Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.207
Filtrar
1.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 57(9): 1052-1058, 2022 Sep 07.
Artigo em Chinês | MEDLINE | ID: mdl-36177558

RESUMO

Objective: To investigate the clinicopathological characteristics and the survival of re-operated patients for persistent/recurrent papillary thyroid carcinoma (PTC) and risk factors for re-recurrence after the second operation. Method: A retrospective analysis of 69 cases underwent re-operation for persistent/recurrent PTC in Sichuan Cancer Hospital from January 2010 to December 2016 was performed. There were 21 males and 48 females, aged 14-85 (44.8) years old. According to the imaging after initial treatment, they were divided into a recurrence group (42 cases) and a persistent disease/residual group (27 cases). The positive rates of ipsilateral paratracheal lymph node metastases at re-operation were calculated and compared by chi-square test. Patients were divided into different subgroups according to potential risk factors for re-recurrence. Kaplan-Meier (K-M) method was used for survival analysis. Results: The positive rate of ipsilateral paratracheal lymph node metastasis in recurrence group (15/42, 35.7%) was significantly lower than that in the persistent disease/residual group (17/27, 63.0%) (χ2=4.91, P<0.05). The follow-up period after re-operation was 60-104 months, with a median of 66 months, and 8 patients were lost to follow-up. Permanent hypoparathyroidism occurred in 2 cases (2.9%) and permanent recurrent laryngeal nerve palsy in 1 case (1.4%). Twenty patients had structural recurrences and/or distant metastases. The 5-year disease-specific survival rate was 92.8% and the 5-year recurrence-free survival rate was 68.1%. Survival analysis was performed on risk factors such as age≥55 years old, recurrent tumor diameter ≥4 cm, number of positive lymph nodes ≥ 10, and obvious extracapsular invasion (ENE). Among them, age and diameter of recurrent tumor had significant influences on recurrence-free survival rate (χ2 was 6.36, 8.17, respectively, both P values<0.05). There was a statistically significant difference in recurrence-free survival rates between ENE(+) group and ENE(-) group (χ2=5.52, P<0.05). Conclusion: For the re-operated patients due to persistence/ recurrence PTC, attention should be paid to protecting the parathyroid gland and recurrent laryngeal nerve during re-operation. Timely and effective postoperative follow-up for patients aged ≥ 55 years, with recurrent tumor diameter ≥ 4 cm and ENE(+), can significantly improve their prognoses.


Assuntos
Carcinoma Papilar , Carcinoma , Neoplasias da Glândula Tireoide , Adulto , Carcinoma/patologia , Carcinoma Papilar/cirurgia , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos
2.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 57(9): 1072-1078, 2022 Sep 07.
Artigo em Chinês | MEDLINE | ID: mdl-36177561

RESUMO

Objective: To evaluate the feasibility, safety, and short-term efficacy of robotic lateral neck dissection via combined axillary-retroauricular approach for N1b papillary thyroid carcinoma (PTC). Methods: Thirty patients with cT1-2N1bM0 PTC who received robotic lateral neck dissection via combined axillary-retroauricular approach were included in the Department of Otorhinolaryngology of Sun Yat-sen Memorial Hospital from December 2016 to December 2020. There were 10 males and 20 females, with a median age of 34.5 years and a median body mass index of 25.55 kg/m2. The clinical, surgical, complications, pathology and follow-up data were analysed with SPSS 25.0 software package. Results: The median operative time of 30 patients was 255.50 min, the median operative blood loss was 69.00 ml, and the median postoperative hospital stay was 6.00 days. The incidence of postoperative temporary recurrent laryngeal nerve paralysis was 3.33% (1/30), temporary hypoparathyroidism was 16.67%(5/30), temporary accessory nerve injury was 3.33% (1/30), hematoma was 3.33% (1/30) and chylous leakage was 3.33% (1/30). The median visual analogue scale (VAS) score was 8.00, and the follow-up time was 13-38 months, with a median of 25.5 months. One case showed cervical lymph node recurrence 14 months after surgery. The most recent dynamic recurrence risk stratification showed 21 patients (70.00%) had excellent responses. Conclusions: Robotic lateral neck dissection via combined axillary-retroauricular approach for unilateral cN1b PTC is safe, feasible and aesthetic. The short-term efficacy and dynamic recurrence risk stratification results of short-term follow-up are satisfactory. It can provide a surgical option for cN1b PTC patients.


