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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.
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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
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Directing Effect of Substituents: meta-Directing Groups01:09

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Substituents on the benzene ring that direct an incoming electrophile to undergo substitution at the meta position are called meta directors. All meta directors either have a positive charge on the atom directly bonded to the ring or a partial positive charge. These groups function by withdrawing electrons from the ring through inductive and resonance effects. Consider the carbocation intermediates formed upon the addition of an electrophile on nitrobenzene at the...
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Functions of Thyroid Hormones01:18

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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meta-Directing Deactivators: –NO2, –CN, –CHO, –⁠CO2R, –COR, –CO2H01:13

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All meta-directing substituents are deactivating groups. These substituents withdraw electrons from the aromatic ring, making the ring less reactive toward electrophilic substitution. For example, the nitration of nitrobenzene is 100,000 times slower than that of benzene because of the deactivating effect of the nitro group. The first step in an electrophilic aromatic substitution is the addition of an electrophile to form a resonance-stabilized carbocation. The energy diagrams for...
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Thyroidectomy for thyroid cancer in the elderly: A meta-analysis.

Kyle R Joseph1, Senarath Edirimanne1, Guy D Eslick1

  • 1The Whiteley-Martin Research Centre, Department of Surgery, Nepean Hospital, Penrith, New South Wales, Australia.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|January 16, 2019
PubMed
Summary

Elderly patients undergoing thyroidectomy for thyroid cancer face higher risks of recurrence and complications. This meta-analysis highlights the need for increased vigilance and early intervention in older adults with this endocrine malignancy.

Keywords:
ElderlyMortalityRecurrenceRisk factorsThyroid cancerThyroidectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Geriatric Medicine

Background:

  • Thyroid cancer is the most common endocrine malignancy with generally good prognosis.
  • Elderly patients often receive less aggressive treatment for more aggressive disease, leading to worse outcomes.
  • The risks associated with thyroidectomy in elderly patients require further quantitative investigation.

Purpose of the Study:

  • To quantitatively assess the risks of mortality/survival, disease recurrence, and surgical complications in elderly patients undergoing thyroidectomy for thyroid cancer.
  • To compare these risks with those of younger patient cohorts.

Main Methods:

  • A systematic search and meta-analysis of electronic databases (PubMed, Medline) was performed.
  • Included studies focused on patients over 60 years old undergoing thyroidectomy for thyroid cancer, examining mortality, recurrence, and complication data.
  • A total of 16 studies met the inclusion and exclusion criteria.

Main Results:

  • Elderly patients demonstrated an increased risk of disease recurrence (HR 4.84), including lymph node and distant metastases.
  • These patients also faced a higher risk of complications following thyroidectomy (OR 1.82).
  • Qualitative analysis indicated reduced overall survival and disease-free survival in the elderly cohort.

Conclusions:

  • Elderly patients are at higher risk following total thyroidectomy for thyroid cancer.
  • These findings support classifying elderly patients as higher risk.
  • Emphasis should be placed on early detection and intervention strategies for this demographic.