The Experts below are selected from a list of 299121 Experts worldwide ranked by ideXlab platform
Carmen C Solorzano - One of the best experts on this subject based on the ideXlab platform.
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toxic nodular goiter and Cancer a compelling case for thyroidectomy
Annals of Surgical Oncology, 2013Co-Authors: Joshua J Smith, Xi Chen, David F Schneider, Ratnam Nookala, James T Broome, Rebecca S Sippel, Herbert Chen, Carmen C SolorzanoAbstract:Recent American Thyroid Association guidelines call for thyroidectomy or 131I (Recommendation 31) in managing hyperthyroidism due to toxic nodular goiter (TNG). Concern for concomitant malignancy favors surgery. A 3 % thyroid Cancer incidence in TNG patients has been reported, yet recent studies suggest this Rate is underestimated. This multi-institutional study examined Cancer incidence in TNG patients referred to surgery. Patients referred for thyroidectomy at three tertiary-care institutions were included (2002–2011). Patients with concurrent indeterminate or malignant diagnosis by fine-needle aspiration (FNA) were excluded. Cancer incidence in TNG patients was determined. Fisher’s exact and chi-square tests and nonparametric t tests were used. Among 2,551 surgically treated patients, 164 had TNG (6.4 %). Median age at presentation was 49.7 years, and 86 % were female. Overall Cancer incidence was 18.3 % (30 of 164), and Rates were not significantly different between institutions. A significantly greater Cancer Rate was noted in toxic multinodular goiter versus single toxic nodule patients (21 vs. 4.5 %, P 0.05). No significant Cancer association was noted with age, preoperative dominant nodule size, lymphocytic thyroiditis or preoperative FNA (P > 0.05). These data demonstRate a higher than expected incidental Cancer Rate in TNG patients compared to historical reports (18.3 vs. 3 %). This higher Cancer incidence may alter the risk/benefit analysis regarding TNG treatment. This information should be provided to TNG patients before decision making regarding treatment.
Christopher R Mchenry - One of the best experts on this subject based on the ideXlab platform.
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thyroid Cancer in patients with toxic nodular goiter is the incidence increasing
American Journal of Surgery, 2015Co-Authors: Kevin C Choong, Christopher R MchenryAbstract:Abstract Background There has been a dramatic increase in the incidence of thyroid Cancer, but it is unclear if this has occurred in patients with toxic nodular goiter (TNG). Methods TNG was defined as one or more thyroid nodules in combination with a low serum TSH level. Patients who underwent thyroidectomy for TNG were identified from a prospectively maintained database. The Rates of incidental thyroid Cancer were compared over the intervals 1990 to 1999, 2000 to 2009, and 2010 to 2014. Results There was no significant difference in Cancer Rate between the 3 time periods. Overall, 7 (4.7%) of the 148 patients had thyroid Cancer; similarly, 1 (3.2%) of the 31 patients from 1990 to 1999, 3 (4.2%) of 72 patients from 2000 to 2009, and 3 (6.7%) of the 45 patients from 2010 to 2014 ( P > .05) had thyroid Cancer. Conclusions No significant increase in the Rate of carcinoma was observed in patients with TNG. As a result, the risk benefit analysis should not change when considering therapeutic options for TNG.
Kevin C Choong - One of the best experts on this subject based on the ideXlab platform.
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thyroid Cancer in patients with toxic nodular goiter is the incidence increasing
American Journal of Surgery, 2015Co-Authors: Kevin C Choong, Christopher R MchenryAbstract:Abstract Background There has been a dramatic increase in the incidence of thyroid Cancer, but it is unclear if this has occurred in patients with toxic nodular goiter (TNG). Methods TNG was defined as one or more thyroid nodules in combination with a low serum TSH level. Patients who underwent thyroidectomy for TNG were identified from a prospectively maintained database. The Rates of incidental thyroid Cancer were compared over the intervals 1990 to 1999, 2000 to 2009, and 2010 to 2014. Results There was no significant difference in Cancer Rate between the 3 time periods. Overall, 7 (4.7%) of the 148 patients had thyroid Cancer; similarly, 1 (3.2%) of the 31 patients from 1990 to 1999, 3 (4.2%) of 72 patients from 2000 to 2009, and 3 (6.7%) of the 45 patients from 2010 to 2014 ( P > .05) had thyroid Cancer. Conclusions No significant increase in the Rate of carcinoma was observed in patients with TNG. As a result, the risk benefit analysis should not change when considering therapeutic options for TNG.
Konstantinos A Toulis - One of the best experts on this subject based on the ideXlab platform.
