担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AME Publishing Company  

DOI： 10.21037/gs-23-171

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

担当区分：筆頭著者,　最終著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.beem.2022.101630

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE Publications  

Pheochromocytomas can present with various symptoms. Nonspecific manifestations of pheochromocytoma include intestinal pseudo-obstruction and weight loss. Here, we present a case of pheochromocytoma in which prolonged intestinal pseudo-obstruction due to excess catecholamines was one of the factors leading to the development of a liver abscess. An 18-year-old male patient with a history of status epilepticus and severe intellectual disability was transferred to our hospital for a thorough examination of fever and constipation that had lasted for 2 months. When admitted to our hospital, he had fever, and his body mass index was 9.5 kg/m². Upon comprehensive examination of the patient’s fever, the blood culture was found positive for Bacteroides. Computed tomography showed findings of intestinal pseudo-obstruction and a low density region in the liver that indicated a liver abscess. Imaging studies also revealed a right adrenal mass and endocrinological test showed elevated plasma norepinephrine and urine normetanephrine levels. In addition, the right adrenal mass showed uptake on ¹²³I-metaiodobenzylguanidine scintigraphy. These findings led to a definite diagnosis of pheochromocytoma. The patient was eventually diagnosed with a pheochromocytoma coexisting with a liver abscess. After treating the liver abscess with antibiotics and ultrasound-guided drainage, an adrenalectomy was performed. The pathological findings were consistent with pheochromocytoma. Postoperatively, the catecholamine excess normalized and intestinal pseudo-obstruction and weight loss improved. We suspected that prolonged intestinal pseudo-obstruction resulted in bacterial translocation and development of a liver abscess. To the best of our knowledge, this is the first report of a pheochromocytoma associated with a liver abscess. Moreover, the clinical presentation of this patient was unusual for pheochromocytoma, as the patient did not have typical symptoms such as hypertension or tachycardia, but rather presented with constipation, intestinal pseudo-obstruction, and weight loss. This case provides valuable insight regarding the impact of catecholamine excess on the intestinal tract and body weight.

DOI： 10.1177/20420188221139652

researchmap

その他リンク： http://journals.sagepub.com/doi/full-xml/10.1177/20420188221139652

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本生化学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

BACKGROUND: This cross-sectional study compared patient-reported outcomes of low-risk papillary thyroid carcinoma (PTC, T1N0M0) between patients who underwent active surveillance (AS) and those who received immediate surgery, METHODS: Using the State-Trait Anxiety Inventory, Short-Form 36 version 2, and a visual analog scale for neck symptoms, 249 patients under AS and 32 patients underwent immediate surgery were compared. To match the difference in time from the onset of treatment to the survey, we conducted propensity score matching. We also investigated factors affecting anxiety in patients under AS in multiple linear regression analysis. RESULTS: In the entire group, patients under AS had significantly longer time from the onset to the survey than patients underwent immediate surgery (7.9 vs. 4.0 years). After matching, AS group showed significantly better trait anxiety and mental component summary (MCS) compared to surgery group, while surgery group showed better role-social component summary. AS group also had significantly better MCS than the Japanese norm-based score. Surgery group displayed worse neck symptoms than AS group. Among AS group, trait anxiety and time from the onset were significant predictors of state anxiety. Compared with the group with < 5 years since starting AS, the group with ≥ 5 years of follow-up showed a significantly better state anxiety only in patients with better trait anxiety. CONCLUSIONS: Low-risk PTC patients under AS showed better trait anxiety and mental health than surgery group. After a certain period, the anxiety of patients under AS seems to be improved, especially in patients with better trait anxiety.

DOI： 10.1007/s00268-022-06786-5

PubMed

researchmap

その他リンク： https://link.springer.com/article/10.1007/s00268-022-06786-5/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Parathyroid tumors (PTs) are sometimes difficult to diagnose because they are small and have a low-velocity blood flow, which can be missed by current imaging modalities. PTs consist of parathyroid adenoma (PA), parathyroid cyst, and parathyroid carcinoma (PC). Detective flow imaging (DFI) is a new imaging technology that displays a low-velocity blood flow. Herein, we report two cases in which DFI was useful for the diagnosis of PTs. One case consisted of a PA and a parathyroid cyst in close proximity, and the other was a PC. To the best of our knowledge, this is the first report to demonstrate the usefulness of DFI in the diagnosis of PTs.

DOI： 10.1272/jnms.JNMS.2023_90-604

PubMed

researchmap

担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

Downhill varices are usually caused by superior vena cava (SVC) obstruction due to bronchogenic carcinoma or mediastinal tumors. These structures show retrograde blood flow and are located in the proximal esophagus. Varices in the hypopharynx resulting from mediastinal thyroid tumor are extremely rare. A 70-year-old man visited a local hospital with a 35-year history of enlarging thyroid tumor in the right neck. Fine needle aspiration cytology of the tumor revealed benign goiter. Contrast-enhanced computed tomography showed a huge tumor (13×10×5 cm) in the right to left lobe of the thyroid extending into the mediastinum. Further, a well-enhanced mass mimicking hypopharyngeal cancer was identified in the hypopharynx. Endoscopic examination demonstrated varices in the postcricoid region, so we avoided biopsy. The preoperative diagnosis was huge adenomatous goiter and hypopharyngeal varices caused by obstruction of the internal jugular and brachiocephalic vein by the goiter. Total thyroidectomy was performed and hypopharyngeal varices had disappeared by the next day. The histopathological diagnosis of the thyroid tumor was poorly differentiated carcinoma. Mediastinal thyroid tumor rarely causes downhill varices due to SVC obstruction. However, in this case, signs of SVC obstruction were absent and varices were found not in the upper esophagus, but in the hypopharynx. Obstructed venous flow from the thyroid plexus might circulate via superior laryngeal vein and cause varices in the postcricoid region. When a patient with large mediastinal tumor shows a tumor-like lesion in the hypopharynx, considering the possibility of downhill varices is important before conducting immediate biopsies.

DOI： 10.1272/jnms.jnms.2023_90-601

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Mary Ann Liebert Inc  

DOI： 10.1089/thy.2022.0061

researchmap

その他リンク： https://www.liebertpub.com/doi/pdf/10.1089/thy.2022.0061

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

PURPOSE: Anaplastic thyroid cancer (ATC) is a rare and highly aggressive cancer for which effective systemic therapy has long been sought. Here, we assessed the efficacy and safety of lenvatinib in patients with unresectable ATC. PATIENTS AND METHODS: The study was investigator-initiated and conducted under a multicenter, open-label, nonrandomized, phase II design. Eligibility criteria included pathologically proven ATC; unresectable measurable lesion as defined by RECIST 1.1; age 20 years or older; ECOG PS 0-2; and adequate organ function. The primary end-point was overall survival. Secondary end-points were progression-free survival, objective response rate, disease control rate, clinical benefit rate, and safety. RESULTS: Of 52 patients enrolled from 17 institutions, 42 patients who were confirmed to have ATC were included for efficacy analysis, and 50 patients were included for safety analysis. The estimated 1-year overall survival rate was 11.9% (95% CI, 4.4%-23.6%). One patient (2.4%) achieved complete response, four patients (9.5%) partial response, and 26 patients (61.9%) stable disease, including nine patients (21.4%) who demonstrated durable stable disease, giving an objective response rate of 11.9%, disease control rate of 73.8%, and clinical benefit rate of 33.3%. Adverse events of any grade were observed in 45 patients (90.0%), the most common of which of any grade included loss of appetite (48.0%), fatigue (48.0%), hypertension (44.0%), and palmar-plantar erythrodysesthesia syndrome (26.0%). CONCLUSION: Lenvatinib treatment resulted in disappointing survival for unresectable ATC patients. Although the number of responders was small, responses were durable, indicating that lenvatinib may be beneficial for selected patients. Further investigation to identify suitable candidates for lenvatinib monotherapy is needed.

