Publications by authors named "Takashi Uruno"
Context: The specific characteristics of pediatric and adolescent differentiated thyroid cancer (DTC) is the more frequent occurrence of distant metastasis (DM) compared with adult DTC.
Objective: To investigate the clinical outcomes of DM in this population and analyze risk factors related to DM.
Design, Setting, And Participants: Medical records of 171 patients with DTC < 19 years old, who underwent initial surgery between 1979 and 2014 were retrospectively reviewed.
Article Synopsis
- Radioactive iodine (RAI) therapy is typically used for treating papillary thyroid carcinoma (PTC) patients with distant metastasis (DM), but its effectiveness remains uncertain against more recent treatments like tyrosine kinase inhibitors (TKIs).
- A study involving 64 PTC patients treated solely with RAI therapy revealed 10, 15, and 20-year survival rates of 68.2%, 63.6%, and 61.1%, highlighting the long-term risks associated with the disease.
- Key risk factors linked to increased mortality included age over 55, metastasis outside the lungs, and lack of RAI avidity, with specific combinations of these factors significantly raising mortality expectations in patients.
Background: Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein-creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria.
View Article and Find Full Text PDFPurpose: Studies have shown that inflammatory biomarkers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), are associated with prognosis or treatment efficacy in various cancers. The present study investigated the association between the inflammatory biomarkers and dynamics of NLR, and prognosis or disease progression in anaplastic thyroid carcinoma (ATC).
Methods: This study included 55 patients with ATC who had available complete blood count (CBC) data.
Article Synopsis
- Some thyroid cancer patients experience a rapid deterioration in their condition, known as the flare phenomenon, after stopping lenvatinib, a type of tyrosine kinase inhibitor.
- In this study, about 14.3% of patients (8 out of 56) showed this phenomenon, with symptoms appearing typically around 9 days post-treatment cessation.
- Patients who experienced the flare phenomenon had a median overall survival of 15.1 months, which was notably lower than the 41.9 months seen in those who did not experience the flare, indicating a trend toward poorer outcomes for flare patients.
In the recent American Thyroid Association (ATA) guidelines for adult differentiated thyroid carcinoma (DTC) patients, risk stratification is clearly defined and lobectomy is acceptable for low-risk DTC. However, risk stratification for children with DTC in the ATA pediatric guidelines is rather unclear, and total thyroidectomy is recommended for all patients with any risk. The aim of this study was to attempt risk stratification based on our experience and to consider the appropriate extent of thyroidectomy, especially for low-risk DTC in the pediatric population.
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- Sarcopenia, or loss of muscle mass, is linked to poorer survival and treatment results in cancer patients, prompting a study on its impact on metastatic thyroid cancer patients undergoing TKIs (tyrosine kinase inhibitors).
- The observational study included 54 patients, revealing that those with sarcopenia had significantly lower progression-free survival (PFS) compared to those without it.
- Results indicate that sarcopenia may serve as an independent predictive factor for TKI treatment outcomes, highlighting the need for further research to explore its implications for patient management.
The ultimate clinical goal of advanced cancer treatment is improvement of survival. Tyrosine kinase inhibitors (TKIs) were recently approved for radioiodine-refractory differentiated thyroid carcinoma (RR-DTC) that is resistant to conventional therapies since they have significant potential to improve survival in patients who previously had no more treatment strategies available. However, eligible patients are limited in clinical practice, making it difficult to accurately determine the efficacy of TKIs.
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- Differentiated thyroid cancer (DTC) usually has a good prognosis, but bone metastases can lower quality of life and survival rates for patients.
- A study investigated the effectiveness of CyberKnife stereotactic radiotherapy (SRT) for treating bone metastases in 13 patients over a period from 2013 to 2018, focusing on the response to the treatment and any adverse events that occurred.
- Results showed that SRT was generally effective, with a 97.1% local control rate after one year, minimal adverse effects, and various responses among the treated lesions, making SRT a viable option for DTC bone metastases.
Background: The Turin criteria including solid, trabecular, and/or insular architecture, lack of typical nuclear features of papillary carcinoma, and mitoses, necrosis, or convoluted nuclei were adopted in the recent 4th edition of the World Health Organization classification published in 2017.
Materials And Methods: Between 2006 and 2017, 11,001 cases underwent initial surgery for primary malignant thyroid tumor derived from follicular cells. A total of 75 (0.
Article Synopsis
- The treatment approach for Graves' disease at the hospital transitioned from subtotal thyroidectomy (ST) to total thyroidectomy (TT) based on clinical studies suggesting ST was not effective long-term.
- A study involving 1,476 patients from 2006 to 2014 tracked surgical outcomes, revealing that TT led to significantly higher rates of both transient and prolonged hypocalcemia compared to ST.
- While total thyroidectomy is effective for managing hyperthyroidism, its increased risk of prolonged hypocalcemia indicates a need for surgeons to focus on minimizing surgical complications.
Article Synopsis
- * In a study involving 31 patients with 52 recurrent lesions treated with SRT from 2011 to 2017, the treatment was administered using the CyberKnife system, with follow-up CT scans used to evaluate effectiveness.
- * Results showed a 3-year local control rate of 84.6%, with various responses observed; SRT was deemed feasible and effective, though one patient experienced a serious adverse event requiring tracheostomy.
