2 research outputs found
Supplementary Material for: Metformin Is Associated with a Favorable Outcome in Diabetic Patients with Cervical Lymph Node Metastasis of Differentiated Thyroid Cancer
<b><i>Background and Objective:</i></b> Type 2 diabetes is known to increase the risk and progression of certain types of cancer. Metformin treatment of diabetic patients is reported to have beneficial effects on some cancers. We evaluated the clinical outcome of diabetic patients with differentiated thyroid cancer (DTC) according to metformin treatment. <b><i>Methods:</i></b> We reviewed 943 patients diagnosed with DTC after total thyroidectomy between 1995 and 2005 in a tertiary hospital. The study involved 60 diabetic patients and 210 control patients matched for age, sex, body mass index (BMI), and tumor size. <b><i>Results:</i></b> There were no differences in the clinicopathological features and disease-free survival (DFS) between diabetic patients and the control group over 8.9 years of follow-up. Of the diabetic patients with DTC, 35 patients (58%) were treated with metformin. There were no differences in age, sex, BMI, tumor size, antidiabetic medication, glycated hemoglobin, or C-peptide levels in metformin and nonmetformin groups. However, cervical lymph node (LN) metastasis was more prevalent in the metformin group than in the nonmetformin group (OR 3.52, p = 0.035). Among diabetic patients with cervical LN metastasis of DTC, the metformin subgroup (17.1 years) was associated with longer DFS than the nonmetformin subgroup (8.6 years) (HR 0.16, p = 0.021); metformin treatment was also associated with longer DFS in this subgroup in multivariate analysis after adjusting age, BMI, duration of diabetes, presence of tumor at resection margin, and serum thyroglobulin level at ablation (HR 0.03, p = 0.035). <b><i>Conclusions:</i></b> Metformin treatment is associated with low recurrence in diabetic patients with cervical LN metastasis of DTC
Supplementary Material for: Differences in Physicians' and Patients' Perception of Acute Hypothyroid Symptoms Induced by Thyroid Hormone Withdrawal in Thyroid Cancer Patients: A Multicenter Survey in Korea
<p><b><i>Background:</i></b> Acute short-term hypothyroidism induced by
thyroid hormone withdrawal (THW) for follow-up surveillance or
therapeutic radioiodine causes patients with differentiated thyroid
cancer to suffer from a myriad of deleterious symptoms. <b><i>Objectives:</i></b> To know how patient recognition of hypothyroid symptoms compares to physician perception of patient symptoms. <b><i>Methods:</i></b>
The survey was performed in 10 referral hospitals throughout Korea from
December 2010 to May 2011 and targeted patients with total
thyroidectomy and remnant ablation. The survey consisted of questions
regarding the effect of THW on patient symptoms, the duration of
symptoms, impact on social life, and patient complaints. The physicians
treating thyroid cancer patients also responded to the survey and
provided their perceptions of patient symptoms and treatment decisions. <b><i>Results:</i></b>
About 70% of the patients responded that they experienced a negative
physical or psychological impact on their life and work due to
hypothyroid symptoms. However, 76% of doctors thought hypothyroidism
could negatively impact a patient's daily life but would be endurable.
Two thirds of physicians do not routinely recommend recombinant human
TSH (rhTSH) to their patients. Multivariate analysis showed patients
with female sex, stronger educational background, emotionally negative
experiences of hypothyroidism, and younger age were more willing to pay
for therapy that could prevent hypothyroidism symptoms. <b><i>Conclusions:</i></b>
There was a substantial gap in the perception of hypothyroid symptoms
during THW between physicians and patients. Physicians who are aware of
the seriousness of hypothyroidism in their patients were more likely to
recommend the use of rhTSH for their patients.</p