Background: To review our long-term clinical experience, analyze the failure patterns, and give suggestions for target volume delineation of carcinoma showing thymus-like differentiation (CASTLE) treated with intensity-modulated radiotherapy (IMRT).
Methods: From April 2008 to May 2019, 30 patients with CASTLE treated by postoperative or radical IMRT in our center were retrospectively reviewed. A total dose of 56-60 Gy in 28-30 fractions was prescribed to patients without residual disease and 66 Gy in 33 fractions for patients with residual or unresectable disease. Survival rates were calculated using the Kaplan-Meier method. Treatment-related toxicities were graded by National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 4.0.
Results: Among the 30 patients, 12 (40%) received partial resection or biopsy. Lateral lymph node metastasis was observed in 7 (23.3%) patients. During follow-up, regional lymph node recurrence occurred in 2 patients and distant metastasis in 5 patients. With a median follow-up time of 63.5 months, the 5-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), overall survival (OS) and progression-free survival (PFS) rates were 100, 88.9, 78.9, 93.1 and 78.9%, respectively. For patients with no lateral neck node metastasis, prophylactic radiotherapy for lateral neck nodal regions failed to improve RRFS (p = 0.381) and OS (p = 0.153).
Conclusion: Distant metastasis was the major failure pattern for CASTLE after surgery and IMRT. For patients with no lateral neck node metastasis, the omission of irradiation for lateral neck nodal regions seems to be safe and feasible.
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http://dx.doi.org/10.1186/s12885-022-10171-9 | DOI Listing |
Background: The purpose of this study was to assess impingement-free internal rotation (IR) in a virtual reverse shoulder arthroplasty simulation using a Statistical Shape Model based on scapula size.
Methods: A database of over 10,000 scapulae utilized for preoperative planning for shoulder arthroplasty was analyzed with a Statistical Shape Model to obtain 5 scapula sizes including the mean and 2 standard deviations. For each scapula model, one glenosphere size (33-42 mm) was selected as the best fit based on consensus among 3 shoulder surgeons.
Cureus
December 2024
General Surgery, King Fahad Specialist Hospital, Buraydah, SAU.
Papillary thyroid cancer (PTC) is the most frequent thyroid malignancy. Recently, the incidence has become widespread among both male and female individuals worldwide. In this article, we aim to report a 32-year-old Saudi female who presented with a painless lateral neck mass for more than seven months, and on excisional biopsy, was found to have features of PTC.
View Article and Find Full Text PDFGland Surg
December 2024
Department of Thyroid and Neck Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Background: Multifocality is a distinctive feature of papillary thyroid carcinoma (PTC); however, the biological behavior of PTC and its optimal management strategy remain unclear. The aim of this study was to analyze the clinical features and prognostic differences of multifocal papillary carcinoma and to guide the precise treatment of multifocal papillary carcinoma.
Methods: The medical records of 1,139 patients with PTC who had undergone total or hemi-thyroidectomy between April and October 2013 at the Tianjin Medical University Cancer Institute and Hospital were reviewed.
Otolaryngol Head Neck Surg
January 2025
Madison ENT & Facial Plastic Surgery, New York, New York, USA.
Objective: To evaluate the efficacy, safety, and durability of temperature-controlled radiofrequency (TCRF) treatment of the nasal valve in patients with severe or extreme nasal airway obstruction (NAO).
Study Design: A long-term, prospective, multicenter, single-blind, randomized controlled trial.
Setting: Sixteen otolaryngologic clinics and academic centers.
World J Surg Oncol
January 2025
Department of Thoracic Surgery, University Hospitals Birmingham, Birmingham, UK.
A 34-year-old male patient with recently diagnosed with medullary thyroid carcinoma underwent total thyroidectomy and radical neck dissection, requiring sharp dissection to separate the tumour from the trachea. He required post operative intubation due to bilateral vocal cord paralysis. He developed ischaemic necrosis of the upper two thirds of the trachea presenting with marked surgical emphysema and an infective wound.
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