Abstract:
BACKGROUND:Medullary thyroid cancer (MTC) disseminates early to lymph nodes (LN). There is no pre- or intraoperative marker to exclude LN involvement and thereby avoid lateral neck dissection in LN-negative patients. MATERIALS AND METHODS:This study was intended to verify the observation that patients with MTC lacking desmoplastic stromal reaction (DSR) never have LN metastases. In 120 patients undergoing primary operation for sporadic MTC the prognostic value of DSR with respect to LN involvement was evaluated. RESULTS:Thirty-two (27%) of 120 tumors were DSR negative, and 88 (73%) were DSR positive. All 32 (100%) DSR-negative tumors were LN negative (N0), and all patients were biochemically cured. Of 88 DSR-positive tumors, 57 (65%) were staged N0, and 31 (36%) were staged N1(LN positive; Fisher's exact test: P = 0.0001). In a comparison of the LN involvement to the DSR characteristics, 32 (36%) of the 89 N0 patients and none of the 31 N1 patients were DSR negative. The sensitivity of DSR in predicting N0 is 38% (95% confidence interval: CI 95% = 27 %-55%), the specificity is 100% (CI 95% = 88%-100%). The sensitivity and specificity for the parameter DSR to differentiate between N0 or N1 were 100% and 36%, respectively. CONCLUSIONS:The desmoplastic stromal reaction appears to be an excellent intraoperative marker to predict LN involvement with a high specificity but low sensitivity. We therefore propose to avoid initial lateral neck dissection in MTC patients without DSR.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Scheuba C,Kaserer K,Kaczirek K,Asari R,Niederle Bdoi
10.1007/s00268-005-0391-4subject
Has Abstractpub_date
2006-05-01 00:00:00pages
853-9issue
5eissn
0364-2313issn
1432-2323journal_volume
30pub_type
杂志文章abstract:BACKGROUND:Insertion of a nasogastric tube (NGT) in an anesthetized, paralyzed, and intubated patient is difficult, and many methods have been proposed to aid in the procedure. We present a simple insertion technique. METHODS:A silicone NGT was made rigid by filling it with distilled water and freezing it. Patients we...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-009-0144-x
更新日期:2009-09-01 00:00:00
abstract::Tamoxifen is being used successfully in breast cancer patients as adjuvant hormonal therapy. The aim of this retrospective cohort study is to evaluate the impact of tamoxifen on gallstone formation in postmenopausal breast cancer patients. A total of 3165 patients who were treated for invasive breast cancer between 19...
journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1996-02-01 00:00:00
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更新日期:2018-06-01 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
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更新日期:1997-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2006-12-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2005-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2014-11-01 00:00:00