Assuntos
Carcinoma Papilar , Procedimentos Cirúrgicos Robóticos , Neoplasias da Glândula Tireoide , Adulto , Carcinoma Papilar/cirurgia , Feminino , Humanos , Masculino , Esvaziamento Cervical/métodos , Estudos Retrospectivos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos
3.
BMJ Open ; 12(9): e059615, 2022 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100307

RESUMO

INTRODUCTION: In early-stage oral tongue squamous cell carcinoma (OTSCC), elective neck dissection (END) is recommended when occult lymph node metastasis is suspected; however, there is no unanimous consensus on the risks and benefits of END in such cases. The management of clinically node-negative (cN0) OTSCC remains controversial. This study, therefore, aimed to evaluate the efficacy of END and its impact on the quality of life (QoL) of patients with cN0 OTSCC. METHODS AND ANALYSIS: This is a prospective, multicentre, nonrandomised observational study. The choice of whether to perform END at the same time as resection of the primary tumour is based on institutional policy and patient preference. The primary endpoint of this study is 3-year overall survival. The secondary endpoints are 3-year disease-specific survival, 3-year relapse-free survival and the impact on patient QoL. Propensity score-matching analysis will be performed to reduce selection bias. ETHICS AND DISSEMINATION: This study was approved by the Clinical Research Review Board of the Nagasaki University. The protocol of this study was registered at the University Hospital Medical Information Network Clinical Trials Registry. The datasets generated during the current study will be available from the corresponding author on reasonable request. The results will be disseminated internationally, through scientific and professional conferences and in peer-reviewed medical journals. TRIAL REGISTRATION NUMBER: UMIN000027875.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias da Língua , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Esvaziamento Cervical/métodos , Recidiva Local de Neoplasia/cirurgia , Estudos Prospectivos , Qualidade de Vida , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Neoplasias da Língua/patologia , Neoplasias da Língua/cirurgia
4.
World J Surg Oncol ; 20(1): 327, 2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36180912

RESUMO

BACKGROUND: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and its incidence has increased. Lateral lymph node metastasis (LLNM) implies a worse prognosis than central lymph node metastasis, with a higher recurrence rate and decreased disease-free survival. The 2015 American Thyroid Association guidelines recommend compartmental node dissection in patients with LLNM to reduce the risk of recurrence and mortality. The purpose of this study was to identify the risk factors for level V lymph node (LN) metastasis in patients with N1b papillary thyroid cancer (PTC). METHODS: A total of 110 consecutive patients who underwent total thyroidectomy with lateral neck dissection for PTC between April 2016 and April 2022 were retrospectively enrolled. Based on level V metastasis, 94 patients were divided into two groups, and their clinicopathological characteristics were compared. Univariable analysis were used to assess the factors associated with level V metastasis. Spearman correlation analysis were used to assess the correlation between tumors and LN. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value for the number of metastatic LNs at each level for level V metastasis. RESULTS: The number of metastatic LNs and lymph node ratio (LNR) in level II were significantly associated with level V metastasis (P = 0.011 and 0.001, respectively). The number of metastatic LNs in level II and those in the total number of levels correlated with the number of metastatic LNs in level V (rho = 0.331, 0.325, and P = 0.001, 0.001, respectively). The cutoff value for the number of metastatic LNs in level II was defined as 2.5 (area under the curve = 0.757, sensitivity = 50%, specificity = 82.5%, 95% confidence interval [CI] 0.626-0.889, P = 0.002). Simultaneous 3-level metastasis (level II, III, and IV) and 3-level with ≥ 2.5 metastatic LNs in level II were significantly associated with level V metastasis (P = 0.003 and 0.002). CONCLUSIONS: The number of metastatic LNs and LNR in level II, simultaneous 3-level metastasis (level II, III, and IV), and 3-level with ≥ 2.5 metastatic LNs in level II were significantly associated with level V metastasis. (P = 0.011, 0.001, 0.003, and 0.002, respectively). In the future, larger-scale multi-institutional studies were needed to find out predictors for level V metastasis.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/patologia , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , Esvaziamento Cervical , Estudos Retrospectivos , Fatores de Risco , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
5.
World J Surg Oncol ; 20(1): 293, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104749

