Interpretation of 2016 Chinese Expert Consensus on Diagnosis and Treatment of Papillary Thyroid Microcarcinoma / 中国实用内科杂志

Led by the Thyroid Cancer Professional Committee of the China Anti-cancer Association(CATO), experts from 21 thyroid centers jointly formulated the 2016 Chinese expert consensus on the diagnosis and treatment of papillary thyroid microcarcinoma.Its content covers surgical, pathological, imaging, endocrine and nuclear medicine and other professional fields, and summarizes the latest clinical research results in the field of papillary thyroid microcarcinoma in recent years and the actual situation in China.The expert consensus includes 23 recommendations, including the epidemiology, diagnosis, treatment, follow-up and outlook of papillary thyroid microcarcinoma, which provides a more reasonable and standard diagnosis and treatment plan.The purpose of this paper is to interpret the application of the consensus two years after its release and the reactions in the industry.

A prospective randomized and controlled study on no drainage after surgery for benign thyroid disorders / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the necessity of drainage after thyroidectomy for benign thyroid disorders.</p><p><b>METHODS</b>A total of 272 patients who underwent thyroidectomy for benign thyroid disorders were randomly divided into drainage group or non-drainage group. Operating time, postoperative stay time in hospital, comfort of neck assessed by visual analogue scale (VAS) on postoperative day (POD) 0 and POD1 were and the incidence of complications, including post-thyroidectomy bleeding, hematoma, seroma, wound infection, hoarseness, and hypoparathyroidism, were assessed and compared between two groups.</p><p><b>RESULTS</b>Both groups were similar in the mean age, the sex ratio and the underwent procedure types. There was no significant difference in the mean operating time between two groups (87.5 ± 32.0) min and (93.8 ± 30.1) min (t = 0.12, P = 0.45). The mean postoperative hospital stay time of non-drainage group (1.9 ± 0.3) d was significantly shorter than that of drainage group (2.6 ± 0.6) d (t = 1.45, P = 0.02). The mean VAS scores of neck comfort on POD0 and POD1 in non-drainage group were significantly high than those in non-drainage group(t = 2.67, P = 0.03 and t = 0.33, P = 0.006). There were no significant difference in postoperative complications, including permanent hoarseness and hypoparathyroidism, between two groups.</p><p><b>CONCLUSIONS</b>No drainage after thyroidectomy for benign thyroid disorders does not increase postoperative complications, with the increase in postoperative neck comfort, the decrease in hospital stay time and potential wound infections. The routine drainage is not necessary after thyroid surgery for benign disorders.</p>

Thyroid lymphography:a new clinical approach for protecting parathyroid in surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To research the role of lymph tracers to protect parathyroid in surgery for papillary thyroid carcinoma.</p><p><b>METHODS</b>Patients with papillary thyroid carcinoma who met selected criteria were enrolled in this study. Patients were divided into carbon nanoparticle group, methylene blue group, and conventional surgery group.</p><p><b>RESULTS</b>No significant complication occurred in the patients of carbon nanoparticle and methylene blue groups. In carbon nanoparticle group, methylene blue group and conventional surgery group, the mean numbers of parathyroid glands detected during surgery were 3.1 ± 0.3, 2.9 ± 0.4 and 2.3 ± 0.3 (F = 3.78, P < 0.01) , the rates that parathyroid was cut mistakenly were 1.37% (2/146) , 2.62% (2/97) and 7.14% (6/84) respectively (χ(2) = 17.372, P < 0.05) ; and the incidence of postoperative hypocalcemia were 10.4% (5/48) , 9.1% (3/33) and 17.5% (7/40,χ(2) = 0.671, P = 0.037) .</p><p><b>CONCLUSION</b>Thyroid lymphography technique is helpful to protect from the injury to the parathyroid glands in surgery.</p>

Clinical observation of XELOX (Capecitabine puls Oxaliplatin): an adjuvant chemotherapy regimen used in stage III colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of an adjuvant chemotherapy regimen: XELOX (Capecitabine puls Oxaliplatin) used after curative resection for stage III colorectal cancer.</p><p><b>METHODS</b>From Jan. 1998 to Jan. 2004, 256 cases with stage III colorectal cancer randomized received de Gramont, modified FOLFOX4 (mFOLFOX4) and XELOX regimens. The 3-year disease-free survival (DFS) and overall survival (OS) were compared within the three groups and relative prognosis factors within mFOLFOX4 and XELOX groups. Therapeutic adverse events were recorded and analyzed with Kaplan-Meier test.</p><p><b>RESULTS</b>98, 87 and 71 cases were respectively enrolled in the de Gramont, mFOLFOX4 and XELOX groups, mFOLFOX4 and XELOX had superior efficacy compared with de Gramont regimen. The two former could significantly improve 3-year DFS (79.7% vs. 66.2%, P = 0.015; 81.5% vs. 66.2%, P = 0.004) and medium survival time (40.2 mon vs. 37.8 mon, P = 0.024; 41.4 mon vs. 37.8 mon, P = 0.014). Meanwhile they could respectively decrease the ratio of recurrence risk by 18.0% (P = 0.024) and 21.0% (P = 0.003). The relative benefit of mFOLFOX4 versus XELOX didn't differ for 3-year DFS [hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.79-1.12, P = 0.13] and OS (HR: 0.87, 95% CI: 0.84-1.06, P = 0.54). In the analysis of DFS in relative prognosis factors, XELOX had a better trend of survival advantage. mFOLFOX4 had higher adverse events within these regimens, especially in grade 3 or 4 neutropenia and peripheral neurologic adverse events.</p><p><b>CONCLUSION</b>XELOX maintains its efficacy and safety ratio in advanced colorectal cancer. Patients have good tolerance and compliance. The regiment is deserves to be applied in clinical treatment. Oxaliplatin;</p>