Publications by authors named "Zafereo M"

Background: Definitive radiotherapy (dRT) has been shown to be an effective option for patients with oligometastatic and oligoprogressive cancers; however, this approach has not been well-studied in metastatic thyroid cancer.

Methods: This retrospective cohort included 119 patients with oligometastatic (34%) and oligoprogressive (66%) metastatic thyroid cancer treated from 2005 to 2024 with 207 dRT courses for 344 sites (50% thoracic, 37% bone, 7.5% brain, 4% abdominopelvic, and 1.

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Two selective RET inhibitors (RETis) are effective in treating ()-altered medullary thyroid carcinoma (MTC), but clinical trials did not distinguish responses between hereditary MTC (hMTC) and sporadic MTC (sMTC) cases. We reviewed our single-center experience using a RETi to treat advanced hMTC. We conducted a retrospective cohort study of patients with hMTC treated with a selective RETi at a tertiary cancer center.

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Importance: Genome-wide association studies have identified germline variants associated with the development of papillary thyroid carcinoma (PTC) that can be used to construct a polygenic score (PGS). It is important to determine whether patients with higher germline genetic risk, as summarized using PGS, present with more aggressive disease and/or develop worse clinical outcomes.

Objective: To assess whether germline risk defined by PGS is associated with clinicopathologic features and survival outcomes for patients with PTC.

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Background And Purpose: Neoadjuvant BRAF-directed therapy and immunotherapy followed by surgery improves survival in patients with BRAF-mutant anaplastic thyroid carcinoma (ATC), more so in those who have complete ATC pathologic response. This study assesses the ability of FDG-PET to non-invasively detect residual high-risk pathologies including ATC and poorly differentiated thyroid carcinoma (PDTC) in the preoperative setting.

Materials And Methods: This retrospective, single-center study included consecutive BRAF-mutant ATC patients treated with at least 30 days of neoadjuvant BRAF-directed therapy and who underwent FDG-PET/CT within 30 days prior to surgery.

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  • This study investigates the progression patterns and outcomes of anaplastic thyroid cancer (ATC) patients with neck disease who received high-dose intensity-modulated radiation therapy (IMRT), focusing on those with unresected or partially resected tumors. !* -
  • The analysis included 40 patients treated from 2010 to 2020, revealing a median overall survival of 7.1 months and a median progression-free survival of 7.4 months for those with locoregional disease. !* -
  • The findings indicate that despite aggressive treatment, 53% of patients experienced loco-regional progression, predominantly in highly irradiated areas, emphasizing the need for improved targeting and strategy in treatment planning. !
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Importance: Anaplastic thyroid carcinoma (ATC) is a rare and lethal cancer. Although progress has been made in recent years in patients with mutated BRAF tumors, those who respond initially eventually die of their disease; furthermore, there are no approved therapies for non-BRAF mutated tumors.

Objective: To determine whether treatment with matched-targeted therapy plus immune checkpoint inhibitors were associated with improved overall survival (OS).

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  • * NIFTP is diagnosed through histological examination, avoiding high-risk mutations, and has a low chance of recurrence, leading to less aggressive surgical treatment strategies compared to traditional thyroid cancers.
  • * The review aims to provide a detailed overview of NIFTP, covering its characteristics, diagnosis, management, and future research possibilities while highlighting challenges in improving preoperative diagnostics and follow-up care.
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  • - The study aimed to evaluate how effective surgical loupes are in preventing complications like recurrent laryngeal nerve (RLN) palsy and hypocalcemia after thyroid surgery.
  • - A total of 813 patients from six studies were analyzed, showing that using loupes significantly reduced the incidence of temporary RLN palsy by about 41.8%.
  • - Although trends suggested lower rates of permanent RLN palsy and hypocalcemia with loupes, these results were not statistically significant, indicating potential benefits that need further research.
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Context: Pediatric papillary thyroid carcinoma (PTC) is usually treated with total thyroidectomy followed by radioactive iodine (RAI). Recently, RAI has been used more selectively based on surgical pathology and postoperative dynamic risk stratification (DRS).

Objective: To describe patients with pediatric PTC not initially treated with RAI and their disease outcomes.

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Context: Thyroid differentiation score (TDS), calculated based on mRNA expression levels of 16 genes controlling thyroid metabolism and function, has been proposed as a measure to quantify differentiation in papillary thyroid carcinoma (PTC).

Objective: The objective of this study is to determine whether TDS is associated with survival outcomes across patient cohorts.

Methods: Two independent cohorts of patients with PTC were used: (1) The Cancer Genome Atlas (TCGA) thyroid cancer study (N = 372), (2) MD Anderson Cancer Center (MDACC) cohort (N = 111).

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  • BRAF/MEK inhibitors have significantly improved outcomes for patients with BRAF V600E-variant anaplastic thyroid carcinoma (BRAFv-ATC), which was previously considered untreatable.
  • Given that anaplastic thyroid carcinoma is a highly aggressive cancer linked to high mortality, quick diagnosis and treatment are crucial for better patient survival.
  • The FAST Consensus Statement stresses the need for early detection of the BRAF V600E variant and suggests streamlined treatment approaches to enhance patient care, addressing the recent advancements that still need to be reflected in clinical guidelines.
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Large population-based registries, such as the Surveillance, Epidemiology and End Results (SEER) Registry, help in the study of rare tumors, including medullary thyroid cancer (MTC), but lack data to understand the natural history of the disease. The Medullary Thyroid Cancer Collaborative Registry (MTCCoRe) is an exhaustive multi-institutional collection of demographic, clinical, and pathological data. To determine the extent to which MTCCoRe represents the real-world MTC population, we compared the characteristics of patients enrolled in MTCCoRe with patients enrolled in population-based cancer registries.