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incidental thyroid Cancer in toxic and nontoxic goiter is tsh associated with malignany Rate results of a meta analysis
Endocrine Practice, 2013Co-Authors: Roberto Negro, Roberto Valcavi, Konstantinos A ToulisAbstract:OBJECTIVE In the last 6 years, several studies reported a positive association between thyrotropin (TSH) and papillary Cancer risk. The rationale is based on stimulatory action exerted by TSH on thyroid cell proliferation and/or progression of a pre-existing papillary carcinoma. To validate this hypothesis, we performed a meta-analysis comparing the incidence of thyroid Cancer in 2 groups of patients who underwent surgery for toxic or nontoxic nodular goiter. METHODS Using data from 2,150 patients with toxic multinodular goiter (TMNG) and 873 patients with toxic adenoma (TA), the overall incidence of thyroid Cancer (and 95% confidence interval [CIs]) was estimated to be 5.9% (3.9 to 8.3) for patients with TMNG and 4.8% (2.5 to 7.9) for patients with TA. Four studies were included in the meta-analysis with a total of 1,964 subjects undergoing thyroidectomy for allegedly benign thyroid disease (520 patients with TMNG or TA and 1,444 for multinodular goiter [MNG] or uninodular goiter [UNG]). RESULTS We did not find any significant differences in the risk of incidental thyroid Cancer (ITC) in patients with TMNG versus MNG (odds ratio [OR]: 0.91, 95% CI: 0.47 to 1.77, I²: 62.6%), TA versus uninodular goiter (UNG) (OR: 0.46, 95% CI: 0.12 to 1.79, I²: 12%), and TMNG or TA versus MNG or UNG (pooled analysis) (OR: 0.86, 95% CI: 0.46 to 1.60, I²: 51.5%). CONCLUSIONS The results of this meta-analysis did not confirm an association between low TSH values and lower thyroid Cancer Rate, at least in patients with nodular disease.
N. Mamelle - One of the best experts on this subject based on the ideXlab platform.
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Mediterranean dietary pattern in a randomized trial: prolonged survival and possible reduced Cancer Rate.
Archives of Internal Medicine, 1998Co-Authors: M. De Lorgeril, P. Salen, J. L. Martin, I. Monjaud, P. Boucher, N. MamelleAbstract:BACKGROUND: The Mediterranean dietary pattern is thought to reduce the risk of Cancer in addition to being cardioprotective. However, no trial has been conducted so far to prove this belief. METHODS: We compared overall survival and newly diagnosed Cancer Rate among 605 patients with coronary heart disease randomized in the Lyon Diet Heart Study and following either a cardioprotective Mediterranean-type diet or a control diet close to the step 1 American Heart Association prudent diet. RESULTS: During a follow-up of 4 years, there were a total of 38 deaths (24 in controls vs 14 in the experimental group), including 25 cardiac deaths (19 vs 6) and 7 Cancer deaths (4 vs 3), and 24 Cancers (17 vs 7). Exclusion of early Cancer diagnoses (within the first 24 months after entry into the trial) left a total of 14 Cancers (12 vs 2). After adjustment for age, sex, smoking, leukocyte count, cholesterol level, and aspirin use, the reduction of risk in experimental subjects compared with control subjects was 56% (P=.03) for total deaths, 61% (P=.05) for Cancers, and 56% (P=.01) for the combination of deaths and Cancers. The intakes of fruits, vegetables, and cereals were significantly higher in experimental subjects, providing larger amounts of fiber and vitamin C (P
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Mediterranean Dietary Pattern in a Randomized Trial: Prolonged Survival and Possible Reduced Cancer Rate
Archives of Internal Medicine, 1998Co-Authors: M. De Lorgeril, P. Salen, J. L. Martin, I. Monjaud, P. Boucher, N. MamelleAbstract:Background The Mediterranean dietary pattern is thought to reduce the risk of Cancer in addition to being cardioprotective. However, no trial has been conducted so far to prove this belief. Methods We compared overall survival and newly diagnosed Cancer Rate among 605 patients with coronary heart disease randomized in the Lyon Diet Heart Study and following either a cardioprotective Mediterranean-type diet or a control diet close to the step 1 American Heart Association prudent diet. Results During a follow-up of 4 years, there were a total of 38 deaths (24 in controls vs 14 in the experimental group), including 25 cardiac deaths (19 vs 6) and 7 Cancer deaths (4 vs 3), and 24 Cancers (17 vs 7). Exclusion of early Cancer diagnoses (within the first 24 months after entry into the trial) left a total of 14 Cancers (12 vs 2). After adjustment for age, sex, smoking, leukocyte count, cholesterol level, and aspirin use, the reduction of risk in experimental subjects compared with control subjects was 56% (P=.03) for total deaths, 61% (P=.05) for Cancers, and 56% (P=.01) for the combination of deaths and Cancers. The intakes of fruits, vegetables, and cereals were significantly higher in experimental subjects, providing larger amounts of fiber and vitamin C (P Conclusions This randomized trial suggests that patients following a cardioprotective Mediterranean diet have a prolonged survival and may also be protected against Cancer. Further studies are warranted to confirm the data and to explore the role of the different lipids and fatty acids in this protection.
