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Toraih E, Hussein M, Anker A, Baah S, Pinion D, Jishu J, Sadakkadulla S, Case M, LaForteza A, Moroz K, Kandil E. Survival Outcomes of Medullary Thyroid Cancer With and Without Amyloid Deposition. Endocr Pract 2024; 30:311-318. [PMID: 38184237 DOI: 10.1016/j.eprac.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Amyloid deposition within tumor stroma is a distinctive histologic feature of medullary thyroid cancer (MTC). However, its prognostic significance remains uncertain. We aimed to elucidate the impact of amyloid status on survival outcomes in a large cohort. METHODS The Surveillance, Epidemiology, and End Results registry was queried to identify patients diagnosed with MTC from 2000 to 2019. Patients with amyloid-positive (International Classification of Diseases for Oncology, third edition code 8345/3) and amyloid negative (International Classification of Diseases for Oncology, third edition code 8510/3) tumors were analyzed. Overall and disease-specific survival were compared between matched cohorts using Kaplan-Meier and Cox proportional hazards analyses. RESULTS Of the 2526 MTC patients, 511 of which were amyloid-positive and 2015 that were amyloid negative. Amyloid-positive patients displayed lower T stage (T3/4: 28% vs 85%, P < .001) and less extrathyroidal extension (11.3% vs 81.6%, P < .001). No difference in distant metastasis rate was observed between groups (14.5% vs 14.4%, P = .98). However, amyloid-positive patients showed a tendency for distal lymph node metastasis (1.2% vs 0.3%, P = .020). On univariate analysis, amyloid-positive status showed comparable overall survival times (mean 172.2 vs 177.8 months, P = .17), but a trend toward worse cancer-specific survival (hazard ratios [HR] = 1.31, 95% CI = 0.99-1.71, P = .051). After adjusting for covariates, amyloid deposition did not independently predict overall (HR = 1.15, 95% CI = 0.91-1.47, P = .25) or cancer-specific survival (HR = 1.30, 95% CI = 0.96-1.77, P = .09). Initiating therapy later than 1 month following diagnosis was associated with worse overall survival (HR = 1.25, 95% CI = 1.02-1.54, P = .029). CONCLUSIONS The presence of amyloid in MTC paradoxically associates with lower T stage yet exhibits a trend toward worse cancer-specific mortality. Amyloid deposition alone does not independently influence prognosis. Delayed treatment adversely impacted overall survival.
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Affiliation(s)
- Eman Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Mohammad Hussein
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Allison Anker
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Solomon Baah
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Dylan Pinion
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Jessan Jishu
- School of Medicine, Tulane University, New Orleans, Louisiana
| | | | - Madeline Case
- School of Medicine, Tulane University, New Orleans, Louisiana
| | | | - Krzysztof Moroz
- Department of Pathology and Laboratory Medicine, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Emad Kandil
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana
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Brix E, Prantl L, Anker A, Klein S, Kehrer A. Free neurovascular toe-(joint)-transfers compared to alternative reconstructive procedures for amputation injuries of two and tripartite fingers with substance loss. Clin Hemorheol Microcirc 2024; 86:71-88. [PMID: 37742630 DOI: 10.3233/ch-238114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Complex injuries of the hand frequently result in loss of essential functional features. Common reconstructive procedures for soft tissue defects of the thumb or phalanges are locoregional flaps like Moberg-, Foucher-, Cross-Finger- or Littler flaps. Microneurovascular toe (joint-) transfers complete the arsenal of operative reconstructive procedures and allow for most detailed reconstructions. Our experiences with free toe transplants are reported and diversely discussed regarding contending procedures. METHODS From 2010 until 2019 14 patients who received emergency or elective partial or complete toe transfers were compared with a control group (n = 12) treated with contending reconstructive procedures. Aim of the reconstructions was to cover the defect with well-vascularized, sensate tissue, while preserving length and range of motion in a reliable manner. RESULTS The Kapandji score showed a significant difference (p- value = 0.04) with a score of 9.8 in comparison to control group (Kapandji index = 8.0). CONCLUSION In our heterogenic patient collective free toe transplants have proven to achieve comparable functional results for reconstruction of two and tripartite phalanxes as opposed to common local reconstructive procedures.