DOI： 10.1016/j.ejca.2022.06.044

PubMed

researchmap

担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00268-022-06705-8

researchmap

その他リンク： https://link.springer.com/article/10.1007/s00268-022-06705-8/fulltext.html

記述言語：日本語   出版者・発行元：(公社)日本人間ドック学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

A metastatic thyroid tumor (MTT) arising from breast carcinoma (BC) is rare and sometimes difficult to diagnose. We present a case of MTT from BC; we suspected anaplastic thyroid carcinoma at initial presentation. The patient was a 58-year-old female with a hard nodule in the right anterior neck and a history of breast cancer. Computed tomography indicated tumors on both thyroid lobes, and ultrasonography (US) with shear wave measurement (SWM) showed malignant features. We performed fine needle aspiration cytology (FNAC), the results of which led us to strongly suspect MTT from BC. The surgically resected specimen was evaluated histopathologically, including by immunohistochemistry (IHC), and the diagnosis was confirmed. In addition to FNAC and IHC, SWM is useful to diagnose MTT from BC.

DOI： 10.1272/jnms.JNMS.2023_90-501

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research USA Inc.  

DOI： 10.21873/invivo.12700

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background and purpose</title>
The spread of COVID-19 has restricted the delivery of standard medical care to surgical patients dramatically. Surgical triage is performed by considering the type of disease, its severity, the urgency for surgery, and the condition of the patient, in addition to the scale of infectious outbreaks in the region. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the number of surgical procedures performed and whether the effects were more prominent during certain periods of widespread infection and in the affected regions.


</sec><sec>
<title>Methods</title>
We selected 20 of the most common procedures from each surgical field and compared the weekly numbers of each operation performed in 2020 with the respective numbers in 2018 and 2019, as recorded in the National Clinical Database (NCD). The surgical status during the COVID-19 pandemic as well as the relationship between surgical volume and the degree of regional infection were analyzed extensively.


</sec><sec>
<title>Results</title>
The rate of decline in surgery was at most 10–15%. Although the numbers of most oncological and cardiovascular procedures decreased in 2020, there was no significant change in the numbers of pancreaticoduodenectomy and aortic replacement procedures performed in the same period.


</sec><sec>
<title>Conclusion</title>
The numbers of most surgical procedures decreased in 2020 as a result of the COVID-19 pandemic; however, the precise impact of surgical triage on decrease in detection of disease warrants further investigation.


</sec>

DOI： 10.1007/s00595-021-02406-2

PubMed

researchmap

その他リンク： https://link.springer.com/article/10.1007/s00595-021-02406-2/fulltext.html

記述言語：日本語   出版者・発行元：(有)科学評論社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Endoscopic thyroidectomy offers excellent cosmetic outcomes, but requires a period of time for surgeons to become proficient. We examined the learning curve for the first 100 cases experienced by a single surgeon using a video-assisted neck surgery (VANS) subclavian approach. METHODS: We retrospectively studied 100 patients (99 women, 1 man; mean age, 36.2 years) with both benign and malignant thyroid diseases treated between 2016 and 2020. RESULTS: Preoperative diagnosis was papillary thyroid carcinoma (PTC) in 36 cases and other (non-PTC) in 64 cases. All patients underwent lobectomy, with unilateral central node dissection added for patients with PTC. Mean operative time was 125 min for non-PTC cases and 129 min for PTC cases (p = 0.43), with blood loss of 33.8 ml and 7.6 ml, respectively (p = 0.01). Recurrent laryngeal nerve paralysis (RNP) was observed in 12 patients (12%) and hemorrhage in 2 patients (2%). Comparing the first 30 cases with the last 70 cases, no significant differences in operative time or blood loss were evident, although tumor size of non-PTC cases was significantly greater among later cases (32.4 mm vs. 39.5 mm, p = 0.039). RNP was significantly decreased in later cases (26.7% vs. 5.7%, p = 0.003). Multivariate analysis revealed tumor size as a significant risk factor for increased blood loss, and increased experience correlated significantly with the decrease in RNP. CONCLUSIONS: In VANS, a certain surgical level was reached after experiencing 30 cases.

DOI： 10.1272/jnms.JNMS.2022_89-302

PubMed

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：学位論文（博士）   出版者・発行元：Springer Science and Business Media LLC  

BACKGROUND: Prospective trials of active surveillance (AS) have shown low rates of progression in low-risk papillary thyroid microcarcinoma (PTMC; T1aN0M0). However, the significance of multifocality as a prognostic factor remains controversial. METHODS: Data from 571 patients (mean age, 53.1 years; 495 females) who underwent AS were reviewed. PTMC was unifocal in 457 patients (80.0%) and multifocal in 114 patients (20.0%), with 2-5 lesions each (261 tumors in total). Tumor progression was defined as tumor size enlargement ≥ 3 mm and/or development of clinically evident lymph node metastasis (LNM). RESULTS: After a mean duration of AS of 7.6 years, 53 patients (9.3%) showed tumor enlargement and 8 patients (1.4%) developed LNM. The 10-year progression rate was 13.1%. Age, sex, and calcification pattern did not differ significantly between uni- and multifocal diseases. However, anti-thyroglobulin antibody and/or anti-thyroid peroxidase antibody was more frequently positive with multifocal PTMCs (46.7%) than with unifocal disease (34.4%, p = 0.024). Patients with uni- and multifocal disease showed no significant differences in 10-year rate of tumor enlargement (11.4% vs. 14.8%), LNM development (1.1% vs. 2.4%), or progression (12.4% vs 15.9%). Multivariate analysis of predictors for progression showed multifocality was not a significant risk factor (odds ratio, 1.45; 95% confidence interval, 0.79-2.54; p = 0.22). Eventually, 9 patients (7.9%) with multifocal PTMCs underwent surgery and 7 needed total thyroidectomy, although 7 still showed T1N0M0 low-risk cancer. CONCLUSIONS: Even patients with multiple PTMCs (T1amN0M0) are good candidates for AS. Many patients can avoid total thyroidectomy and subsequent surgical complications.

DOI： 10.1007/s00268-021-06185-2

PubMed

researchmap

その他リンク： https://link.springer.com/article/10.1007/s00268-021-06185-2/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Postoperative bleeding in thyroid surgery is a serious complication with fatal outcomes. Risk factors for postoperative hemorrhage have been reported as old age, male sex, Graves' disease, use of anticoagulants, and hematological disorders. Among the hematological diseases, congenital hemophilia is an inherited bleeding disorder characterized by absence or reduced levels of clotting factors VIII or IX. Most patients with hemophilia display bleeding symptoms during infancy or childhood, but diagnosis could be delayed in mild cases. We report a case of congenital hemophilia A that was diagnosed after three episodes of postoperative bleeding after thyroid surgery. CASE PRESENTATION: A 46-year-old man developed repeated postoperative hemorrhage after thyroid surgery for thyroid cancer. In this case, several irregularities were seen in the postoperative course, such as a relatively long interval between surgery and bleeding, the lack of an obvious bleeding point, fresh red blood dripping from the drain insertion site on the second postoperative day, and repeated bleeding three times. We therefore considered that the cause of postoperative hemorrhage might be other than the surgical operations. After a thorough examination, hemophilia A was diagnosed. CONCLUSIONS: Hemophilia is a risk factor for postoperative bleeding in thyroid surgery. However, mild hemophilia shows normal prothrombin time and activated partial thromboplastin time. We encountered a case of papillary thyroid carcinoma associated with congenital hemophilia A, which was diagnosed after repeated bleeding.

DOI： 10.1186/s40792-021-01272-x

PubMed

researchmap

記述言語：日本語   出版者・発行元：(公社)日本人間ドック学会  

researchmap

担当区分：責任著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)医学書院  

＜文献概要＞Point ◎日常診療において認める甲状腺結節は高頻度で良性結節であり,経過観察でよいことが多い.◎悪性腫瘍の90%以上は乳頭癌であり,多くは予後良好である.リスク評価に基づいて治療方針を決定する.◎専門医に紹介すべき症例として,(1)穿刺吸引細胞診(FNAC)が必要なもの,(2)手術が必要なもの,(3)腫瘤が急速増大するものがある.