RESUMO

OBJECTIVES: To discuss management protocol, surgical complications, and outcomes of thyroid carcinoma in children. METHODS: We performed a retrospective analysis including all pediatric patients with thyroid carcinoma who were managed at our institution between January 2011 and January 2021. Data were analyzed regarding demographics, clinical features, operative details, postoperative complications, and survival data. RESULTS: Thirty-two patients were identified; 26 females (81.25%) and 6 males (18.75%). The median age at operation was 14 years (range: 5-18). Twenty-six (81.25%) patients presented with palpable thyroid swelling. Median tumor size was 3 cm (range: 1-7). Metastatic workup did not detect any pulmonary metastases. Total thyroidectomy was performed in 25 patients (78%), and 16 of them underwent additional bilateral neck dissection (16 had central nodal dissection, and 7 had both central and lateral nodal dissection). Seven patients (22%) underwent hemithyroidectomy, and only one of them had a completion thyroidectomy after 2 weeks. Conservative resection was adopted in six children with similar criteria (tumor size < 1.5 cm in one lobe, no extrathyroid extension, differentiated thyroid carcinoma, no detected lymph nodes). Postoperative complications occurred in eight patients (all had total thyroidectomy) with an overall incidence of 25%. Seven patients had transient morbidities that were managed conservatively (chylous leak n = 1, hypoparathyroidism n = 3, and nerve palsy n = 3). At a median follow-up time of 54 months, four patients had relapsed (all underwent total thyroidectomy). The 5-year OS and EFS were 100% and 87.5%, respectively. CONCLUSION: Operative resection for pediatric thyroid carcinoma can be performed with average short-term complications and achieving excellent outcomes. Total thyroidectomy remains the standard procedure of choice in the majority of those patients. However, conservative surgery can be successfully adopted in a well-selected group of children with favorable long-term results as per our findings.


Assuntos
Neoplasias da Glândula Tireoide , Criança , Feminino , Humanos , Masculino , Esvaziamento Cervical/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos
6.
BMC Surg ; 22(1): 320, 2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-35987629

RESUMO

INTRODUCTION: In papillary thyroid cancer patients, the extent of dissection is still a matter of debate. Evaluating Delphian lymph nodes (DLNs) during the surgery has been speculated as a valuable tool to determine the extent of dissection. Herein, we aimed to evaluate the incidence and features of DLNs involvement in patients with papillary thyroid carcinoma. METHOD: We conducted this cross-sectional study among surgical cases of papillary thyroid cancer. Patients were divided based on their DLNs involvement status. Their age, gender, location of the mass, lymphatic involvement, tumor size, tumor characteristics, pathology report, and operation note features were compared between the two groups. Definitive pathology slides of the patients were evaluated regarding DLN features. RESULTS: Of the 61 patients (mean age: 38.2 ± 12.0), 45 (73.8%) were females. In 13 (21.3%) patients, DLNs involvement was reported. A statistically significant relationship was noted between DLNs involvement and other lymph nodes' involvement on the same side of the mass (P < 0.001), the opposite side (P = 0.041), and also central lymph nodes (P < 0.001). Vascular invasion was also significantly higher among patients with DLNs involvement (P = 0.012). CONCLUSION: Since DLNs involvement is significantly associated with extensive nodal involvement, intraoperative evaluation of DLNs is recommended to establish the extent to which dissection should be performed.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adulto , Carcinoma Papilar/cirurgia , Estudos Transversais , Feminino , Humanos , Incidência , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estudos Retrospectivos , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
7.
Oral Oncol ; 133: 106026, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35914443