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Background: The aberrant expression of phosphofructokinase-platelet (PFKP) plays a crucial role in the development of various human cancers by modifying diverse biological functions. However, the precise molecular mechanisms underlying the role of PFKP in head and neck squamous cell carcinoma (HNSCC) are not fully elucidated.

Methods: We assessed the expression levels of PFKP and c-Myc in tumor and adjacent normal tissues from 120 HNSCC patients.

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Article Synopsis
  • Most follicular-derived thyroid cancers are well differentiated and typically have a good prognosis, but advanced forms like iodine refractory and poorly differentiated types present management challenges.
  • Recent advances in understanding the genetics and immune environment of these cancers have led to improved treatment options, including new targeted kinase inhibitors now approved by the FDA.
  • This review covers the genetic landscape of advanced thyroid cancers, current treatment strategies, and potential future therapies, highlighting progress in managing these complex cases.
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Genetic factors underlying lymphocyte telomere length (LTL) may provide insights into genomic stability and integrity, with direct links to susceptibility to cancer recurrence. Polymorphisms in telomere-associated genes are strongly associated with LTL and cancer risk, while few large studies have explored the associations between LTL-related polymorphisms and recurrence risk of non-oropharyngeal head and neck squamous cell carcinoma (non-OPHNSCC). Totally 1403 non-OPHNSCC patients were recruited and genotyped for 16 LTL-related polymorphisms identified by genome-wide association studies.

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Introperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is a well-established technique to aid in thyroid/parathyroid surgery. However, there is little evidence to support its use in non-thyroid or non-parathyroid surgery. The aim of this paper was to review the current evidence regarding the use of IONM in non-thyroid/non-parathyroid surgery in the head and neck and thorax.

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Context: Next-generation sequencing (NGS) analysis of sporadic medullary thyroid carcinoma (sMTC) has led to increased detection of somatic mutations, including M918T, which has been considered a negative prognostic indicator.

Objective: This study aimed to determine the association between clinicopathologic behavior and somatic mutation identified on clinically motivated NGS.

Methods: In this retrospective cohort study, patients with sMTC who underwent NGS to identify somatic mutations for treatment planning were identified.

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We report the case of a laryngectomized patient with an enlarged tracheoesophageal puncture (TEP) that is refractory to standard treatments and culminating in life-threatening recurrent dislodgement and aspiration of custom fabricated dual extra-large flange voice prostheses (VP). The fabrication and use of a novel intraluminal prosthetic device to prevent dislodgement, lessen aspiration, and preserve TE voice is described. A custom device insetting a commercial VP into the posterior wall of a LaryTube (coined "inset-VP") was devised with the primary goal of eliminating chronic VP dislodgement and lessening aspiration while maintaining TE voice.

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TGF-β1 and TGF-βR1 play important roles in immune and inflammatory responses. Genetic variants of TGF-β1 rs1800470 and TGF-βR1 rs334348 have emerged as potentially prognostic biomarkers for HPV-related head and neck cancer, while their prognostic effect on survival of smoking-related head and neck cancer remains unknown. This study included 1403 patients with smoking-related head and neck cancer, and all these patients were genotyped for TGF-β1 rs1800470 and TGF-βR1 rs334348.

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Background: Iatrogenic injury of the parathyroid glands is the most frequent complication after total thyroidectomy.

Objective: To determine the effectiveness of near-infrared autofluorescence (NIRAF) in reducing postoperative hypocalcemia following total thyroidectomy.

Methods: PubMed, Scopus, and Google Scholar databases were searched.

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  • Sporadic medullary thyroid carcinoma (sMTC) is a rare form of thyroid cancer in children and young adults, with this study focusing on its clinical characteristics and outcomes compared to hereditary medullary thyroid carcinoma (hMTC).
  • The study reviewed 144 patients diagnosed with medullary thyroid carcinoma from 1961 to 2019, finding that those with sMTC tend to be older, have larger tumors, and present with more advanced disease compared to those with hMTC, although their overall survival rates are similar.
  • The research indicates that sMTC is largely driven by RET gene alterations, highlighting the need for somatic molecular testing in patients to inform treatment options, especially for those with clinically advanced
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  • More people are getting thyroid cancer, so doctors need to better understand how risky certain thyroid nodules (Bethesda III nodules) are for becoming cancerous.
  • Different methods like special tests and scans are being studied to help figure out these risks more accurately.
  • Using both tests and scans together can help doctors make better choices for their patients, possibly avoiding unnecessary surgeries and personalizing treatment for each person.
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Poorly differentiated thyroid carcinomas (PDTC) are rare diseases; nevertheless, they account for the majority of deaths from non-anaplastic follicular cell-derived thyroid carcinomas. Establishing the diagnosis and treatment of PDTC is challenging given the low incidence and the lack of standardization of diagnostic criteria. These limitations hamper the ability to compare therapeutic modalities and outcomes between recent and older studies.

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