103 research outputs found
Response assessment after induction chemotherapy for head and neck squamous cell carcinoma: From physical examination to modern imaging techniques and beyond
Significant correlations between the response to induction chemotherapy and success of subsequent radiotherapy have been reported and suggest that the response to induction chemotherapy is able to predict a response to radiotherapy. Therefore, induction chemotherapy may be used to tailor the treatment plan to the individual patient with head and neck cancer: following the planned subsequent (chemo)radiation schedule, planning a radiation dose boost, or reassessing the modality of treatment (eg, upfront surgery). Findings from reported trials suggest room for improvement in clinical response assessment after induction chemotherapy, but an optimal method has yet to be identified. Historically, indices of treatment efficacy in solid tumors have been based solely on systematic assessment of tumor size. However, functional imaging (eg, fluorodeoxyglucoseâpositron emission tomography (FDGâPET) potentially provides an earlier indication of response to treatment than conventional imaging techniques. More advanced imaging techniques are still in an exploratory phase and are not ready for use in clinical practice.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138890/1/hed24883_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138890/2/hed24883.pd
Hurthle Cell Carcinoma of the Thyroid Gland : Systematic Review and Meta-analysis
Introduction Hurthle cell carcinoma (HCC) comprises about 5% of thyroid carcinoma cases. Partly because of its rarity there is much we still need to know about HCC as compared to other histological cancer subtypes. Methods We conducted a systematic literature review following PRISMA guidelines and meta-analysis, from 2000 to 2020, to investigate the main characteristics of HCC and clarify information concerning tumor behavior and treatment. Results Our review included data from 9638 patients reported in 27 articles over the past 20 years. This tumor occurred more frequently in women (67.5%). The mean age was 57.6 years, and the mean size of the neoplasm at diagnosis was 30 mm. Extrathyroidal extension was common (24%) but lymph node metastasis was not (9%). Total thyroidectomy was the most common surgical approach, with neck dissection usually performed in cases with clinically apparent positive neck nodes. Radioiodine therapy was frequently applied (54%), although there is no consensus about its benefits. The mean 5- and 10-year overall survival was 91% and 76%, respectively. Conclusion This review serves to further elucidate the main characteristics of this malignancy. HCC of the thyroid is rare and most often presents with a relatively large nodule, whereas lymph node metastases are rare. Given the rarity of HCC, a consensus on their treatment is needed, as doubts remain concerning the role of specific tumor findings and their influence on management.Peer reviewe
Management of Recurrent Well-Differentiated Thyroid Carcinoma in the Neck: A Comprehensive Review
Surgery has been historically the preferred primary treatment for patients with well-differentiated thyroid carcinoma and for selected locoregional recurrences. Adjuvant therapy with radioactive iodine is typically recommended for patients with an intermediate to high risk of recurrence. Despite these treatments, locally advanced disease and locoregional relapses are not infrequent. These patients have a prolonged overall survival that may result in long periods of active disease and the possibility of requiring subsequent treatments. Recently, many new options have emerged as salvage therapies. This review offers a comprehensive discussion and considerations regarding surgery, active surveillance, radioactive iodine therapy, ultrasonography-guided percutaneous ablation, external beam radiotherapy, and systemic therapy for well-differentiated thyroid cancer based on relevant publications and current reference guidelines. We feel that the surgical member of the thyroid cancer management team is empowered by being aware and facile with all management options
Papillary Thyroid Cancer-Aggressive Variants and Impact on Management : A Narrative Review
Introduction Aggressive variants of papillary thyroid cancer (PTC) have been described with increasing frequency. These variants include diffuse sclerosing variant, tall cell variant, columnar cell variant, solid variant, and hobnail variant. Methods We have performed a review of the more aggressive variants of PTC with respect to main characteristics, histological and molecular features, and the consequences that the knowledge of these variants should have in the treatment of the patients. Results At the present time, we do not know the prognostic value of these aggressive PTC variants. The extent of the surgical treatment and adjuvant therapy necessary should be decided on the basis of the extent of the tumor at presentation and the opinion of experienced clinicians. Conclusion These aggressive variants should be known by clinicians, to avoid underdiagnosis, and treated according to the latest recommendations in the literature.Peer reviewe
Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology
BackgroundPostoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement.MethodsA multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations.ResultsConsensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management.ConclusionSalivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163491/2/hed26417.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163491/1/hed26417_am.pd
Fungal chitinases: diversity, mechanistic properties and biotechnological potential
Chitin derivatives, chitosan and substituted chito-oligosaccharides have a wide spectrum of applications ranging from medicine to cosmetics and dietary supplements. With advancing knowledge about the substrate-binding properties of chitinases, enzyme-based production of these biotechnologically relevant sugars from biological resources is becoming increasingly interesting. Fungi have high numbers of glycoside hydrolase family 18 chitinases with different substrate-binding site architectures. As presented in this review, the large diversity of fungal chitinases is an interesting starting point for protein engineering. In this review, recent data about the architecture of the substrate-binding clefts of fungal chitinases, in connection with their hydrolytic and transglycolytic abilities, and the development of chitinase inhibitors are summarized. Furthermore, the biological functions of chitinases, chitin and chitosan utilization by fungi, and the effects of these aspects on biotechnological applications, including protein overexpression and autolysis during industrial processes, are discussed in this review
Impact de l évidement ganglionnaire cervical prophylactique sur la survie et le re-traitement des carcinomes différenciés de la thyroïde
Le rĂŽle de l Ă©videment ganglionnaire prophylactique (ECP) dans le cancer diffĂ©renciĂ© de la thyroĂŻde (CDT) sur la survie est actuellement en dĂ©bat. L objectif Ă©tait d analyser l influence de l ECP sur l administration de doses d iode radioactif (I131) en post-opĂ©ratoire et sur le taux de rĂ©-intervention.Une Ă©tude rĂ©trospective a Ă©tĂ© menĂ©e entre 1995 et 2010 chez les patients diagnostiquĂ©s avec un CDT cN0 et traitĂ©s par thyroĂŻdectomie totale (TT) avec ou sans ECP. Tous les patients ont reçu de l I131 adjuvant. Le nombre de rĂ©-intervention dans le compartiment central et de sĂ©ances supplĂ©mentaires d I131 a Ă©tĂ© comparĂ© entre les deux groupes.Au total, 265 patients dont l Ăąge moyen Ă©tait de 45 ans ont Ă©tĂ© traitĂ©s soit par TT (n=108) ou TT et ECP (n=155). Les deux groupes Ă©taient comparables pour l Ăąge, le sexe et la taille tumorale. La durĂ©e moyenne du suivi a Ă©tĂ© de 6,4 ans. Dans le groupe TT + ECP, 80 patients (52%) ont Ă©tĂ© classĂ©s pN1. Dans le groupe TT comparĂ© au groupe TT et ECP, il y avait : 12 rĂ©-interventions du compartiment central contre 3 (p=0,001) et une dose totale de 3,85 GBq d I131 contre 4,25 GBq (p=0,93), respectivement. Les taux de paralysie rĂ©currentielle et d hypoparathyroĂŻdie Ă©taient similaires.Ă la lecture de ces rĂ©sultats, l ECP semble rĂ©duire significativement le nombre rĂ©-intervention au niveau compartiment central. L ECP est un geste qui a amĂ©liorĂ© la survie sans re-traitement sans pour autant augmenter la morbiditĂ© opĂ©ratoire.PARIS6-Bibl.PitiĂ©-SalpĂȘtrie (751132101) / SudocSudocFranceF
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