RESUMO

OBJECTIVES: To identify the factors related to the presence of occult metastases before salvage total laryngectomy (STL) in rcN0 patients and to propose an algorithm to identify patients who do not require neck dissection (ND). PATIENTS AND METHODS: This multicentric retrospective study included five centers with recruitment from 2008 to 2018. Inclusion criteria were: i) having been treated for laryngeal squamous cell carcinoma in first intention by radiotherapy (either alone or potentiated or preceded by induction chemotherapy), ii) having received STL with or without ND, iii) having an rcN0 neck at the time of STL. RESULTS: 120 patients met the inclusion criteria. The overall rate of occult metastases was 9.1 %. The rate was significantly higher in patients with an initial positive cN+ lymph node status (p < 0.005) and in advanced stages with rcT3-T4 lesions at recurrence (p < 0.005). Patients with occult metastases recurred earlier than those without (p = 0.002). The overall survival of patients was the same with or without ND (p = 0.16). There were significantly more healing complications requiring revision surgery in the group with ND than in the group without (p = 0.048). CONCLUSION: ND does not confer a net survival benefit and is associated with significant complications. Patients without initial lymph node metastases who are rcT1-T2 at recurrence or rcT3-T4 with a recurrence period of more than 12 months could benefit from STL without ND. This decisional algorithm, which needs to be validated, would help avoid 58 % of ND procedures and their proven morbidity. DISCIPLINE: Head and neck surgery.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Laríngeas , Algoritmos , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Neoplasias Laríngeas/patologia , Laringectomia/métodos , Esvaziamento Cervical/métodos , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Terapia de Salvação/métodos
8.
Viruses ; 14(8)2022 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-36016315

RESUMO

Human-papillomavirus (HPV)-positive tonsillar and base of tongue carcinomas (TSCC/BOTSCC) are rising in incidence and treatments with radiotherapy, chemoradiotherapy (RT/CRT), and neck dissections (NDs) have several side effects. Therefore, an improved selection of patients needing salvage NDs would be beneficial. We examined the prevalence and localisations of viable tumour cells in neck lymph nodes in patients post-RT/CRT, identified by fluorodeoxyglucose positron-emission tomography with computer-tomography (FDG PET-CT), with a focus on HPV-associated tumours. Patients with 217 TSCC/BOTSCC with tumours assessed for HPV-DNA and p16INK4a undergoing FDG PET-CT 12 weeks after treatment and/or an ND were included. The FDG PET-CT data were compared with the findings in the pathology report after the ND. In total, 36/217 (17%) patients were selected for an ND due to positive findings in post-treatment FDG PET-CT. Of these, 35/36 were HPV-associated, 10/36 (28%) had viable tumour cells in the pathology reports of the neck specimen, and 8/10 (80%) were consistent with the FDG PET-CT findings, while 2/36 (5%) were missed by FDG PET-CT. We conclude that FDG PET-CT 12 weeks after RT/CRT is useful, but not completely reliable for finding all the metastases of HPV-associated TSCC/BOTSCC. Nonetheless, our data indicate that an ND could be more selectively guided by FDG PET-CT.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Infecções por Papillomavirus , Neoplasias da Língua , Neoplasias Tonsilares , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/terapia , Fluordesoxiglucose F18 , Humanos , Esvaziamento Cervical , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Língua/diagnóstico por imagem , Língua/patologia , Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/terapia , Neoplasias Tonsilares/diagnóstico por imagem , Neoplasias Tonsilares/terapia
9.
Artigo em Inglês | MEDLINE | ID: mdl-35954583