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Affiliation(s)
- E Brix
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A Anker
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S Klein
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A Kehrer
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
- Department of Plastic and Reconstructive Surgery, Ingolstadt Hospital, Ingolstadt, Germany
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Hussein MH, Toraih EA, Ohiomah IE, Siddeeque N, Comeaux M, Landau MB, Anker A, Jishu JA, Fawzy MS, Kandil E. Navigating Choices: Determinants and Outcomes of Surgery Refusal in Thyroid Cancer Patients Using SEER Data. Cancers (Basel) 2023; 15:3699. [PMID: 37509360 PMCID: PMC10378250 DOI: 10.3390/cancers15143699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
With thyroid cancer being a prevalent endocrine cancer, timely management is essential to prevent malignancy and detrimental outcomes. Surgical intervention is a popular component of the treatment plan, yet patients often refuse to undergo such procedures even if clinicians explicitly recommend them. This study gathers data from the Surveillance, Epidemiology, and End Results database (2000-2019) to learn more about the sociodemographic factors that predict the likelihood of surgical intervention. A total of 176,472 patients diagnosed with either papillary or follicular thyroid cancer were recommended surgery, of which 470 were refused. Cancer-specific mortality and overall mortality were determined with the Kaplan-Meier method and univariate and multivariate Cox proportional hazards regression model. Mortality rates for patients who delayed surgery (≥4 months vs. <4 months) were determined using similar methods. The findings reveal that surgical delay or refusal increased overall mortality. The surgical refusal was associated with increased thyroid cancer-specific mortality. However, the impact on thyroid cancer-specific mortality for those who delay surgery was not as pronounced. Significant sociodemographic determinants of surgical refusal included age greater than or equal to 55 years, male sex, being unmarried, race of Asian and Pacific Islander, and advanced tumor staging. The results underscore the importance of patient education, shared decision-making, and access to surgical interventions to optimize outcomes in thyroid cancer management.
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Affiliation(s)
- Mohammad H Hussein
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Eman A Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ifidon E Ohiomah
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | | | - Marie Comeaux
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | | | - Allison Anker
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Jessan A Jishu
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Manal S Fawzy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 91431, Saudi Arabia
| | - Emad Kandil
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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Brebant V, Lemonnier L, Georgieva M, Anker A, Heine N, Seitz S, Frank K, Prantl L, Eigenberger A. Comparison of analog and digitally evaluated volume of the female breast in reconstructive breast surgery. Validation of a noninvasive measurement method with 3D camera1. Clin Hemorheol Microcirc 2023; 85:277-287. [PMID: 36502309 DOI: 10.3233/ch-229101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Reconstructive surgery is established as a standard treatment option after mastectomy due to cancer. It is crucial to patients to achieve a natural and symmetric looking breast through reconstruction. Anthropometric measurements are used to assess the objective symmetry of the breast, which are prone to errors and difficult to reproduce. OBJECTIVE The aim of this work is to validate breast volumetry using three-dimensional surface imaging. METHODS We compared preoperatively analog and digitally evaluated volume of the breast with our gold standard, direct water displacement measurement of the mastectomy specimen. We examined 34 breast specimens in total. RESULTS Each measurement method (Breast Sculptor, VAM, Breast-V) for breast volume/mass determination demonstrates acceptable agreement ranges when compared with resected volumes and masses. The strongest volumetry instrument is Breast Sculptor (digital), the weakest is Breast-V (analog). CONCLUSIONS 3D surface imaging is a quick, effective, and convenient method to evaluate breast shape and volume. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study.This takes us a step closer to the long-term goal of establishing robust instruments to plan breast reconstructive surgery, achieve better surgical results, and contribute to quality assurance in breast surgery.