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01440&link_issn=&doc_id=20210804040024&doc_link_id=10.11477%2Fmf.1402227766&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1402227766&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1411202765

CiNii Research

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1111/ped.14575

PubMed

researchmap

その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ped.14575

掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Endocrine Society  

DOI： 10.1507/endocrj.ej20-0692

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)医学書院  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

症例は26歳女性で、右下顎骨腫瘍(骨形成線維腫)術後の血液検査でカルシウム(Ca)とi-PTHが高値を示した。頸部造影CTでは嚢胞変性を伴う左上副甲状腺の腫大(長径20mm大)を認めたが、MIBIシンチグラフィでは病変に一致した集積はなく、産婦人科で子宮ポリープを指摘された。hyperparathyroidism-jaw tumor syndrome(HPT-JT)による原発性副甲状腺機能亢進症と判断して左上副甲状腺腫摘出術を行い、病理検査の結果は副甲状腺腺腫の所見であり、術後は血中Ca、i-PTHが正常化した。後日、遺伝子検査でCDC73遺伝子(cell division cycle protein 73 homolog gene)に「c.238-8G>A」変異を認め、HPT-JTと診断された。家族性副甲状腺機能亢進症ではHPT-JTも念頭に置いた診療が必要である。

researchmap

担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

J-GLOBAL

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Non-functioning parathyroid carcinoma is an extremely rare malignancy among endocrine tumors. We report a case in which non-functional oxyphilic parathyroid carcinoma was diagnosed from clinical symptoms and pathological diagnosis. CASE PRESENTATION: The patient was a 42-year-old man with no medical or family history of note. He had presented to a local hospital with a neck mass 2 months earlier. Medullary thyroid carcinoma was diagnosed and he was referred to our department. A 3.5-cm mass was observed in the left thyroid lobe. Laboratory data for thyroid functions, thyroglobulin, anti-thyroglobulin antibodies, anti-thyroid peroxidase antibodies, serum calcium, and parathyroid hormone (PTH) were all within normal ranges. Ultrasonography revealed a 40-mm irregular, hypoechoic mass throughout the left thyroid lobe. Follicular thyroid tumor was suspected from fine-needle aspiration cytology. Left lobectomy was performed. Pathological features revealed a thick fibrous capsule around the tumor, and a thick fibrous band was observed inside the tumor. Both capsular invasions and vascular invasions were observed. Tumor cells were eosinophilic and displayed solid growth. Immunohistochemically, tumor cells were negative for thyroid transcription factor-1, negative for thyroglobulin, negative for chromogranin A (positive for normal parathyroid tissue within the nodule), positive for PTH, and positive for parafibromin. Ki-67 labeling index was 10%. Based on these findings, non-functional oxyphilic parathyroid carcinoma was diagnosed. One and a half years postoperatively, calcium and PTH were within normal ranges, and he has shown no evidence of recurrence or metastasis. CONCLUSIONS: Non-functioning oxyphilic parathyroid carcinoma is an extremely rare malignancy, and definitive diagnosis is difficult to obtain preoperatively. Few reports have been made worldwide, and information on the long-term prognosis is scarce. Long-term surveillance by imaging is mandatory, since no indices that can be used as a marker for postoperative recurrence and metastasis have been identified.

DOI： 10.1186/s40792-021-01201-y

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1272/jnms.JNMS.2022_89-207

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AME Publishing Company  

DOI： 10.21037/gs-20-859

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Mary Ann Liebert Inc  

Background: The question of how to manage patients with low-risk papillary thyroid microcarcinoma (PTMC; T1aN0M0) has recently become an important clinical issue. Two Japanese centers have conducted prospective clinical trials of active surveillance (AS) for low-risk PTMC since the 1990s, reporting favorable outcomes. This policy has thus seen gradual adoption worldwide to avoid overtreatment. Not all PTMCs are suitable for AS, however, and many physicians still hesitate to apply the management policy in daily clinical practice. A task force on management for PTMC created by the Japan Association of Endocrine Surgery collected and analyzed bibliographic evidence and has produced the present consensus statements regarding indications and concrete strategies for AS to facilitate the management of adult patients diagnosed with low-risk PTMC. Summary: These statements provide indications for AS in adult patients with T1aN0M0 low-risk PTMC. PTMCs with clinical lymph node metastasis, distant metastasis, recurrent laryngeal nerve (RLN) paralysis due to carcinoma invasion, or protrusion into the tracheal lumen warrant immediate surgery. Tumors suspected of aggressive subtypes on cytology are recommended for immediate surgery. Immediate surgery is also recommended for tumors adherent to the trachea or located along the course of the RLN. Practical strategies include diagnosis, decision-making, follow-up, and monitoring related to the implementation of AS. The rate of low-risk PTMC progression is lower in older patients. However, we recommend continuing AS as long as circumstances permit. Future tasks in optimizing management for low-risk PTMC are also described, including molecular markers and patient-reported outcomes. Conclusions: An appropriate multidisciplinary team is necessary to accurately evaluate primary tumors and lymph nodes at the beginning of and during AS, and to adequately reach a shared-decision with individual patients. If appropriately applied, AS of low-risk PTMC is a safe management strategy offering favorable outcomes and preserves quality of life at low cost.

DOI： 10.1089/thy.2020.0330

PubMed

researchmap

その他リンク： https://www.liebertpub.com/doi/pdf/10.1089/thy.2020.0330

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Endocrine Society  

The incidence of papillary thyroid carcinoma (PTC) is increasing worldwide. The biomarkers to identify aggressive types of PTC are limited, illustrating the need to establish reliable novel biomarkers. Protein disulfide isomerase A3 (PDIA3) is a chaperone protein that modulates the folding of newly synthesized glycoproteins and stress-responsive proteins in the endoplasmic reticulum. Although the role of PDIA3 in various cancers such as breast, uterine cervix, head and neck, and gastrointestinal tract has been examined, its expression in thyroid cancer has not been reported. We retrospectively reviewed accumulated data with long-term follow-up of 1,139 PTC patients, and investigated the correlation between immunohistochemical expression of PDIA3 in PTC patients and clinicopathological features and prognosis. PDIA3 expression was significantly lower in PTCs compared to normal thyroid tissues (NTT; n = 80, p = 0.002). In PTCs, correlation between low PDIA3 expression and lymph node metastasis (p = 0.018) and the number of positive nodes (p = 0.004) was observed. Patients with low PDIA3 expression exhibited worse cause-specific survival compared to those with high PDIA3 expression (p = 0.013). Our findings indicate that low PDIA3 expression is related to poor clinical outcome in PTC patients, and that PDIA3 may potentially be a novel ancillary biomarker. Further clarification of the biological role of PDIA3 in PTC is warranted for the future clinical application.

DOI： 10.1507/endocrj.ej21-0394

PubMed

researchmap

掲載種別：研究論文（学術雑誌）  

A 26-year-old woman visited our hospital to undergo an evaluation for primary hyperparathyroidism (PHPT). She had undergone surgery for a mandibular tumor three years prior. Her blood calcium level and intact parathyroid hormone (PTH) levels were high, and computed tomography revealed swelling of the upper parathyroid on her left side. She underwent sur¬gery for the parathyroid tumor, and subsequently, her blood calcium level and intact parathyroid hormone level became normal. Genetic analysis revealed a CDC73 mutation. Based on the PHPT. mandibular tumor, and genetic analysis, she was diagnosed with hyperparathyroidism-jaw tumor syndrome (HPT-JT).

