Thyroid cancer overdiagnosis revisited

Заридзе, Давид; Maximovitch, Dimitry; Smans, M.; Стилиди, И. С.

doi:10.1016/j.canep.2021.102014

Cited by 18 publications

(14 citation statements)

References 18 publications

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“…Positive physical examination and ultrasonic examination should be attached of importance for the early diagnosis and treatment of DTC in pre-school children. Notably, it is acknowledged that there is overdiagnosis in children with DTC due to the overdiagnosis with ultrasonography screening, leading to lifelong side effects, medical care, and even psychological problems ( 18 ). For clinical implications, children with potential specific risk factors (such as adolescence in girls, Hashimoto thyroiditis, and family history) are feasible for active screening ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of clinical characteristics and risk factors of differentiated thyroid cancer in children

Chen

Lei²,

Wu³

et al. 2022

Front. Pediatr.

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BackgroundThe incidence rate of children with thyroid cancer has an increasing trend. This study aimed to investigate the clinical characteristics and therapeutic approaches of differentiated thyroid cancer (DTC) in Chinese children.Materials and methodsFrom January 1998 to March 2022, 52 cases undergoing surgical resection in Xinhua Hospital affiliated to Shanghai Jiao Tong University were divided by age (≤ 7 years old: n = 14 and 8–13 years old, n = 38). Treatment methods and clinical features were analyzed to evaluate prognostic factors for oncological outcomes.ResultsAmong the 52 cases, the proportion of local invasion in the pre-school group was found to be higher than that in the school-age group (p = 0.01). T stage was significantly different between the two groups (p ≤ 0.05); the proportion of T1–2 was higher in the school-age group (32 cases, 84.2%), while the proportion of T4 was higher in the pre-school group (6 cases, 42.8%) relatively. The postoperative complication rate was dramatically higher in pre-school children (p ≤ 0.05). Additionally, the total thyroidectomy rate in the non-recurrent group was slightly higher than that in the recurrent group (p ≤ 0.05). Over half of the recurrent cases had low T stage and low ATA (American Thyroid Association) risk levels at initial diagnosis (78.3 and 51.4%).ConclusionThe local invasion, tumor stage, and recurrent laryngeal nerve (RLN) injury rates of the pre-school group were higher than that of the school-age group, where young age served as a potential hazard in DTC children. Hence, surgeons should emphasize high-risk features and optimize individualized surgical procedures for DTC children.

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Section: Discussionmentioning

confidence: 99%

Retrospective analysis of clinical characteristics and risk factors of differentiated thyroid cancer in children

Chen

Lei²,

Wu³

et al. 2022

Front. Pediatr.

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“…For example, the increase in incidence rates of thyroid and breast cancer are reported to reflect overdiagnosis of clinically unimportant indolent lesions due to the introduction of high-resolution ultrasonography and mammography. 29,30 Conversely, EC and HNC are considered to be rather aggressive cancers to be the cause of death; thus, there is very little possibility for overdiagnosis of these cancers. Endoscopic surveillance is therefore strongly recommended based on the reduced mortality risk of metachronous EC and HNC after ER for ESCC.…”

Section: Discussionmentioning

confidence: 99%

“…The other reason is thought to be overdiagnosis, meaning that tumors that would never have led to clinical symptoms or death during a patients' ordinarily expected lifetime are detected on screening. For example, the increase in incidence rates of thyroid and breast cancer are reported to reflect overdiagnosis of clinically unimportant indolent lesions due to the introduction of high‐resolution ultrasonography and mammography 29,30 . Conversely, EC and HNC are considered to be rather aggressive cancers to be the cause of death; thus, there is very little possibility for overdiagnosis of these cancers.…”

Section: Discussionmentioning

confidence: 99%

Impact of endoscopic surveillance on mortality of metachronous esophageal and head and neck cancer after esophageal endoscopic resection

Matsueda

Ishihara

Morishima

et al. 2022

J of Gastro and Hepatol

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Background and Aim:As more superficial esophageal cancer (EC) patients are being treated with endoscopic resection (ER), it is important to understand the outcomes, including survival data, of patients who develop metachronous EC and head and neck cancer (HNC). We aimed to evaluate the long-term surveillance and survival outcomes of metachronous EC and HNC after esophageal ER. Methods: This study included 627 patients who underwent ER of superficial esophageal squamous cell carcinoma from 2008 to 2016 and were generally followed by annual or biannual esophagogastroduodenoscopy up to 2019 at Osaka International Cancer Institute. Data on metachronous cancer development and causes of death were collected from an integrated database of hospital-based cancer registry and Vital Statistics of Japan. Results: During a median (range) follow-up period of 67.4 (3.8-142.7) months, 230 patients (36.7%) developed 500 metachronous ECs and 126 patients (20.1%) developed 239 metachronous HNCs, post-ER of index EC. The 3-year, 5-year, and 7-year cumulative incidences were 25.8%, 36.0%, and 43.6% for metachronous EC and 10.9%, 16.0%, and 26.9% for metachronous HNC, respectively. No patients died of metachronous EC, and only seven patients (1.1%) died of metachronous HNC. The 3-year, 5-year, and 7-year disease-specific survival rates were 99.8%, 99.6%, and 98.6%, respectively. Conclusions: The incidences of metachronous EC and HNC increase with time over 5 years after esophageal ER; therefore, surveillance endoscopy should be continued over 5 years. Endoscopic surveillance is useful for survivors after esophageal ER given the high incidence and extremely low mortality of metachronous EC and HNC.

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“…The goal of new biomarkers discovery is to better identify or classify pathological conditions to reduce overdiagnosis and overtreatment, i.e., unnecessary surgeries. Overtreatment is due to uncertain diagnosis of malignant nodules but also to excessive clinical importance given to indolent microcarcinomas [ 94 , 95 ]. Indeed, in most cases, low-risk thyroid cancer will never impact a patient’s life.…”

Section: Concerns and Further Directionsmentioning

confidence: 99%

Role of Extracellular Vesicles in Thyroid Physiology and Diseases: Implications for Diagnosis and Treatment

2022

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Extracellular vesicles are spherical subcellular structures delimited by a lipid bilayer and released by most cells in the human body. They are loaded with a myriad of molecules (i.e., nucleic acids and proteins) depending on their cell of origin and provide the ability to transmit a message to surrounding or distant target cells. In several organs, including the thyroid, abundant recent literature reports that extracellular vesicles are responsible for intercellular communication in physiological and pathological processes, and that their utilization as a potential biomarker of pathological states (i.e., cancer, autoimmune diseases) or as therapeutic delivery vehicles promise clinical options. In this review, we present the current knowledge and understanding regarding the role of extracellular vesicles in developing thyroid diseases and diagnosis.

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Thyroid cancer overdiagnosis revisited

Cited by 18 publications

References 18 publications

Retrospective analysis of clinical characteristics and risk factors of differentiated thyroid cancer in children

Retrospective analysis of clinical characteristics and risk factors of differentiated thyroid cancer in children

Impact of endoscopic surveillance on mortality of metachronous esophageal and head and neck cancer after esophageal endoscopic resection

Role of Extracellular Vesicles in Thyroid Physiology and Diseases: Implications for Diagnosis and Treatment

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