15 research outputs found
Marqueurs d'envahissement ganglionnaire des cancers médullaires de la thyroïde sporadiques de plus de 1 cm (étude lilloise à partir de 54 cas)
LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF
Treatment of refractory thyroid cancer
Distant metastases from thyroid cancer of follicular origin are uncommon. Treatment includes levothyroxine administration, focal treatment modalities with surgery, external radiation therapy and thermal ablation, and radioiodine in patients with uptake of 131I in their metastases. Two-thirds of distant metastases become refractory to radioiodine at some point, and when there is a significant tumor burden and documented progression on imaging, a treatment with a kinase inhibitor may provide benefits
Challenging pre-surgical localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism: the added value of18F-Fluorocholine PET/CT
Toxicities of tyrosine kinase inhibitors: Occurrence of hemoptysis and tracheo-oesophageal fistula in 150 patients with advanced thyroid cancer.
Surgery for neck recurrence of differentiated thyroid cancer: Outcomes and risk factors
Background:
Persistent/recurrent disease in the neck is frequent in patients with differentiated
thyroid cancer (DTC).
Objective:
Assess efficacy, safety, and prognostic factors of first neck reoperation in DTC.
Methods:
Retrospective study of consecutive patients undergoing neck reoperation for recurrent/
persistent DTC in a referral cancer center. Response after reoperation was defined according to the
2015 American Thyroid Association guidelines.
Findings:
One hundred sixty-one DTC patients were enrolled (64% females, median age 35 years,
96% papillary DTC). Initial stage was pT3 in 43% and pT4 in 10%, pN1 in 74%. Aggressive histology
was present in 25% of the patients, in both primary and persistent/recurrent tumor. Four patients
had no malignancy in the reoperative specimen, and 1 patient died due to postoperative hematoma
and was excluded from further analysis. Following reoperation, 15 patients (10%) had persistent
structural disease, 16 (10%) had biochemical incomplete response, 26 (17%) had indeterminate
response, and 99 (63%) had complete response (CR), among whom 24 relapsed later. After a median
follow-up of 5 years, only 83 patients (53%) had CR without the need for further treatments. The
rate of permanent complications was: hypoparathyroidism 2%, laryngeal nerve palsy 0.6%, other
6%. Age
0.6 at initial surgery were independent
risk factors for incomplete response after reoperation. Male sex, aggressive histology, and
$
10
metastases at reoperation were independent risk factors of secondary relapse following CR
achieved with reoperation.
Conclusion:
A careful risk-benefit analysis should guide surgical decision, particularly in patients
with risk factors for incomplete respon
Challenging pre-surgical localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism: the added value of 18F-Fluorocholine PET/CT
Large sporadic thyroid medullary carcinomas: predictive factors for lymph node involvement
International audienceLymph node involvement (LNI) is one of the most important prognostic factors for poor survival in medullary thyroid carcinoma (MTC). At diagnosis, LNI is found in over 50% of sporadic MTCs, and especially in large tumours. Cervical lymph node dissection is therefore mandatory during MTC surgery. However, some large tumours (responsible for high preoperative basal calcitonin levels) are found to lack LNI, and can be cured definitely. Preoperative detection of these particular tumours might spare patients from undergoing extensive cervical dissection. The objective of the present retrospective study of a series of large sporadic MTCs was to identify clinical, biological and pathological factors that were predictive of LNI. Consecutive cases of large, sporadic MTCs (measuring at least 1 cm in diameter) were retrieved and reviewed. The levels of several mature microRNAs (miRs) in paraffin-embedded samples were assessed using qPCR. Of the 54 MTCs, 26 had LNI and 28 were pN0. Relative to pN0 patients, patients with LNI had a significant higher preoperative basal calcitonin level (p = 0.0074) and a greater prevalence of infiltrative margins (p < 0.0001), lymphovascular invasion (p = 0.0004), extrathyroidal extension (p < 0.0001), a higher pT stage (p = 0.0003) and more abundant desmoplastic stroma (p = 0.0006). Tumour expression levels of miR-21 (p = 0.0008) and miR-183 (p = 0.0096) were higher in the LNI group. The abundance of desmoplastic stroma (p = 0.007) and the miR-21 expression level (p = 0.0026) were independent prognostic factors for LNI. The abundance of desmoplastic stroma and high levels of miR-21 expression were strong indicators of LNI, and may thus help the surgeon to choose the extent of cervical lymph node dissection for large, sporadic MTCs with no preoperatively obvious LNI
Redifferentiation of a BRAF K601E -Mutated Poorly Differentiated Thyroid Cancer Patient with Dabrafenib and Trametinib Treatment
International audienc