Scopus

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s13104-020-05080-8

PubMed

researchmap

記述言語：英語  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

担当区分：最終著者,　責任著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本臨床外科学会  

甲状腺は他臓器と交通がないため,甲状腺内異物の発生は非常に稀である.今回,術前に異物の存在が予想できず,術後に甲状腺内異物を認めた経験をしたため報告する.症例は46歳の男性で,15年前より甲状腺腫瘤を指摘されていた.重症潰瘍性大腸炎のため入院した際に,再度甲状腺腫瘤を指摘された.頸部USで甲状腺右葉に粗大石灰化を伴う辺縁不整な低エコー腫瘤を認め,穿刺吸引細胞診にて甲状腺乳頭癌と診断した.cT2N0M0の診断にて甲状腺右葉切除,中央領域郭清術を行った.検体に割を入れた際,内部より針様の異物を認めた.病理診断は甲状腺乳頭癌.異物は針生検に使用される器械の内針のような形態をしていた.本人に確認したところ,15年前に甲状腺の針生検を受けたようだった.甲状腺隣接臓器の気管,食道,総頸動脈などに針が穿通する可能性を有する非常に危険な状態であった.術前に甲状腺腫瘍の石灰化と判断した部位が異物を反映していたと考えられた.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

担当区分：最終著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.jnms.2021_88-409

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1272/jnms.JNMS.2019_86-408

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

40歳女性。不育症の精査を主訴とした。血液検査でTSHの感度未満、FT4の高値を認め、Tcシンチグラフィで甲状腺にびまん性の取り込み低下を認め、破壊性甲状腺炎と診断した。その後に妊娠に至り、妊娠中に甲状腺中毒症が増悪した。TRAbが陰性で、ヒト絨毛性ゴナドトロピン(hCG)の上昇を認めたが、妊娠一過性甲状腺機能亢進症と考えられた。出産後、123Iシンチグラフィで甲状腺全体の取り込み低下を認めたが、結節影の取り込みが見られ、機能性結節と診断した。出産後も抗甲状腺薬の内服が必要であり、治療抵抗性のため、出産後5ヵ月に甲状腺全摘術を施行した。術中、甲状腺は多発する結節で腫大しており、これを摘出した。病理診断は腺腫様甲状腺腫様の所見で、プランマー病としても矛盾しない結果であった。

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)東京医学社  

researchmap

DOI： 10.1089/thy.2018.0462

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0300060519873481

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Lenvatinib is a molecular-targeting agent that was recently approved in Japan for treatment of curatively unresectable, radioactive iodine-refractory, progressive differentiated thyroid cancer (DTC). Because only a few Japanese patients have received lenvatinib in clinical trials, there are limited domestic data on its safety and efficacy or prognostic factors. Therefore, a prospective observational study has been designed to collect safety and efficacy data in at least 300 patients with curatively unresectable DTC receiving lenvatinib therapy (24 mg/day), in order to find predictors of antitumor activity and survival. Patients with progressive curatively unresectable DTC refractory to radioiodine therapy will be enrolled and the primary endpoint will be overall survival. This study is designed to estimate the 95% confidence intervals of the 1-year and 2-year survival rates with a two-sided width of less than 10%. Secondary endpoints will be the time to treatment failure, time to strategy failure, progression-free survival time with clinical progressive disease, response rate, quality of life, safety, and patient reports. The ultimate goal is to obtain information for developing evidence-based guidelines for treatment of DTC, including recommendations on patient selection, dosages, and duration of treatment. This study has been registered with the UMIN Clinical Trials Registry (UMIN000022243).

DOI： 10.1507/endocrj.EJ18-0261

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Fine-needle aspiration biopsy (FNAB), an important diagnostic tool given its simplicity, safety, and cost-effectiveness, is fast becoming a popular procedure in the diagnosis of thyroid diseases. Generally, cells isolated from biopsies are transferred directly to microscope slides to prepare smears for cytopathological examination; however, the technical difficulties of this procedure often cause poor reproducibility, which limits the accuracy of diagnostic results. Liquid-based cytology (LBC), in which isolated cells are collected in a fixative solution, is advantageous in that it facilitates the preparation of homogenous cytological specimens. However, LBC has not been applied to molecular diagnoses, such as RNA expression-based diagnosis, mainly because of difficulties in cell recovery and RNA isolation. This study was aimed to improve RNA extraction from papillary cancer-derived K1 cells and thyroid FNAB specimens suspended in LBC solutions. RESULTS: K1 cells suspended in CytoRich-Red and CytoRich-Blue, fixatives for LBC, were efficiently recovered by trapping to glass-fiber filters. Importantly, subsequent Proteinase K treatment was essential for efficient RNA extraction from the fixed cells. This finding was also applicable to RNA extraction from CytoRich-Red-fixed thyroid FNAB specimens processed in the same way. Consistently, U6 small nuclear RNA was detected in these RNA samples by reverse transcription-polymerase chain reaction.

DOI： 10.1186/s13104-018-3914-4

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本人間ドック学会  

researchmap

記述言語：英語   出版者・発行元：Mary Ann Liebert Inc.  

DOI： 10.1089/thy.2018.0203

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1272/jnms.JNMS.2018_85-26

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：エーザイ(株)  

researchmap

記述言語：英語  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

＜POINT＞▼根治切除不能な甲状腺癌に対して分子標的薬(TKI)であるソラフェニブ,レンバチニブ,バンデタニブが保険収載された。▼甲状腺分化癌でのTKIの適応は,放射性ヨウ素(radioactive iodine:RAI)内用療法不応(抵抗性)かつ進行性であることが前提である。▼術前後の補助療法としての適応はない。RAI治療不応の進行・再発甲状腺分化癌を対象としたTKIの国際第III相試験では,プラセボに対して有意の無増悪生存期間の延長を認めた。▼TKIは血管新生阻害薬であるため,頸動脈や気管・食道浸潤症例では大出血や瘻孔形成をきたす場合があり,注意を要する。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ireland Ltd  

Objective While the biological behavior of follicular thyroid carcinoma (FTC) has been studied in great detail using clinical experience, few studies have investigated pre- or intraoperative factors related to the risk of distant metastasis (DM) among patients with FTC. The aim of this study was to analyze the characteristics of FTC with DM. Methods This study retrospectively investigated 102 patients with FTC who underwent surgery between 1988 and 2013. We compared clinicopathological characteristics between FTC with and without DM. Results Univariate analysis revealed nodal metastasis (p = 0.045), serum thyroglobulin (Tg) at initial operation (≥1000 ng/ml
p &lt
0.0001), widely invasive appearance according to macroscopic findings (p &lt
0.0001), thick tumor capsule (≥1 mm
p &lt
0.0001), vascular invasion (p = 0.0003), extrathyroidal invasion (p = 0.047), and venous tumor embolism (p = 0.045) as significant risk factors for DM. Multivariate analysis conducted using pre- and intraoperative factors identified thick tumor capsule (≥1 mm), serum Tg at initial operation (≥1000 ng/ml), and macroscopically widely invasive appearance as risk factors independently associated with development of DM. Conclusion Patients with these risk factors should undergo total thyroidectomy and radioactive iodine ablation.

DOI： 10.1016/j.anl.2017.05.002

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

根治切除不能な甲状腺癌を適応とするmulti-kinase inhibitor(MKI)が登場し,国際第3相試験によってprogression-free survival(PFS)の有意な延長が示された.しかし,現時点でも甲状腺癌に対する第一選択の治療法が外科的根治切除であることに変わりはない.分化癌に対しては放射性ヨウ素(radioactive iodine:RAI)不応であることがMKI使用の前提となるため,高リスク癌には早い段階で甲状腺全摘・RAI治療が行われる必要がある.これらの標準治療に抵抗性でかつ進行が明らかな症例に対してのみMKIが考慮され,術前・術後補助療法としての適応はない.特有の有害事象に対してチーム医療下での管理により,治療を長く継続することがPFS延長につながる.重大な有害事象として創傷治癒遅延や頸動脈などからの生命に関わる大出血事例が報告されている.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：英語   出版者・発行元：Medical Association of Nippon Medical School  

Anaplastic thyroid carcinoma (ATC) accounts for only 1 to 2% of all thyroid carcinomas, but it is one of the most lethal neoplasms in humans. To obtain further insights into this ”orphan disease,” we have established the ATC Research Consortium of Japan (ATCCJ) in 2009. It represents a multicenter registry for ATC that have been treated in Japan. To date, 67 institutions have taken part in the collaborative research system and over 1,200 cases have been accumulated in its database. Using this big data, several retrospective studies were carried out to evaluate 1) prognostic factors to determine initial treatment policy, 2) significance of extended radical surgery for Stage IVB cases, 3) characteristics of ATC incidentally found on pathological examination and 4) pathological features of ATC with long-term survival. Moreover, the ATCCJ has conducted an investigator-initiated, nationwide, prospective clinical trial since 2012
namely, the feasibility, safety and efficacy study of weekly paclitaxel administration for patients with ATC (UMIN: 000008574). Revised Japanese guidelines for treatment of thyroid tumors are going to adopt the recommendations from the results of this research. Since 2016, the ATCCJ has started the phase II study assessing the efficacy and safety of lenvatinib, a newly developed tyrosine kinase inhibitor for ATC (UMIN: 000020773). Our nationwide clinical trial network will strengthen the activity to recruit orphan disease patients and may discover new strategies to conquer this dismal malignancy in the near future.

