)
| | - Iwona Pałyga
- Endocrinology ClinicHolycross Cancer Centre, Kielce, Poland
| | | | - Artur Kowalik
- Department of Molecular DiagnosticsHolycross Cancer Centre, Kielce, Poland
| | | | - Janusz Kopczyński
- Department of Surgical PathologyHolycross Cancer Centre, Kielce, Poland
| | | | - Anna Słuszniak
- Laboratory of Tumor MarkersHolycross Cancer Centre, Kielce, Poland
| | - Janusz Słuszniak
- Department of Surgical OncologyHolycross Cancer Centre, Kielce, Poland
| | | | - Ryszard Mężyk
- Cancer EpidemiologyHolycross Cancer Centre, Kielce, Poland
| | - Stanisław Góźdź
- Oncology ClinicHolycross Cancer Centre, Kielce, Poland
- The Faculty of Health SciencesJan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Endocrinology ClinicHolycross Cancer Centre, Kielce, Poland
- The Faculty of Health SciencesJan Kochanowski University, Kielce, Poland
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21
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Duan L, Zhu H, Xing B, Gu F. Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1-3): a retrospective cohort study conducted at a single center. BMC Endocr Disord 2017; 17:55. [PMID: 28874187 PMCID: PMC5585918 DOI: 10.1186/s12902-017-0205-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/29/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Follow-up duration was ≥3 months. Tumor invasion was evaluated by magnetic resonance imaging (MRI) and classified according to the Knosp grading system. RESULTS Most patients were diagnosed with macroadenoma. Among all patients (Knosp grades 0-4), preoperative SSA therapy did not significantly improve the curative effect of surgery, according to the levels of growth hormone (GH) and/or insulin-like growth factor 1 (IGF-1) markers. In patients with macroadenoma (Knosp grades 1-3), the remission rates were significantly higher in the SSA group compared to the surgery group when considering GH (56.4% vs. 37.3%, P = 0.048) and IGF-1 (43.2% vs. 17.6%, P = 0.004). In the preoperative medical therapy group, long-term use of SSAs (>6 months) led to higher remission rates (GH, 72.2% vs. 51.0%; and IGF-1, 61.1% vs. 29.8%; P = 0.12 and 0.02, respectively]. CONCLUSIONS The long-term preoperative SSAs treatment may improve the surgical curative rate in acromegalic patients with invasive macroadenomas (Knosp grades 1-3).
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Affiliation(s)
- Lian Duan
- Key Laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Bing Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Feng Gu
- Key Laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730 China
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Liang L, Luo Y, Yang X, Zhang R, Wang H, Yang H, He Y, Chen G, Ma W, Chen J. Lowered levels of microRNA-129 and potential signaling pathways in papillary thyroid carcinoma: a determination of microRNA sequencing in 507 patients and bioinformatics analysis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:7511-7527. [PMID: 31966595 PMCID: PMC6965262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/26/2017] [Indexed: 06/10/2023]
Abstract
Papillary thyroid carcinoma (PTC) is one of the most common endocrine system malignancies. However, the mechanism of tumor development is unclear. microRNA-129-5p is a microRNA that plays an important role in the development of tumors. The main purpose of our article is to find the potential target genes of microRNA-129 and their pathways based on gene array, sequencing and bioinformatics studies. We obtained microRNA-129 expression and clinical associations in the TCGA database. In addition, we found a microRNA-129-related chip GSE19933, which is overexpressing microR-129-5p in thyroid cancer cell lines. The down-regulated gene is considered to be a potential target gene for microRNA-129. The target genes were predicted through 12 online tools. We performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of all down-regulated and predicted target genes. Furthermore, protein-protein interactions (PPI) were also analyzed for all potential genes. Finally, with intersecting down-regulated genes by overexpressed microRNA-129 and predicted target genes, the 889 genes are mainly enriched in the calcium signaling pathway, cGMP-PKG signaling pathway, ErbB signaling pathway and Proteoglycans in cancer, etc. The role of ten hub genes is particularly prominent in PPI analysis. These genes are differentially expressed in the thyroid by immunohistochemistry. We confirmed that microRNA-129 may play a major role in PTC through the above pathways, but more experiments are still needed to prove our results.
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Affiliation(s)
- Liang Liang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yihuan Luo
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Xia Yang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Rui Zhang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Hanlin Wang
- Department of Pathology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Hong Yang
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yun He
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Wei Ma
- Department of Pathology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Junqiang Chen
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi Zhuang Autonomous Region, P. R. China
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