RESUMO

The prognosis of oral cancer that has metastasized to the contralateral cervical lymph nodes is poor, although the appropriate treatment method has not been established because of its rarity. A multicenter retrospective study on the treatment and prognosis of pN2c oral cancer patients was conducted. We investigated the treatment and prognosis of 62 pN2c patients out of 388 pN+ patients with oral squamous cell carcinomas. Statistical analysis was performed on the various factors with overall survival (OS) and disease specific survival (DSS). In multivariate cox regression analysis, advanced T stage was significantly correlated with poor OS (p = 0.011) and DSS (p = 0.023) of patients with pN2c neck. In pN2c patients, OS, DSS, and neck control was not different between those undergoing ipsilateral neck dissection initially and those undergoing bilateral neck dissection. Thus, contralateral elective neck dissection is not recommended. The most important risk factor for prognosis in pN2c oral cancer patients is advanced T stage. No evidence was found to recommend contralateral elective neck dissection in clinically N1/2b patients. Therefore, the indication for contralateral elective neck dissection in N1/2b patients should be carefully determined in consideration of individual conditions.


Assuntos
Neoplasias Bucais , Humanos , Metástase Linfática , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos
10.
Sci Rep ; 12(1): 13696, 2022 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-35953555

RESUMO

The significance of postoperative radiotherapy (PORT) to the neck for pN1 status head and neck squamous cell carcinomas (HNSCC) after neck dissection is unclear. A total of 208 patients with pN1 status HNSCC treated from January 1, 2001, to December 31, 2014, were enrolled in the current study. The 5-year regional recurrence-free survival (RRFS), overall survival (OS) and distant metastasis-free survival (DMFS) were compared between patients with or without PORT to the dissected neck. Moreover, the stratified Cox proportional hazards models were used to assess the association between PORT to the neck and survival before and after propensity score matching. Seventy-nine patients received PORT to the neck, while 129 did not. All patients were followed for over 5 years, with a median follow-up duration of 64.6 months. The PORT group did not show better survival results than the group without PORT to the neck in RRFS, OS or DMFS. Moreover, no evidence showed that PORT to the neck was independently associated with 5-year survival. PORT to the neck for pN1 status HNSCC after neck dissection did not lead to better survival. However, it is necessary to conduct prospective randomized clinical trials to confirm these results.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Estudos Prospectivos , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia
11.
Am J Otolaryngol ; 43(5): 103597, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35987100

RESUMO

BACKGROUND: The complication of brachial plexus injury (BPI) after surgical suture of chylous fistula caused by neck dissection is extremely rare. For the first time, we investigated the treatment and prevention strategy of BPI caused by surgical suture of neck dissection induced chylous fistula. METHODS: Forty-two patients undergoing surgical suture of neck dissection induced chylous fistula were identified between January 2015 to March 2022 at a single tertiary academic center. All patients were divided into two groups, medial anterior scalene muscle (MASM) group (24 patients) and lateral anterior scalene muscle (LASM) group (18 patients), according to the location of fistula regarding scalene muscle described in the surgical records. The incidence of BPI between the two groups after surgical suture was summarized and compared. RESULTS: There was significant difference in the incidence of different degrees of BPI between the two groups. In the MASM group, the incidence of BPI was 0 % (0/24), while in the LASM group, 6 cases suffered different degrees of BPI immediately after operation and the incidence of BPI was 33.3 % (6/18) (p < 0.05). The neurological function of all BPI cases recovered within 1-3 months after the suture was removed in time. CONCLUSION: The incidence of BPI in patients of LASM group was significantly higher than that of MASM group. When suturing this kind of fistula, the depth of the needle should be properly controlled to avoid BPI. In case of BPI, the suture should be removed as soon as possible to promote the recovery of neurological function.


