Significance of a solid component in the papillary thyroid carcinoma associated with clinicopathological parameters.

Significance of a solid component in the papillary thyroid carcinoma associated with clinicopathological parameters.

Histopathology. 2016 Nov 24;:

Authors: Ohashi R, Kawahara K, Namimatsu S, Igarashi T, Sakatani T, Sugitani I, Naito Z

Abstract
AIMS: Solid variant of papillary thyroid carcinoma (SVPTC) is characterized by a solid component (SC) involving more than 50% of the tumor with the preservation of the classical cytological features of papillary thyroid carcinoma (PTC). However, clinical significance of SC in PTC has rarely been examined. Herein, we retrospectively investigated the clinicopathological features of PTC with various degree (10 to 85%) of SC (PTCSC).
METHODS: Patients with PTCSC (n=27) were stratified into SC-major (SC >50% of the tumor) and SC-minor (SC <49%) groups. The clinicopathological parameters were compared to well-differentiated PTC (WPTC) group (n=47).
RESULTS: Both SC-minor (n=18) and SC-major (n=9) groups had increased incidence of a large-sized tumor, extra-capsular extension, and a high recurrence rate, compared to WPTC. Disease-free survival (DFS) of both SC-minor and SC-major was shorter than that of WPTC (p=0.035 and 0.016, respectively). Overall survival was similar among all the groups. Univariate analysis revealed that SC was significantly associated with a recurrence rate (p=0.018). By multivariate analysis, SC appeared to be associated with a recurrence rate with the borderline significance (p=0.055) CONCLUSIONS: Our findings indicate that the presence of SC in PTC, regardless of the proportion, is associated with adverse clinical parameters and a shorter DFS. This article is protected by copyright. All rights reserved.

PMID: 27882585 [PubMed - as supplied by publisher]

} http://ift.tt/2fYUPju


http://ift.tt/2gtz5KJ


http://ift.tt/2fylinw

Gender impact on the correlation between thyroid function and serum lipids in patients with differentiated thyroid cancer.

Gender impact on the correlation between thyroid function and serum lipids in patients with differentiated thyroid cancer.

Exp Ther Med. 2016 Nov;12(5):2873-2880

Authors: Li X, Meng Z, Tan J, Liu M, Jia Q, Zhang G, He Y, Zhang Q, Liu L, Song K, He Q, Zhu M, Wang S, Zhang J, Zheng W, Wang R, Hu T, Liu N, Upadhyaya A

Abstract
The present study aimed to explore the association between thyroid stimulating hormone (TSH) and serum lipids in patients with differentiated thyroid cancer (DTC), with a focus on the risk of hyperlipidemia between different genders. The study included 352 DTC patients who were ready to receive I-131 therapy as well as 352 matched normal controls. In the DTC group, 157 patients were monitored for TSH and lipid parameters prior to and after 1 month of thyroxine therapy. Results were analyzed using t-tests, Pearson bivariate correlation and binary logistic regression analyses. All participants were divided into 3 subgroups according to TSH levels: Subgroup 1 (normal TSH level), subgroup 2 (TSH between 5 and 30 µIU/ml), and subgroup 3 (TSH >30 µIU/ml). Serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein-cholesterol (LDL-C) levels were significantly higher in the DTC group than in the control group. The levels of these parameters decreased after thyroxine therapy and significant positive correlations were observed between TSH and TC, and TG and LDL-C in both genders. Binary logistic regression demonstrated that female DTC patients had higher risks of developing hyperlipidemia than male patients, and these risks increased when TSH increased. For example, the odds ratios (ORs) of high TC in subgroup 2 were 3.30 in males and 4.60 in females, respectively. However, in subgroup 3, the ORs were 9.40 in males and 13.12 in females, respectively. The results of the present study showed that after thyroidectomy, the risk of dyslipidemia markedly increased in DTC patients. More importantly, female patients had a higher risk than male patients.

PMID: 27882089 [PubMed - in process]

} http://ift.tt/2fLXuu9


http://ift.tt/2gH1cJn


http://ift.tt/2fvCt5H

A different prognostic value of BRAFV600E mutation positivity in different age groups of patients with papillary thyroid cancer.

A different prognostic value of BRAFV600E mutation positivity in different age groups of patients with papillary thyroid cancer.

Neoplasma. 2016 Nov 24;64(1):