DOI： 10.1272/jnms.2018_85-3

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)最新医学社  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(株)最新医学社  

進行性,転移性の甲状腺がんへの薬物療法は皆無であったが,近年甲状腺がんへのさまざまな分子標的薬(MKI)が開発されている.第III相臨床試験の良好な成績により,本邦では,レンバチニブ,ソラフェニブ,バンデタニブが保険適応となった.病勢制御にはMKIの長期投与が必要となるが,MKI投与初期には重篤な副作用が出現することがある.MKI投与の適切な患者選択,開始のタイミング,副作用管理には,医師,コメディカルによるチーム医療が重要である.(著者抄録)

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：最新医学社  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Solid variant of papillary thyroid carcinoma (PTC) is characterized by a solid component (SC) retaining classical cytological features of PTC. Despite some controversies, PTC with SC (PTCSC) cases have poor prognosis compared with well-differentiated PTC. We investigated if cancer stem cells (CSCs) may have a role in pathogenesis of PTCSC. PTCSC tumors (n = 27) were histologically represented by a mixture of papillary component (PC) and varying degrees of SC involving 10% to 85% of the tumor. Immunohistochemical expression of CSC markers ABCG2 and MRP1, and HBME1 and CK19 was compared between SC and PC within each tumor in association with clinicopathological parameters. ABCG2 and MRP1 were highly expressed in SC, whereas their expression was limited or absent in PC (P = .04 and .002, respectively). In contrast, expression of HBME1 and CK19 appeared higher in PC than in SC (P = .08 and .02, respectively). Higher expression of ABCG2 was associated with higher incidence of large-sized SC (P = .01). Higher expression of MRP1 was associated with higher incidence of lymphovascular invasion (P = .049). Higher expression of ABCG2 and MRP1, and lower expression of CK19 in SC were associated with higher tumor recurrence rate (P = .02,.01, and .02, respectively), and shorter disease free survival (P &lt; .001 for all the variables). Our findings indicate that the tumor cells harboring CSC-like characteristics in SC could contribute to the pathogenesis of PTCSC and might account for the poor disease prognosis. (C) 2017 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.humpath.2017.03.012

Web of Science

PubMed

researchmap

記述言語：日本語  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MARY ANN LIEBERT, INC  

Background: Therapeutic options for treating advanced or metastatic medullary thyroid carcinoma (MTC) and anaplastic thyroid carcinoma (ATC) are still limited in Japan, even though vandetanib for MTC and lenvatinib for MTC and ATC have been approved. Sorafenib is an oral multikinase inhibitor approved for the treatment of patients with radioactive iodine-refractory differentiated thyroid cancer (DTC). An uncontrolled, open-label, multicenter, single-arm, Phase 2 clinical study was conducted to evaluate the safety and efficacy of sorafenib in Japanese patients with MTC and ATC.
Methods: Japanese patients with histologically confirmed ATC and locally advanced or metastatic MTC were enrolled from April to September 2014. The primary endpoint was to evaluate the safety of sorafenib. Treatment efficacy variables including progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and maximum reduction in tumor size were evaluated as secondary endpoints. Patients received sorafenib 400 mg orally twice daily on a continuous basis and then continued treatment until the occurrence of disease progression, unacceptable toxicity, or withdrawal of consent.
Results: Atotal of 20 patients were screened, and 18 (8 with MTC and 10 with ATC) were enrolled. The most common drug-related adverse events were palmar-plantar erythrodysesthesia (72%), alopecia (56%), hypertension (56%), and diarrhea (44%). In the ATC patients, median PFS was 2.8 months [confidence interval 0.7-5.6], and median OS was 5.0 months [confidence interval 0.7-5.7]; ORR and DCR were 0% and 40%, respectively. In the MTC population, neither median PFS nor OS had been reached at the time of this analysis; ORR was 25% and DCR was 75%.
Conclusions: The toxicities reported in this study were consistent with the known safety profile of sorafenib. Sorafenib seems to be effective in the treatment of advanced MTC but not ATC, and could be a new treatment option for locally advanced or metastatic MTC and radioactive iodine-refractory DTC.

DOI： 10.1089/thy.2016.0621

Web of Science

PubMed

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

甲状腺癌の多様性と自然史の理解に基づいてQOLを重視する診療を説いた藤本吉秀先生(1926〜2016年)の教えに導かれ、臨床研究を行ってきた。後向き研究によって得られた知見から新たな診療方針を定め、その妥当性を前向きに検証することでエビデンスレベルの向上に努めた。乳頭癌の癌死危険度分類に基づくrisk-adapted managementの提唱、ランダム化試験によるTSH抑制療法の評価、微小乳頭癌のactive surveillanceの前向き試験、未分化癌のprognostic indexに基づく診療方針の提示などが主な成果である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J04260&link_issn=&doc_id=20170725400001&doc_link_id=%2Fcw1nimed%2F2017%2F001303%2F002%2F0118-0119%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcw1nimed%2F2017%2F001303%2F002%2F0118-0119%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：メディカルレビュー社  

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2017253214

記述言語：日本語   出版者・発行元：日本医科大学医学会  

DOI： 10.1272/manms.13.118

CiNii Research

researchmap

その他リンク： https://search.jamas.or.jp/link/ui/2017288785

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOSCIENTIFICA LTD  

There are limited treatment options for patients with radioactive iodine refractory, progressive differentiated thyroid cancer. Although there is consensus that multikinase inhibitor therapy should be considered in patients with progressive disease with considerable tumor load or symptomatic disease, uncertainty exists on the optimal timing to treat with a multikinase inhibitor, especially for asymptomatic patients. RIFTOS MKI is an international, prospective, open-label, multicenter, noninterventional study with the primary objective to compare the time to symptomatic progression from study entry in asymptomatic patients with radioactive iodine refractory, progressive differentiated thyroid cancer for whom there is a decision to initiate multikinase inhibitors at study entry (cohort 1) with those for whom there is a decision to not initiate multikinase inhibitors at study entry (cohort 2). Secondary endpoints are overall survival and progression-free survival, which will be compared between cohorts 1 and 2. Additional secondary endpoints are postprogression survival from time of symptomatic progression, duration of and response to each systemic treatment regimen and dosing of sorafenib throughout the treatment period. Asymptomatic, multikinase inhibitor-naive patients aged = 18 years with histologically/cytologically documented differentiated thyroid cancer that is radioactive iodine refractory are eligible. Patients may receive any therapy for differentiated thyroid cancer, including sorafenib or other multikinase inhibitors if indicated and decided on by the treating physician. In total, 700 patients are estimated to be enrolled from &gt;20 countries. Final analysis will be performed once the last enrolled patient has been followed up with for 24 months

DOI： 10.1530/ERC-17-0016

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

BackgroundSolid variant of papillary thyroid carcinoma is a rare subtype of papillary thyroid carcinoma (PTC) containing a solid component (SC), and thus its cytological and clinicopathological features remain elusive. We examined fine needle aspiration (FNA) cytological features of PTC with variable degrees of SC (20-80% of the tumor)(PTCSC) in comparison to well-differentiated PTC (WPTC).
MethodsTwenty-six cases of PTCSC were histologically stratified into major-SC (SC &gt;50% of the tumor) and minor-SC (&lt;49%) groups. Pre-operative FNA smears were compared between major-SC (n = 11) and minor-SC (n = 15) groups, and between PTCSC and WPTC (n = 39) groups.
ResultsIn FNA smears of PTCSC, the presence of cohesive solid nests, trabecular patterns, overlapping, enlarged nuclei, pleomorphism, and distinct nucleolus, and the absence of colloid and psammoma bodies were noted more often than in WPTC, while classical cytological features of PTC, such as nuclear grooves and/or pseudo-nuclear inclusions, were preserved. There was no significant difference in FNA findings between the major-SC and minor-SC groups. The presence of either solid nests or trabecular patterns, and overlapping in FNA smears of PTCSC was associated with a higher recurrence rate of the tumor (P=0.007 and P&lt;0.001, respectively).
ConclusionPTCSC may pre-operatively be identified by detecting its characteristic cytological features in FNA smears, regardless of the proportion of SC within the tumor. Because clinical outcomes of PTCSC remain undetermined, it is imperative to postulate PTCSC as a differential diagnosis, even when classical nuclear features of PTC are present. Diagn. Cytopathol. 2017;45:391-398. (c) 2017 Wiley Periodicals, Inc.