Assuntos
Plexo Braquial , Quilo , Fístula , Plexo Braquial/lesões , Fístula/epidemiologia , Fístula/etiologia , Fístula/prevenção & controle , Humanos , Esvaziamento Cervical/efeitos adversos , Suturas/efeitos adversos
12.
Front Endocrinol (Lausanne) ; 13: 856278, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35784530

RESUMO

Background: Thyroid carcinoma is one of the most common endocrine tumors, and papillary thyroid carcinoma (PTC) is the most common pathological type. Current studies have reported that PTC has a strong propensity for central lymph node metastases (CLNMs). Whether to prophylactically dissect the central lymph nodes in PTC remains controversial. This study aimed to explore the risk factors and develop a predictive model of CLNM in PTC. Methods: A total of 2,554 patients were enrolled in this study. The basic information, laboratory examination, characteristics of cervical ultrasound, genetic test, and pathological diagnosis were collected. The collected data were analyzed by univariate logistic analysis and multivariate logistic analysis. The risk factors were evaluated, and the predictive model was constructed of CLNM. Results: The multivariate logistic analysis showed that Age (p < 0.001), Gender (p < 0.001), Multifocality (p < 0.001), BRAF (p = 0.027), and Tumor size (p < 0.001) were associated with CLNM. The receiver operating characteristic curve (ROC curve) showed high efficiency with an area under the ROC (AUC) of 0.781 in the training group. The calibration curve and the calibration of the model were evaluated. The decision curve analysis (DCA) for the nomogram showed that the nomogram can provide benefits in this study. Conclusion: The predictive model of CLNM constructed and visualized based on the evaluated risk factors was confirmed to be a practical and convenient tool for clinicians to predict the CLNM in PTC.


Assuntos
Neoplasias da Glândula Tireoide , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Esvaziamento Cervical , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia
14.
Oral Oncol ; 132: 106017, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35830760

RESUMO

OBJECTIVES: The objective of this review was to determine the rate and risk factors of paratracheal lymph node (PTLN) involvement during total laryngectomy (TL) or total pharyngolaryngectomy (TPL). In addition, we aimed to assess its prognostic significance in terms of survival and peristomal recurrence. METHODS: A comprehensive electronic search was performed on PubMed, EMBASE, and CENTRAL databases. We searched for studies reporting outcomes of PTLN dissection during radical laryngeal surgery for squamous cell carcinoma of the larynx, hypopharynx or cervical oesophagus. RESULTS: We included a total of ten studies (838 patients). The overall rate of PTLN dissection positivity was 18.6% (20.7% for primary TL, 8.7% for salvage TL). Random-effects meta-analysis identified T4 stage, N+ stage of the lateral neck, subglottis involvement and primary tumour arising from the hypopharynx or cervical oesophagus as significant risk factors for PTLN involvement. CONCLUSIONS: This meta-analysis allowed to better define the risk of PTLN involvement during TL or TPL, in a bid to guide indication for PTLN dissection. There is a need for further large studies reporting rigorously the outcomes of PTLN dissection in order to establish stronger evidence-based recommendations.


Assuntos
Neoplasias Hipofaríngeas , Neoplasias Laríngeas , Humanos , Neoplasias Laríngeas/patologia , Laringectomia , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , Esvaziamento Cervical , Estudos Retrospectivos
15.
Acta Otorhinolaryngol Ital ; 42(3): 230-236, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35880363

