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With the rapid rise in incidence of micropapillary carcinoma, there is considerable interest in active surveillance or deferred intervention in patients with incidental micropapillary carcinoma. The risk of disease progression is different based on the age of the patient. It is high in third and fourth decade, while very low in sixth and seventh decade. Appropriate selection and close surveillance...
The majority of differentiated thyroid cancer tends to present with limited locoregional disease, leading to excellent long-term survival after operative treatment. Even patients with advanced local disease may survive for long periods with appropriate treatment. The aim of this study is to present our institutional experience of the management of locally advanced differentiated thyroid cancer and...
Over the last 15 years, there has been a change in clinical practice for the detection of recurrence in all patients with papillary thyroid cancer (PTC). In the past, recurrence was detected by clinical examination supplemented with fine-needle aspiration cytology; however, routine neck ultrasonography (US) and measurements of serum thyroglobulin were introduced for follow-up in 2000 and are now used...
The current American Joint Committee on Cancer TNM classification for differentiated thyroid cancer (DTC) separates T1 status into T1a and T1b based on a 1-cm cutoff for maximal tumor dimension. In 2009, the American Thyroid Association recommended total thyroidectomy for tumors >1 cm in contrast to the possibility of lobectomy for tumors ≤1 cm. Our aim was to investigate the prognostic significance...
The role of prophylactic central neck dissection in the management of papillary thyroid cancer (PTC) is controversial. We report our experience of an observational approach to the cN0 neck in PTC.We reviewed 1,129 patients with PTC who had total thyroidectomy between 1986 and 2005. In that group, 470 patients were pN1; 384 had benign nodes removed (pN0); and the remaining 275 had no nodes removed...
Background. Vascular endothelial growth factor (VEGF) induces proliferation of endothelial cells, stimulates angiogenesis, and increases vascular permeability. Increased VEGF expression has been associated with poor clinical outcomes in many malignancies. Several recent reports have documented over expression of VEGF in papillary thyroid cancer. We hypothesized that increased expression of VEGF would...
Background. Although fine-needle aspiration (FNA) is 90% sensitive in the detection of papillary carcinoma (PC) of the thyroid, its specificity has been reported as low as 52%. Consequently, patients who have an FNA suspicious for PC may undergo operation for a benign process. The ribonucleoprotein telomerase has been noted to be activated in a wide variety of carcinomas. We examined 30 PCs for telomerase...
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