DOI： 10.1002/dc.23679

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：AMER SOC CLINICAL ONCOLOGY  

DOI： 10.1200/JCO.2017.35.15_suppl.6084

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

AimsSolid variant of papillary thyroid carcinoma (SVPTC) is characterized by a solid component (SC) involving more than 50% of the tumour with the preservation of the classical cytological features of papillary thyroid carcinoma (PTC). However, the clinical significance of SC in PTC has been rarely examined. Herein, we investigated retrospectively the clinicopathological features of PTC with various degrees (10-85%) of SC (PTCSC).
Methods and resultsPatients with PTCSC (n = 27) were stratified into SC-major (SC &gt; 50% of the tumour) and SC-minor (SC &lt; 49%) groups. The clinicopathological parameters were compared to the well-differentiated PTC (WPTC) group (n = 47). Both SC-minor (n = 18) and SC-major (n = 9) groups had increased incidence of a large-sized tumour, extracapsular extension and a high recurrence rate, compared to WPTC. Disease-free survival (DFS) of both SC-minor and SC-major was shorter than that of WPTC (P = 0.035 and P = 0.016, respectively). Overall survival was similar among all the groups. Univariate analysis revealed that SC was associated significantly with a recurrence rate (P = 0.018). Using multivariate analysis, SC appeared to be associated with a recurrence rate with borderline significance (P = 0.055).
ConclusionsOur findings indicate that the presence of SC in PTC, regardless of the proportion, is associated with adverse clinical parameters and a shorter DFS.

DOI： 10.1111/his.13132

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：医歯薬出版(株)  

近年、検診機器の精度向上や検診機会の増加に伴い甲状腺癌罹患率が著しく上昇しているにもかかわらず、癌による死亡数減少が認められないことから、癌の"過剰診断・過剰治療"があらたな問題となっている。最大径1cm以下の微小乳頭癌(PMC)のうち明らかな浸潤・転移のない症例(clinical T1aN0M0)について非手術経過観察(AS)を行う前向き臨床試験が、日本の2つの施設において1990年代に開始された。そこで得られたエビデンスを踏まえ、無症候性PMCのASは2010年"甲状腺腫瘍診療ガイドライン"において、世界ではじめて治療選択肢のひとつとして容認された。一方で転移や浸潤が臨床的に明らかなPMCには予後不良なものがあり、これらは絶対的手術適応である。癌診療全般においてrisk-adapted managementが重視されるなかで、超低危険度癌に対するASは世界的に標準治療として認められていく途上にあると考えられるが、個々の患者の期待に沿った診療を提供するために、新しい体制整備が求められている。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00060&link_issn=&doc_id=20170307020015&doc_link_id=issn%3D0039-2359%26volume%3D260%26issue%3D9%26spage%3D791&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0039-2359%26volume%3D260%26issue%3D9%26spage%3D791&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：日本語   出版者・発行元：(有)科学評論社  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

甲状腺・副甲状腺疾患に対する内視鏡手術が開発され、他の領域で内視鏡手術が次々と保険収載されるなか、医療行政変遷のため保険収載には至らなかった。2016年の診療報酬改定においてようやく甲状腺良性疾患や副甲状腺機能亢進症やバセドウ病に対して内視鏡下手術が保険収載された。内視鏡下甲状腺手術ワーキンググループ(WG)は2014年に内分泌外科領域における内視鏡下手術の先進医療Aを開始する時に設立された。2015年WGで臨床成績を検討し、通常手術と比較し安全性や有効性に遜色ない結果を示した。また、整容性に対する高い患者満足度や在院日数の短縮などの医療経済面への貢献も示す結果であった。それらの結果が評価され保険収載されたものと思われる。一方、甲状腺癌に対しては同様のデータであったが先進医療Aの継続となった。今後は保険収載に伴う問題や甲状腺悪性腫瘍に対する保険収載の課題など検討すべき問題が存在する。(著者抄録)

DOI： 10.11226/jaesjsts.33.4_200

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

<p>甲状腺・副甲状腺疾患に対する内視鏡手術が開発され，他の領域で内視鏡手術が次々と保険収載されるなか，医療行政変遷のため保険収載には至らなかった。2016年の診療報酬改定においてようやく甲状腺良性疾患や副甲状腺機能亢進症やバセドウ病に対して内視鏡下手術が保険収載された。内視鏡下甲状腺手術ワーキンググループ（WG）は2014年に内分泌外科領域における内視鏡下手術の先進医療Aを開始する時に設立された。2015年WGで臨床成績を検討し，通常手術と比較し安全性や有効性に遜色ない結果を示した。また，整容性に対する高い患者満足度や在院日数の短縮などの医療経済面への貢献も示す結果であった。それらの結果が評価され保険収載されたものと思われる。一方，甲状腺癌に対しては同様のデータであったが先進医療Aの継続となった。今後は保険収載に伴う問題や甲状腺悪性腫瘍に対する保険収載の課題など検討すべき問題が存在する。</p>

DOI： 10.11226/jaesjsts.33.4_200

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

researchmap

DOI： 10.1007/s13691-016-0257-7

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

researchmap

記述言語：日本語   出版者・発行元：日本甲状腺学会  

予後不良な甲状腺未分化癌において、根治切除は重要な生命予後改善因子である。しかし、腫瘍が甲状腺内に限局する症例は少なく、多くは隣接臓器への浸潤を有する症例で、拡大根治切除の適応には十分な根拠がなかった。2009年、わが国における多施設共同研究組織である甲状腺未分化癌研究コンソーシアムが設立された。多数の症例データ集積により、根治切除の重要性や腫瘍の広がりと生物学的悪性度による予後予測に基づく治療方針の決定法などが示された。拡大根治切除については、適切な症例選択により予後改善が見込めるものの、QOLとのバランスへの配慮が重要であった。近年では化学療法や放射線療法、放射線化学療法の進歩もあって、集学的治療により手術可能な症例が増加したり、予後を改善したりする効果が期待されている。根治切除不能な未分化癌に対する分子標的薬の登場もあり、外科治療の位置付けが変化してきている。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MARY ANN LIEBERT, INC  

Background: Anaplastic thyroid cancer (ATC) is a rare and extremely aggressive malignancy, with a median survival of less than 6 months due to rapid progression and resistance to multimodal therapies. Effective treatment strategies have not been identified. A prospective clinical study was performed to objectively evaluate outcomes of treatment with paclitaxel.
Methods: An investigator-initiated, multicenter, nonrandomized, open-label, single-arm study to evaluate the feasibility and efficacy of weekly paclitaxel (80 mg/m(2)) administration for patients with pathologically confirmed ATC was conducted in a nationwide organization.
Results: Feasibility was analyzed in 56 patients. More than one course of treatment was performed in 52 (93%) patients retaining sufficient dose intensity (&gt;84%). No patient had to terminate the treatment because of an adverse event. The median overall survival was 6.7 months [confidence interval 4.4-9.0]. The 6-month survival was 54%. Among the 42 patients with an evaluable lesion, none demonstrated complete remission, 9 (21%) showed partial remission, 22 (52%) achieved stable disease, and 8 (19%) exhibited progressive disease; 3 did not complete the initial treatment course. The objective response rate was 21%, and the clinical benefit rate was 73%. The median time to progression was 1.6 months. Statistically, no additional effect of concomitant radiation was demonstrated in 6 patients receiving combined therapy. Eight patients, in whom a complete post-treatment surgical removal of the tumor was feasible, survived significantly longer (median 7.6 months [CI 8.1-23.0]) than the other 34 patients in whom the tumor could not be completely removed after chemotherapy (5.4 months [CI 3.0-7.8], p = 0.018).
Summary: The study demonstrates objective and accurate information concerning the feasibility and efficacy of a standardized treatment with weekly paclitaxel administration for ATC patients.
Conclusions: Weekly paclitaxel administration for ATC patients can be of clinical benefit in a neo-adjuvant setting.