Background: Treatment of patients with liver metastasis of differentiated thyroid carcinoma (DTC) has not been sufficiently defined, because liver metastasis of DTC has been described mostly as case reports. Additionally, such patients are considered end-of-treatment responders. A relatively new approach using tyrosine kinase inhibitors (TKIs) may provide opportunities to manage systemic metastasis.
View Article and Find Full Text PDFBackground: Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is rare; it may occur in cases of familial adenomatous polyposis (FAP) or be sporadic. To clarify the clinicopathological features of CMV-PTC, the medical records of these patients were investigated retrospectively.
Materials And Methods: Between 1979 and 2016, a total of 17,062 cases with PTC underwent initial surgery at Ito Hospital.
New insights in thyroid cancer biology propelled the development of targeted therapies as salvage treatment for radioiodine-refractory differentiated thyroid cancer (RR-DTC), and the tyrosine kinase inhibitor (TKI) lenvatinib has recently become available as a new line of therapy for RR-DTC. The aim of this study is to investigate clinical factors related to the efficacy of TKI therapy in recurrent RR-DTC patients and identify the optimal timing for the start of TKI therapy. The subjects consisted of 29 patients with progressive RR-DTC, 9 males and 20 females, median age 66 years.
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- The study investigates the prevalence and duration of globus pharyngeus symptoms in patients undergoing thyroid surgery due to various conditions, including thyroid cancer and benign tumors.
- Patients were assessed using a throat sensation score and a depression scale before and after surgery, showing that many experienced increased discomfort post-surgery.
- Results indicated that most patients had high discomfort levels shortly after surgery, with significant correlations found between preoperative depression and longer-lasting throat symptoms.
Article Synopsis
- Advanced thyroid carcinoma patients previously lacking effective treatments can now benefit from multitargeted tyrosine kinase inhibitors, like lenvatinib, which rapidly shrink tumors.
- In a study involving 16 patients, lenvatinib showed that 83.3% experienced more than a 10% tumor reduction within 8 weeks, indicating early tumor shrinkage (ETS) is possible.
- The study emphasizes the importance of early imaging to prevent serious side effects, like fistula formation, especially in tumors located near vital structures.
Background: Lymph node (LN) recurrence detected by ultrasound (US) is a very common problem after initial treatment for papillary thyroid carcinoma (PTC). Most patients with PTC have an excellent disease-specific survival even with LN recurrence. Recently, watchful waiting with serial cervical US evaluations would be considered a reasonable approach to management of LN recurrence in selected patients.
View Article and Find Full Text PDFBackground: In patients with differentiated thyroid carcinoma (DTC), lung and bone metastasis sometimes occur. However, brain metastasis (BM) is extremely rare. Because most previous reports about BM from DTC included a relatively small number of cases, the clinical characteristics and outcomes of BM are still unclear.
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- Metastatic differentiated thyroid carcinoma (DTC) can lead to malignant pleural effusion (MPE), a condition studied in 18 patients (15 women, 3 men) between 2005 and 2014, where most cases involved papillary and follicular carcinoma.
- Patients were diagnosed with lung metastases and MPE developed over a median period of 25 months, often alongside other distant metastases, such as in bones and brain.
- Treatment mainly involved palliative procedures like thoracentesis; while median survival after MPE diagnosis was 10 months, some patients survived much longer, indicating a need for consideration of further systemic therapies.
In the event of a nuclear power plant accident, prophylactic administration of potassium iodide (KI) is recommended to prevent thyroid damage due to uptake of radioiodine. To assess the inhibitory effect of low-dose inorganic iodine on thyroidal radioactive iodine uptake (RAIU) in healthy adults without dietary iodine restriction, single or repeated doses of 10 mg inorganic iodine solution were given to 22 Japanese volunteers, 18 men and 4 women with the mean age of 35.7 years, between 2011 and 2013.
View Article and Find Full Text PDFThe chemosensitivity of anaplastic thyroid cancer (ATC) to some cytotoxic agents was investigated by the histoculture drug response assay (HDRA). Thirty specimens from 22 patients with ATC were obtained from surgically resected subjects. The drugs tested were paclitaxel (PTX), docetaxel (DOC), adriamycin (ADM), nedaplatin (254-S), cisplatin (CDDP), carboplatin (CBDCA), etoposide (VP-16), 5-fluorouracil (5-FU), mitomycin C (MMC), and cyclophosphamide (CPA).
View Article and Find Full Text PDFBackground: The aim of this study was to analyze the clinical features and clinical outcomes of papillary thyroid carcinoma (PTC) in the pediatric and adolescent population treated in our institution.
Methods: The subjects were 227 PTC patients 20 years of age or under treated initially between 1979 and 2012. Their mean age at diagnosis was 18-year old (range 7-20 years).
Background: Diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) is a rare variant more common among younger patients.
Materials And Methods: Excluding patients with microcarcinoma, 5848 patients with PTC underwent initial surgery between 1995 and 2011. Twenty-two patients (0.
Background And Objective: The effectiveness of antimicrobial prophylaxis (AMP) in the prevention of surgical site infection (SSI) following thyroid and parathyroid surgery remains uncertain. The objective of this prospective randomized controlled trial (Ito-RCT1) was to assess the effectiveness of AMP in clean neck surgery performed to treat thyroid and parathyroid disease.
Methods: Participants comprised patients scheduled for clean neck surgery for thyroid and parathyroid disease at Ito Hospital.