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Related Concept Videos

The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Should small papillary thyroid cancer be observed? A population-based study.

Naris Nilubol1, Electron Kebebew

  • 1Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.

Cancer
|November 27, 2014
PubMed
Summary

Small papillary thyroid cancers (PTCs) measuring ≤ 2 cm can still cause cancer-related death. Active surveillance for these small PTCs should be approached cautiously, especially for patients over 45.

Keywords:
Surveillance, Epidemiology, and End Results Programcancer-specific survivalmortalityprognostic factorthyroid cancer

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Area of Science:

  • Oncology
  • Endocrinology
  • Public Health

Background:

  • Active surveillance is debated for small papillary thyroid cancer (PTC) tumors (≤ 2 cm).
  • This study analyzes population-based data to assess thyroid cancer (TC)-related mortality in small PTCs.
  • The impact of small PTCs on TC-related mortality is investigated.

Purpose of the Study:

  • To analyze TC-related mortality in a population-based cohort.
  • To determine the impact of small PTCs (≤ 2 cm) on TC-related mortality.
  • To identify risk factors associated with death from small PTCs.

Main Methods:

  • Utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database (1988-2007).
  • Analyzed characteristics of PTCs ≤ 2 cm in patients who died from TC-related causes.
  • Examined clinical features affecting disease-specific survival.

Main Results:

  • TC-related mortality was 2.8% over 20 years; 12.3% of deaths involved PTCs ≤ 2 cm.
  • Patients dying from PTCs ≤ 2 cm were more likely to be male, aged ≥ 45, and have larger tumors (>1 cm), extrathyroid extension, and lymph node/distant metastases.
  • Independent risk factors for death included age ≥ 45, metastases, extrathyroid extension, and less than thyroid lobectomy.

Conclusions:

  • Small PTCs (≤ 2 cm) contribute to TC-related deaths, even after thyroidectomy.
  • Nonoperative management for small PTCs warrants caution.
  • Thyroidectomy is recommended for patients aged ≥ 45 with PTCs ≤ 2 cm.