DOI： 10.1089/thy.2016.0072

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(公社)日本人間ドック学会  

researchmap

記述言語：英語   出版者・発行元：JAPAN ENDOCRINE SOC  

Differentiated thyroid carcinoma (DTC) is generally indolent in nature and, even though it metastasizes to distant organs, the prognosis is normally excellent. In contrast, the overall survival (OS) of patients with radioactive iodine (RAI)-refractory and progressive metastases is dire, because no effective therapies have been available to control the metastatic lesions. However, recently, administration of tyrosine-kinase inhibitors (TKIs) has become a new line of therapy for RAI-refractory and progressive metastases. Previous studies have reported significant improvement regarding the progression-free survival rates of patients with metastatic lesions. However, TKIs cause various severe adverse events (AEs) that damage patients' quality of life and can even be life-threatening. Additionally, metastatic lesions may progress significantly after stopping TKI therapy. Therefore, it is difficult to determine who is a candidate for TKI therapy, as well as how and when physicians start and stop the therapy. The present review, created by Committee of pharmacological therapy for thyroid cancer of the Japanese Society of Thyroid Surgery (JSTS) and the Japan Association of Endocrine Surgeons (JAES) describes how to appropriately use TKIs by describing what we do and do not know about treatment using TKIs.

DOI： 10.1507/endocrj.EJ16-0064

Web of Science

researchmap

記述言語：英語   出版者・発行元：JAPAN ENDOCRINE SOC  

Differentiated thyroid carcinoma (DTC) is generally indolent in nature and, even though it metastasizes to distant organs, the prognosis is normally excellent. In contrast, the overall survival (OS) of patients with radioactive iodine (RAI)-refractory and progressive metastases is dire, because no effective therapies have been available to control the metastatic lesions. However, recently, administration of tyrosine-kinase inhibitors (TKIs) has become a new line of therapy for RAI-refractory and progressive metastases. Previous studies have reported significant improvement regarding the progression-free survival rates of patients with metastatic lesions. However, TKIs cause various severe adverse events (AEs) that damage patients' quality of life and can even be life-threatening. Additionally, metastatic lesions may progress significantly after stopping TKI therapy. Therefore, it is difficult to determine who is a candidate for TKI therapy, as well as how and when physicians start and stop the therapy. The present review, created by Committee of pharmacological therapy for thyroid cancer of the Japanese Society of Thyroid Surgery (JSTS) and the Japan Association of Endocrine Surgeons (JAES) describes how to appropriately use TKIs by describing what we do and do not know about treatment using TKIs.

DOI： 10.1507/endocrj.EJ16-0064

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：技術情報協会  

CiNii Books

researchmap

記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN ENDOCRINE SOC  

The aim of this study was to clarify the histopathological features of anaplastic thyroid carcinoma in patients who achieved long-term survival. We reviewed 88 anaplastic thyroid carcinoma cases in which the patient survived less than 3 months (short-term survival), and 68 anaplastic thyroid carcinoma cases in which the patient survived more than one year (long-term survival) from the database of the Anaplastic Thyroid Carcinoma Research Consortium of Japan. We examined these cases both histologically and immunohistochemically. Six (6.8%) short-term survival cases and 27 (39.7%) long-term survival cases were considered not to be anaplastic thyroid carcinoma after central review. Of these, 12 were revised to papillary carcinoma with squamous cell carcinoma. In cases without chemotherapy, long-term survival was significantly more common if there was a pre-existing tumor, epithelial growth, or lymphocytic infiltration, and short-term survival was more common if neutrophilic infiltration was present. In cases with chemotherapy, long-term survival was significantly more common if epithelial growth or a squamous cell carcinoma component was present, whereas short-term survival was more common in cases with rhabdoid cells. Immunohistochemical results were not related to survival. Some long-term survival cases showed histological findings other than those typically associated with anaplastic thyroid carcinoma. The presence of a pre-existing tumor, epithelial growth, a squamous cell carcinoma component, no neutrophilic infiltration and lymphocytic infiltration may therefore be favorable prognostic factors in anaplastic thyroid carcinoma.

DOI： 10.1507/endocrj.EJ15-0705

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background: Optimal postoperative managements for anaplastic thyroid carcinoma (ATC) have not yet been sufficiently clarified. We conducted a systematic review and meta-analysis focussing on the impact of postoperative radiotherapy (PORT) in the patients with resected ATC.
Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a comprehensive search was performed in the several databases. We included the studies that reported survival outcome in the patients with or without PORT following any type of surgical resection except biopsy only. Hazard ratio (HR) was extracted, and the random-effects model was used for the pooled analysis.
Results: Seventeen retrospective studies including 1147 analysable patients met all inclusion criteria. The overall research quality was relatively low with considerable methodological limitations. The pooled results showed that PORT significantly reduced the risk of death in all the patients with resected ATC compared with those with surgery alone (HR, 0.556; 95% confidence interval, 0.419-0.737; p &lt; 0.001). Exploratory analyses demonstrated that patients with stage IVA (HR, 0.364; p = 0.012) and IVB (HR, 0.460; p = 0.059) may also have survival benefit from PORT, whereas stage IVC may not. No evidence of publication bias was found (p = 0.352).
Conclusions: This study is the first meta-analysis assessing PORT in patients with ATC and provides convincing evidence that adequate resection followed by PORT may offer the prolonged survival. However, without evidence based on prospective randomised trials, it is still not known which subset of patients can really benefit from PORT. (C) 2016 Elsevier Ltd. All rights reserved.
This work is the first meta-analysis assessing postoperative radiotherapy in anaplastic thyroid cancer and provides convincing evidence that an aggressive multimodality therapy with adequate resection followed by postoperative radiotherapy may offer the prolonged survival whenever feasible. (C) 2016 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.ejca.2016.02.015

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)日本医事新報社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Background Prospective trials of non-surgical observation have shown progression rates of only 5-10 % in patients with asymptomatic papillary microcarcinoma (PMC). This study investigated time-dependent changes in calcification patterns and tumor vascularity on ultrasonography (US) to clarify the natural course of PMC.
Methods We examined calcification patterns and tumor vascularity for 480 lesions in 384 patients. Calcification patterns were classified as: (A) none; (B) micro; (C) macro; or (D) rim. Tumor vascularity was classified as rich or poor via color Doppler US.
Results After a mean of 6.8 years of observation, 29 lesions (6.0 %) had increased in size. Mean age for initial calcification pattern was 52.1 years for A (n = 135), 54.2 years for B (n = 235), 56.3 years for C (n = 96), and 60.1 years for D (n = 14), and the incidence rates of tumor enlargement were 9.6, 5.5, 3.2, and 0 %, respectively. The cumulative rate of upgrade in calcification pattern was 51.8 % at 10 years. Lesions with initially rich vascularity (n = 70) had significantly higher rate of tumor enlargement than those with poor vascularity (n = 410); however, the majority of tumor (61.4 %) with initially rich vascularity had decreased their blood supply during the follow-up. Multivariate analysis showed that strong calcification (C or D) and poor vascularity at last examination correlated significantly with non-progressive disease.
Conclusions PMCs in older patients showed significantly stronger calcification patterns and poorer vascularity. Both consolidation of calcification and loss of vascularity occurred in a time-dependent manner during observation and were significant indicators for non-progressive disease.