RESUMO

Objective: The Neck Dissection Impairment Index (NDII) questionnaire is a useful and validated Quality of Life (QoL) evaluation instrument in patients undergoing major head-neck surgery. Its English version has been used in several studies in the last years. The aim of this work is to validate the NDII in Italian for both patient assessment and future studies. Materials and methods: Cross-cultural adaptation of the NDII was performed using standard techniques. Items of the original NDII were translated into Italian by a professional translator and two bilingual investigators. A final consensus version was obtained and given to two professional translators to produce a literal translation into English. The two translators and an expert committee synthesised the results of the translations in an English back-translated version that was compared with the original to check that they had the same semantic value. Results: Finally, a total of 42 patients completed both copies of the translated questionnaires. Internal consistency proved to be excellent, with Cronbach's alpha = 0.95. Conclusions: The NDII was successfully translated into Italian and its use was easy for patients. The translation of the NDII can represent a useful tool for individual patient assessment and future research.


Assuntos
Esvaziamento Cervical , Qualidade de Vida , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
16.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 36(7): 540-544;558, 2022 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-35822383

RESUMO

Objective:To investigate the effect of transoral endoscopic thyroid surgery in the central lymph node dissection of thyroid cancer. Methods:Twenty patients underwent endoscopic thyroidectomy via oral vestibular approach (TOETVA group) and 20 gender and age matched patients underwent conventional open thyroidectomy were selected in this study. The clinical data, number of lymph node dissection and postoperative complications of the two groups were collected and analyzed. SPSS 24.0 statistical software was used for data analysis. Results:There was no significant differences in age, BMI, tumor size or the number of Hashimoto's thyroiditis patients between the TOETVA group and the open group(P>0.05). The operation time([117.30±10.54]min) and postoperative drainage volume([146.05±30.66]mL) in the TOETVA group were significantly higher than those in the open group([59.05±6.40]min, [77.90±22.18]mL), P<0.001. The pain in the open group 24 h after surgery was more severe than that in the TOETVA group(P<0.05). The total number of central lymph nodes, the number of pre-laryngeal lymph nodes and the number of pre-tracheal lymph nodes cleared by the two groups were similar, and the number of final positive lymph nodes had no significant difference. However, the number of paratracheal lymph nodes removed in the TOETVA group was more(7.8±4.2) nodes than that in the open group(6.4±3.9) nodes, P<0.05. There was no significant difference in postoperative complications between the two groups. The scores of cosmetic evaluation and rating of cicatrices in the TOETVA group six months after surgery were(0.77±0.58) significantly lower than those in the open group(4.30±1.54), P<0.001. Conclusion:In central lymph node dissection, the efficiency of TOETVA is similar to that of traditional open thyroid surgery. For special anatomical regions, endoscopic surgery is more efficient. At the same time, TOETVA does not increase the incidence of related complications, and has good cosmetic effect.


Assuntos
Neoplasias da Glândula Tireoide , Humanos , Esvaziamento Cervical , Complicações Pós-Operatórias/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
17.
Ultrasound Med Biol ; 48(9): 1695-1710, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35688708

RESUMO

Cervical traumatic neuromas (CTNs) are a non-neoplastic hyperplasia of damaged nerves and may be misinterpreted as metastatic lymph nodes during cervical ultrasound of patients with thyroid cancer after lateral neck dissection, resulting in unnecessary and painful fin-needle aspiration biopsy. The anatomy of the cervical plexus is challenging, and the correct identification and recognition of its neural roots and branches on ultrasound are key to the correct CTN diagnosis. This review outlines the US technique used to characterize CTNs in 10 standardized steps and describes the sonographic features of the cervical plexus, to assist the radiologist in the recognition of CTNs and their differentiation from lymph node metastases.