Authors: Takacsova E, Kralik R, Waczulikova I, Zavodna K, Kausitz J

Abstract
The aim of retrospective single-center study was to assess the prognostic value of BRAFV600E mutation positivity (BRAFV600E+) on disease persistence/recurrence in patients with papillary thyroid cancer (PTC). A total of 199 patients having had initial surgery with neck dissection in our hospital between 6/2009-6/2012 were included in the cohort. Excluded were patients with unifocal microcarcinoma ≤1cm. BRAFV600E mutation was tested from formalin-fixed paraffin-embedded surgicaly removed tumors. All included patients were postoperatively treated with radioiodine. The median duration of follow-up was 43 months, quartiles range 30 - 58 months. Variables included in the final model: BRAFV600E+, categorised age, sex, and high-risk status, or alternatively lymph node status. Based on differences in persistence/recurrence rates, patients were divided into three age categories (<35, 35-60, ≥60). Multiple regression analysis showed a significant interaction between BRAFV600E+ and age, modifying the effect of BRAFV600E+ on persistence/recurrence. BRAFV600E+ in low-risk patients of any age and in high-risk middle-aged patients did not confer additional hazard compared with BRAFV600E mutation negativity (BRAFV600E-) and BRAFV600E- high-risk patients, respectively. However, younger (<35 years) and older (≥60 years) high-risk BRAFV600E+ patients had 17.28 and 33.49-fold increased hazard of persistence/recurrence, respectively, compared with low-risk BRAFV600E- patients. The alternative model including lymph node status yielded similar results for the prognostic significance of BRAFV600E+ in younger and older patients. In conclusion, the prognostic value of BRAFV600E+ depends on high-risk status and likely on age-associated factors. Such additional knowledge could change clinical decision-making in treatment modality.

PMID: 27881018 [PubMed - as supplied by publisher]

} http://ift.tt/2fLXx93


http://ift.tt/2gGZ2tr


http://ift.tt/2fvuPIu

Low dose radiation risks for women surviving the a-bombs in Japan: generalized additive model.

Low dose radiation risks for women surviving the a-bombs in Japan: generalized additive model.

Environ Health. 2016 Nov 24;15(1):112

Authors: Dropkin G

Abstract
BACKGROUND: Analyses of cancer mortality and incidence in Japanese A-bomb survivors have been used to estimate radiation risks, which are generally higher for women. Relative Risk (RR) is usually modelled as a linear function of dose. Extrapolation from data including high doses predicts small risks at low doses. Generalized Additive Models (GAMs) are flexible methods for modelling non-linear behaviour.
METHODS: GAMs are applied to cancer incidence in female low dose subcohorts, using anonymous public data for the 1958 - 1998 Life Span Study, to test for linearity, explore interactions, adjust for the skewed dose distribution, examine significance below 100 mGy, and estimate risks at 10 mGy.
RESULTS: For all solid cancer incidence, RR estimated from 0 - 100 mGy and 0 - 20 mGy subcohorts is significantly raised. The response tapers above 150 mGy. At low doses, RR increases with age-at-exposure and decreases with time-since-exposure, the preferred covariate. Using the empirical cumulative distribution of dose improves model fit, and capacity to detect non-linear responses. RR is elevated over wide ranges of covariate values. Results are stable under simulation, or when removing exceptional data cells, or adjusting neutron RBE. Estimates of Excess RR at 10 mGy using the cumulative dose distribution are 10 - 45 times higher than extrapolations from a linear model fitted to the full cohort. Below 100 mGy, quasipoisson models find significant effects for all solid, squamous, uterus, corpus, and thyroid cancers, and for respiratory cancers when age-at-exposure > 35 yrs. Results for the thyroid are compatible with studies of children treated for tinea capitis, and Chernobyl survivors. Results for the uterus are compatible with studies of UK nuclear workers and the Techa River cohort.
CONCLUSION: Non-linear models find large, significant cancer risks for Japanese women exposed to low dose radiation from the atomic bombings. The risks should be reflected in protection standards.

PMID: 27881134 [PubMed - in process]

} http://ift.tt/2fYWUvX


http://ift.tt/2gtBtBq


http://ift.tt/2fyms2c

International Head and Neck Cancer Epidemiology Consortium: Update No. 22

http://ift.tt/2gGTfE8


http://ift.tt/2gtv356

International Head and Neck Cancer Epidemiology Consortium: Update No. 22

http://ift.tt/2gGTfE8


http://ift.tt/2fZ6BKT

Reusable versus disposable instruments: costs and safety

Systematic review of reusable versus disposable laparoscopic instruments: costs and safety:

Background

The quality of instruments and surgical expertise in minimally invasive surgery has developed markedly in the last two decades. Attention is now being turned to ways to allow surgeons to adopt more cost-effective and environmental-friendly approaches. This review explores current evidence on the cost and environmental impact of reusable versus single-use instruments. In addition, we aim to compare their quality, functionality and associated clinical outcomes.

Method

The Medline and EMBASE databases were searched for relevant literature from January 2000 to May 2015. Subject headings were Equipment Reuse/, Disposable Equipment/, Cholecystectomy/, Laparoscopic/, Laparoscopy/, Surgical Instruments/, Medical Waste Disposal/, Waste Management/, Medical Waste/, Environmental Sustainability/ and Sterilization/.

Results

There are few objective comparative analyses between single-use versus reusable instruments. Current evidence suggests that limiting use of disposal instruments to necessity may hold both economical and environmental advantages. Theoretical advantages of single-use instruments in quality, safety, sterility, ease of use and importantly patient outcomes have rarely been examined. Cost-saving methods, environmental-friendly methods, global operative costs, hidden costs, sterilization methods and quality assurance systems vary greatly between studies making it difficult to gain an overview of the comparison between single-use and reusable instruments.

Conclusions

Further examination of cost comparisons between disposable and reusable instruments is necessary while externalized environmental costs, instrument function and safety are also important to consider in future studies.

http://ift.tt/2ffubDS