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Real-life patients with rDTC can benefit from lenvatinib treatment. AEs are frequent and should be closely monitored.

This study confirms that ALK rearrangements in ATC are rare and that the mutational landscape of ATC is heterogeneous, with many genes implicated in the follicular epithelial cell dedifferentiation process. This may explain the limited effectiveness of targeted therapeutic options tested so far.

Context: Papillary thyroid microcarcinomas (PMC) defined as tumors %10 mm in diameter (including pT1a and pT3 according to the latest pTNM classification) have good prognosis, although recurrence is possible. Clinicians are interested in using a scoring system for predicting recurrences. Objective: To identify the prognostic factors for recurrence in patients with PMC and to develop a scoring system based on lymph node involvement, multifocality, and sex. To determine the impact of extrathyroidal invasion (ETI) and a threshold value for analyzing multifocality. Methods: Single-center retrospective study of a cohort of 1669 patients with PMC managed from 1960 to 2007. The Kaplan-Meier survival rate and prognostic factors of events were analyzed using logrank tests and uni-and multivariate Cox model-based analyses. A scoring system was proposed. Results: Sixty-eight recurrences were observed. Initial lymph node metastases (PZ0.0001), multifocality (PZ0.05), and male sex (PZ0.01) were significantly associated with recurrence, although there was a period effect (after 1990). PMC size was not a significant variable. Our scoring system allows us to separate patients into three risk groups according to their recurrence-free probability. For PMC Nx patients, total foci size of multifocal tumors O20 mm was significantly associated with recurrence (P!0.0001). Radioiodine (RAI) ablation was associated with better outcome only in PMC with ETI. Conclusion: Our scoring system classifies recurrence risk. In PMC Nx patients, multifocality is important in planning therapeutic strategies. Recurrence probability of pT3 PMC appears lower if RAI ablation is performed.

Despite high elasticity values in classic PTC variants, conventional SWE indexes failed to discriminate between benign and malignant tumors in thyroid nodules with IC.

Background: Liver cirrhosis may lead to hepatocellular carcinoma (HCC), regardless of its cause. Genetic and/or environmental factors may modulate the risk of HCC. Mutations in the HFE gene are responsible for genetic haemochromatosis, a condition known to be associated with liver cirrhosis, HCC, or both. It has recently been suggested that the C282Y HFE gene mutation may be more frequent in patients with HCC that have developed in the non-cirrhotic liver than in the general population. Whether or not HFE gene mutations are associated with an increased risk of HCC in patients with cirrhosis is unknown. Aim: To assess the prevalence of HFE gene mutations in cirrhotic patients with and without HCC. Patients and methods: A total of 133 consecutive cirrhotic patients with HCC were prospectively studied for the presence of C282Y and H63D mutations. The control group consisted of 100 cirrhotic patients without HCC. We used restriction enzyme digestion of polymerase chain reaction amplified genomic DNA for determination of HFE genotypes. Iron loading was assessed on non-tumoral liver biopsy samples from 89 patients with HCC and 73 patients without HCC. Results: The prevalence of C282Y heterozygotes was similar in patients with and without HCC (5% v 4%, respectively; p=0.65) and did not differ from that expected in the general population. None of the HCC patients was found to be homozygous for C282Y or H63D, nor compound heterozygous. The prevalence of H63D heterozygotes was similar in patients with and without HCC (31% v 38%, respectively; p=0.25). No relation was detected between HFE genotypes and hepatic iron loading in patients with or without HCC. Conclusion: C282Y and H63D mutations do not appear to be associated with an increased risk of HCC in patients with cirrhosis.

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