Publications by authors named "C De Crea"
Article Synopsis
- Management of unifocal node-negative papillary thyroid carcinoma (PTMC) under 1 cm is debated, with nonsurgical options like active surveillance possibly insufficient for assessing aggressive traits or hidden lymph node metastases.
- Out of 4216 thyroidectomies for malignancy, 203 patients underwent thyroid lobectomy plus neck dissection, revealing that 37.4% had positive lymph node involvement and biological aggressive features were found in a significant portion of patients.
- The study identified younger age and multifocality as significant risk factors for hidden lymph node metastases, emphasizing that while PTMC is often seen as low-risk, some patients may exhibit aggressive characteristics, making cautious nonsurgical management essential to avoid undertreatment.
Purpose: In absence of nodal metastases or aggressive features, thyroid lobectomy (TL) should be preferred over total thyroidectomy (TT) for 1-4 cm unifocal, papillary thyroid carcinoma (PTC). However, occult, despite non-microscopic (≥2 mm), nodal metastases may be present in clinically node-negative (cN0) PTC.
Methods: Among 4216 thyroidectomies for malignancy (2014-2023), 110 TL plus ipsilateral central neck dissection (I-CND) were scheduled for unifocal cT1b/small cT2 (≤3 cm) cN0 PTCs.
Article Synopsis
- The study explores the effectiveness of desmoplastic stromal reaction as a marker for nodal metastases in sporadic medullary thyroid carcinoma, questioning the reliance on basal calcitonin levels for surgical decisions.
- Researchers analyzed data from 246 cases of medullary thyroid carcinoma, finding that both desmoplastic stromal reaction positivity and high basal calcitonin levels (>113 pg/mL) were significant independent risk factors for nodal metastases.
- The results indicate that patients with minimal desmoplastic stromal reaction might not need extensive neck surgeries, while those with significant markers should strongly consider undergoing lateral neck dissection.
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