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Affiliation(s)
- V Brebant
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - L Lemonnier
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - M Georgieva
- University Medical Center Regensburg, Department of Radiology, Regensburg, Germany
| | - A Anker
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - N Heine
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - S Seitz
- University Medical Center Regensburg, Department of Gynecology and Obstetrics, Caritas Hospital St. Josef, Regensburg, Germany
| | - K Frank
- Division of Hand-, Plastic- and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - L Prantl
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
| | - A Eigenberger
- University Medical Center Regensburg. Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, Regensburg, Germany
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
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Wenzel C, Brix E, Heidekrueger P, Lonic D, Lamby P, Klein SM, Anker A, Taeger C, Prantl L, Kehrer A. A favorable donor site in microsurgery: Nerve and vein graft harvest from the dorsum of the foot. Clin Hemorheol Microcirc 2021; 83:1-10. [PMID: 34719482 DOI: 10.3233/ch-211135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES In complex hand traumas nerves and vessels are often destructed without the possibility for primary repair. For bridging defects of nerves, veins and arteries grafts are necessary. Commonly nerve and vein grafts from adjacent donor sites as the wrist, forearm or cubital region are harvested. METHODS This study is a retrospective cohort study. Between 2017 and 2019, 10 patients with complex hand injuries were treated. There were 8 males and 2 females, with an average age of 39 years (range 8-63 years). In all cases grafts were used of the dorsum of the foot for reconstructing of the severed digital nerves and arteries. All donor sites could be closed primarily. RESULTS In 100% of cases nerves and veins of the dorsum of the foot showed a good size match as well as adequate length for a sufficient repair. The overall Hand Injury Severity Score (HISS) was determined with a median of 86 (range 57 to 286). In the area of the donor site no relevant complications were seen. CONCLUSIONS In complex hand injuries the dorsum of the foot is a favorable donor site for nerve and vein graft harvest.
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Affiliation(s)
- C Wenzel
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - E Brix
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Heidekrueger
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - D Lonic
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Lamby
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - S M Klein
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Anker
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - C Taeger
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Kehrer
- Department of Plastic and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany.,Department of Plastic and Reconstructive Surgery, Ingolstadt Hospital Ingolstadt, Ingolstadt, Germany
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Hurt C, Silliman K, Anker A, Knowlton N. Ecological speciation in anemone-associated snapping shrimps (Alpheus armatusspecies complex). Mol Ecol 2013; 22:4532-48. [DOI: 10.1111/mec.12398] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 04/29/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- C. Hurt
- Cox Science Center; University of Miami; 1301 Memorial Drive Miami FL 33146 USA
| | - K. Silliman
- Cox Science Center; University of Miami; 1301 Memorial Drive Miami FL 33146 USA
| | - A. Anker
- Instituto de Ciências do Mar - Labomar; Universidade Federal do Ceará; Avenida da Abolição 3207 CEP 60.165-081 Fortaleza Brazil
| | - N. Knowlton
- Department of Invertebrate Zoology; National Museum of Natural History; Smithsonian Institution; MRC 163 PO Box 37012 Washington DC 20013-7012 USA
- Center for Marine Biodiversity and Conservation; Scripps Institution of Oceanography; University of California; La Jolla San Diego CA 92093-0202 USA
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Cai Y, Anker A. On a collection of freshwater shrimps (Crustacea Decapoda Caridea) from the Philippines, with descriptions of five new species. Tropical Zoology 2004. [DOI: 10.1080/03946975.2004.10531207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Defects in the skull have presented difficult reconstructive problems. Recently glass-ionomer cement and preformed. implants have been used to repair bony defects in the skull base and in cranio-facial surgery. Three patients are reported to illustrate possible applications for this new material. METHODS Ionocap cement and Ionoroc-skull standardized implants have been used. The cement is available as a two component blister pack. When mixed and blended a gel is produced which can be worked for approximately 5 min before hardening. It can then be contoured and drilled to the required shape. The resultant material is biocompatible and biostable, is non-toxic and permanently bonds to bone with no increase in temperature or shrinkage. RESULTS The material has been used to fill the temporal defect left by transplantation of the temporalis muscle for oral reconstruction, the anterior and lateral walls of the maxilla and following craniofacial resection, the posterior wall of the frontal sinus and anterior skull base. CONCLUSIONS Three patients with different reconstructive problems have been presented to illustrate the use of an alloplastic material that has a tensile strength similar to bone and firmly adheres to it. The material was found to be safe and easy to use. All three patients have now been followed for 12 months with no adverse affects.
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Affiliation(s)
- I Cole
- Department of Otolaryngology, Head & Neck and Facio-Maxillary Surgery, Sutherland Hospital, Caringbah, Sydney, Australia
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Anker A. Möglichkeiten der continuirlichen hybridisation in der schweinezucht. Genetics Selection Evolution 1976. [PMCID: PMC2764610 DOI: 10.1186/1297-9686-8-2-299a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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