Molecular targeted therapy for locally advanced/metastatic thyroid carcinoma / 中国实用外科杂志

There is still a lack of effective treatment for radioactive iodine-refractory DTC(RAIR DTC),anaplastic thyroid cancer(ATC)and medullary thyroid cancer(MTC).Once recurrence and metastasis occur,the patient's life is seriously threatened. With the vigorous development of molecular biology of thyroid cancer,many effective molecular targets have been found. Based on one or more targets,molecular targeted drugs underwent clinical trials for the treatment of thyroid cancer,showing good development and application prospects. Sorafenib,vandetanib,lenvatinib and cabozantinib have been approved by FDA for the treatment of advanced thyroid carcinoma. Other molecular targeting inhibitors,such as axitinib and selumetinib,have passed phaseⅡ/Ⅲ clinical trials. The emergence of the drugs provides new choices for the treatment of advanced thyroid cancer and advanced MTC. The drugs have many advantages,such as strong specificity,less side effects and good curative effect,having broad prospects in the treatment of thyroid cancer.

Progression of solitary and multifocal papillary thyroid carcinoma - a retrospective study of 368 patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Papillary thyroid carcinoma (PTC) represents one of the most frequent endocrine malignancies. Several factors have been found to be involved in determining the outcome of treatment for patients with PTC. Large tumor size, diagnosis at an early age, extra-thyroidal invasion, aggressive histological variants, and distant metastases are the most important determinants of a poor outcome. BRAF(V600E) mutation has been found to be a major genetic alteration in PTC. This study aimed to evaluate progression in patients with multifocal and solitary PTC.</p><p><b>METHODS</b>We performed a retrospective study to analyze 368 patients with PTC who underwent surgery, including 282 patients with solitary PTC and 86 patients with multifocal PTC. The status of BRAF(V600E) mutation in all tumor foci from multifocal PTC was detected.</p><p><b>RESULTS</b>Our study suggested that multifocal PTC was more related to lymph node metastasis and vascular invasion than solitary PTC. However, the distant metastasis rate and 10-year survival rate showed no difference between these two groups. The number of tumor foci did not affect progression of disease in multifocal PTC patients. Lymph node metastasis in multifocal PTC patients was associated with larger tumors, diagnosis at early stage, and extra-thyroidal invasion.</p><p><b>CONCLUSION</b>The status of BRAF(V600E) mutation was more frequent in multifocal PTC patients with lymph node metastasis and diagnosis at later age.</p>

Biological characteristics and management of familial papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical biological characteristics and investigate the managements of familial papillary thyroid carcinoma (FPTC).</p><p><b>METHODS</b>Clinical data of 36 patients with PTC from 15 families were retrospectively analyzed compared with 95 control cases taken randomly from the patients with sporadic PTC diagnosed and treated in Tianjin Cancer Hospital between January 2010 and August 2011.</p><p><b>RESULTS</b>Of the 36 patients with FPTC, 15 (41.7%) were ≥45 years old, 12 (33.3%) had bilateral carcinoma, 20 (55.6%) were multifocality, 27 (75.0%) had neck lymph node metastases, 17 (47.2%) coexisted thyroid benign tumors. Of the 95 patients with SPTC, 60 (63.2%) were ≥45 years old, 12(12.6%)had bilateral carcinomas, 21 (22.1%) were multifocality, 51 (53.7%) had neck lymph node metastases, and 26(27.4%)coexisted thyroid benign tumors. Of the 36 patients with FPTC, 22 (61.1%) underwent total thyroidectomy and 14 (38.9%) with unilateral thyroidectomy plus isthmusectomy, 3 (8.3%) received unilateral or bilateral lateral neck dissection and central compartment neck dissection (CND), 7 (19.4%) received unilateral or bilateral posterolateral neck dissection and CND, 6 (16.6%) received posterolateral neck dissection and bilateral CND, and 20 (55.6%) received unilateral or bilateral CND.</p><p><b>CONCLUSIONS</b>Age at disease presentation of FPTC was younger than that of SPTC. FPTC has higher rates of multifocality and bilateral carcinoma coexisting with thyroid benign tumor than those of SPTC. It necessary to take family history in detail and to evaluate diseases before operation.</p>

Analysis of variation trends of thyroid cancer treated in Tianjin Cancer Hospital form 1954 to 2009 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate and analyze the variation trends in the pathological composition of thyroid cancer patients treated in Tianjin Cancer Hospital from 1954 to 2009.</p><p><b>METHODS</b>To retrospectively analyze the incidence and clinical features of different pathological types of thyroid cancers in 4342 patients between different time periods from 1954 to 2009.</p><p><b>RESULTS</b>In the four main pathological types of thyroid cancers, the component ratio of papillary thyroid cancer in every period was 68.1%, 78.3%, 81.3%, 82.1%, 85.8%, respectively, while the morbidity of patients with papillary thyroid carcinoma concurrent with Hashimoto's thyroiditis was increased, so was the proportion of tumors in diameter < or = 2 cm. The proportion of follicular thyroid carcinoma and anaplastic thyroid carcinoma was decreasing accordingly; however, the proportion of medullary thyroid carcinoma did not change significantly.</p><p><b>CONCLUSIONS</b>The pathological classification of the thyroid carcinoma patients has significant changes in the 4342 cases treated in our Hospital from 1954 to 2009. The proportion of papillary carcinoma is increased, while that of follicular carcinoma and anaplastic carcinoma is decreased. The reasons might attribute to the improved level of consultations and iodized diet or other factors.</p>