Assuntos
Neuroma , Neoplasias da Glândula Tireoide , Biópsia por Agulha Fina , Plexo Cervical/diagnóstico por imagem , Humanos , Linfonodos/patologia , Pescoço/diagnóstico por imagem , Esvaziamento Cervical/métodos , Neuroma/diagnóstico por imagem , Neuroma/patologia , Neuroma/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia
18.
Niger J Clin Pract ; 25(6): 849-854, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35708427

RESUMO

Background and Aim: The aim of our study is to prepare a head-neck phantom model for ultrasound suitable for submandibular anatomy to be used in the education of research assistants in the department of radiology in dentistry, and to compare different materials for this purpose. Materials and Methods: To make the planned phantom model, we used aluminum foil suitable for the curvature of the mandible instead of bone, pasta, or parsley stalk and balloon/glove to mimic the myofascial structure instead of muscles, tube of an infusion system instead of blood vessels, ketchup/mayonnaise/honey instead of gland structures (in a small balloon), and small balloons filled with water or mayonnaise with a tube of an infusion system or pipette instead of lymph nodes. Results: After the examinations, it was decided to put ballistic gel for soft tissue, aluminum foil for bone, spaghetti and ketchup in a balloon for muscle, mayonnaise in small balloons for lymph nodes, ketchup in a balloon for submandibular gland, and a tube of an infusion system for the artery. Conclusion: The submandibular region phantom can be a useful tool for learning the sonoanatomy of the head, neck, and submandibular region and improving the ability to use ultrasound. The advantage of the prepared model is that it is easy to use, prepare and apply materials accessible to any dentist, and can be used over and over again.


Assuntos
Alumínio , Pescoço , Educação em Odontologia , Humanos , Linfonodos/patologia , Pescoço/diagnóstico por imagem , Esvaziamento Cervical
19.
Head Neck ; 44(10): 2197-2205, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35770328

RESUMO

BACKGROUND: This study aimed to introduce our robotic technique, which can minimize dissection extent using the da Vinci SP robotic system via hairline incision. METHODS: Forty patients underwent robotic thyroidectomy using the da Vinci SP robotic system via a hairline incision between February 2020 and April 2021 at Ulsan University Hospital. All procedures were performed successfully by one surgeon using the SP robotic system. RESULTS: Hemithyroidectomies were performed in 32 patients and total thyroidectomies in eight patients. Central neck dissection was performed in 32 patients. The overall mean operative time was 140.2 ± 50.7 min, and the mean console time was 74.0 ± 42.7 min. All patients were discharged on the second or third day after operation without any complications. CONCLUSIONS: Robotic thyroidectomy using the SP robotic system via hairline incision is technically feasible and safe, with a shorter incision length when compared with that of the Xi system.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Ferida Cirúrgica , Estudos de Viabilidade , Humanos , Esvaziamento Cervical/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Robótica/métodos , Tireoidectomia/métodos
20.
Head Neck ; 44(10): 2151-2161, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35731030

RESUMO

OBJECTIVES: Examine the role of elective neck dissection (END) and adjuvant radiotherapy (RT) in early-stage clinically N0 parotid mucoepidermoid carcinoma (MEC). METHODS: The study is a retrospective analysis of the National Cancer Database, 2004-2016. The study population included adult patients with MEC who underwent parotidectomy. RESULTS: A total of 1233 patients were included. Histopathology demonstrated well, moderately, and poorly differentiated MEC 47.12%, 39.98%, and 12.90% of the time, respectively. END was performed in 78.67% of patients, resulting in nodal upstaging in 4.43% and identification of extracapsular extension (ECE) in 0.72%. RT was utilized in 67.33% of patients with advanced pathological features. Neither END nor RT improved overall survival separately (p < 0.05) or combined (adjusted HR: 1.19, 95%CI: 0.52, 2.70, p = 0.68). CONCLUSION: This study provides an epidemiological perspective regarding patients with clinically T1-2, N0 MEC. There was no observed survival advantage with END and RT.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias Parotídeas , Adulto , Carcinoma Mucoepidermoide/radioterapia , Carcinoma Mucoepidermoide/cirurgia , Humanos , Esvaziamento Cervical , Estadiamento de Neoplasias , Neoplasias Parotídeas/radioterapia , Neoplasias Parotídeas/cirurgia , Radioterapia Adjuvante , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...