DOI： 10.1007/s00268-015-3349-1

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)日本医事新報社  

researchmap

記述言語：日本語   出版者・発行元：日本薬剤師会  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2016139454

記述言語：日本語   出版者・発行元：(公社)日本薬剤師会  

researchmap

記述言語：日本語   出版者・発行元：日本薬剤師会  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2016139454

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J06552&link_issn=&doc_id=20160119160003&doc_link_id=%2Fai1thyrc%2F2016%2F000201%2F003%2F0013-0023%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1thyrc%2F2016%2F000201%2F003%2F0013-0023%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(有)科学評論社  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本気管食道科学会  

DOI： 10.2468/jbes.67.178

researchmap

researchmap

記述言語：日本語   出版者・発行元：(公社)日本生化学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：英語  

PURPOSE: The objectives of this study were to prospectively delineate the efficacy and safety of zoledronic acid for treating bone metastases (BM) from differentiated thyroid carcinoma (DTC), and to evaluate the relationships between levels of bone metabolic markers and occurrence of skeletal-related events (SREs). METHODS: This was a prospective, single-arm, single-center study. Nineteen patients with BM from DTC were assigned to receive zoledronic acid therapy every 4-5 weeks. Imaging studies for sites of BM were conducted every 6 months, and levels of bone metabolic markers, including serum bone-specific alkaline phosphatase (BAP) and urinary N-telopeptide of type I collagen (NTx), were assessed every 3 months. To evaluate the efficacy of zoledronic acid use, data of SREs were compared with those of 16 historical controls. RESULTS: SREs developed in eight patients (42 %), but metastatic spinal cord compression (MSCC) appeared in only one patient. Pain scores were ameliorated in five patients, but aggravated in six patients. Ten patients had stable disease, six showed progressive disease, and none showed partial or complete response during the observation period. Decreases in levels of bone metabolic markers were observed in ten patients for BAP and 15 for NTx. However, no significant correlations were identified between changes in bone metabolic marker levels and development of SREs. CONCLUSIONS: Zoledronic acid may offer a mainstay of multidisciplinary treatment for patients with BM for the purpose of reducing SREs. Levels of serum BAP and urinary NTx do not appear reliable as indicators of amelioration of BM symptoms.

DOI： 10.1245/s10434-015-4497-0

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)ライフメディコム  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2016071671

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：エーザイ(株)  

researchmap

記述言語：日本語  

J-GLOBAL

researchmap

記述言語：日本語  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

We report four cases of acute transient thyroid swelling following fine-needle aspiration biopsy, a rare complication of still unknown origin. The ultrasonographic pattern was fairly similar to that in previous reports: swelling of the thyroid with a patchy and heterogeneous appearance and diffusely scattered hypoechoic "cracks" that showed no blood flow signals with color Doppler ultrasound. There were also some features that differed from those in previous reports. Though thyroid swelling is typically diffuse and bilateral, it was unilateral or asymmetrical in some of our cases. While thyroid swelling is said to resolve spontaneously within 1-20 h, abnormal ultrasonographic findings persisted for more than 48 h in one case. Unlike previous reports, we have experienced cases with ultrasonographic findings of concomitant minor subcapsular hematomas. In one case, CT demonstrated not only thyroid swelling but also abnormal attenuation in perithyroid tissue extending to the retro-hypopharyngeal space and to the paraesophageal mediastinum. Although vasodilatation and diffuse vascular leakage are speculated to be the underlying mechanisms, our ultrasonograms at the time of the complication failed to demonstrate enlarged intrathyroidal vessels or hypervascularity with color Doppler ultrasound. More awareness and a description of the cases may help to clarify the pathogenesis of this self-limited complication.

DOI： 10.1007/s10396-014-0600-6

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: Anaplastic thyroid cancer (ATC) is one of the most aggressive malignancies in humans, often demonstrating resistance to multimodal therapeutic approaches. The median survival of ATC patients after initial diagnosis was reported to be &lt; 6 months due to the rapid progression of disease by dissemination and/or invasion. There have been several reports describing possible effective chemotherapies, but these studies might be biased by the nature of retrospective accumulations of clinical experiences, and thus reliable data concerning the efficacies of the treatment efforts are required.
Design: In 2009, we established the research organization Anaplastic Carcinoma Research Consortium Japan (ATCCJ) to investigate this highly malignant disease. Using this nationwide organization, we conducted a prospective clinical study to investigate the feasibility, safeness, and efficacy of chemotherapy with weekly paclitaxel for ATC patients. This trial is registered on the clinical trials site of the University Hospital Medical Information Network Clinical Trials Registry Web site (UMIN000008574). The study was started in 2012, and enrollment was closed in March 2014 after accumulating 71 patients from 28 registered institutes. The follow-up data will be available in April 2015.
Discussion: Important information concerning the management of this disease is expected to be revealed by this study. The concept and design of the study are described herein.

DOI： 10.1186/s12885-015-1490-8

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.118.444

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2015252825

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：英語   出版者・発行元：Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.82.2

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Anaplastic thyroid carcinoma has a dismal prognosis and lacks an established therapeutic strategy. We have recently conducted chemotherapy with docetaxel and cisplatin as part of multimodal treatment for eight patients with anaplastic thyroid carcinoma. Docetaxel (75 mg/mA(2)) and cisplatin (75 mg/mA(2)) were administered on day 1 every 4 weeks for six courses. This chemotherapy was used as induction therapy in one patient, as therapy for distant metastases in five patients and as postoperative adjuvant therapy in two patients. Three patients showed partial responses and three patients showed stable disease. After excluding the two patients receiving the treatment as adjuvant therapy the response rate was 50 %. Grade 3 or 4 leukocytopenia occurred in seven patients (88 %), but these adverse events were tolerable. Chemotherapy with docetaxel and cisplatin may thus be feasible for anaplastic thyroid carcinoma.

DOI： 10.1007/s00595-013-0751-x

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Anaplastic thyroid carcinoma has a dismal prognosis and lacks an established therapeutic strategy. We have recently conducted chemotherapy with docetaxel and cisplatin as part of multimodal treatment for eight patients with anaplastic thyroid carcinoma. Docetaxel (75 mg/mA(2)) and cisplatin (75 mg/mA(2)) were administered on day 1 every 4 weeks for six courses. This chemotherapy was used as induction therapy in one patient, as therapy for distant metastases in five patients and as postoperative adjuvant therapy in two patients. Three patients showed partial responses and three patients showed stable disease. After excluding the two patients receiving the treatment as adjuvant therapy the response rate was 50 %. Grade 3 or 4 leukocytopenia occurred in seven patients (88 %), but these adverse events were tolerable. Chemotherapy with docetaxel and cisplatin may thus be feasible for anaplastic thyroid carcinoma.

DOI： 10.1007/s00595-013-0751-x

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2015158969

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J06552&link_issn=&doc_id=20150327250003&doc_link_id=%2Fai1thyrc%2F2015%2F000101%2F004%2F0015-0024%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1thyrc%2F2015%2F000101%2F004%2F0015-0024%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J06552&link_issn=&doc_id=20150327250003&doc_link_id=%2Fai1thyrc%2F2015%2F000101%2F004%2F0015-0024%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1thyrc%2F2015%2F000101%2F004%2F0015-0024%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

本邦においても進行甲状腺癌に対する分子標的薬が承認され、放射性ヨウ素治療(RAI)抵抗性進行性分化型甲状腺癌に対する治療が新しい時代に入った。しかし、適応患者の選択に際しては、病理組織型、進行再発後の放射性ヨウ素(RAI)治療に対する反応などを適切に評価した上で判断することが重要であり、分子標的薬特有の有害事象に対する注意も必要である。分子標的薬の適正使用に際しては治療による恩恵と有害事象を十分に考慮した適応患者の選択が肝要である。また、未解決の問題に関しては、本邦での臨床試験による検討が必要と考えられる。(著者抄録)

DOI： 10.11226/jaesjsts.31.4_310

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J06244&link_issn=&doc_id=20141222390011&doc_link_id=10.11226%2Fjaesjsts.31.4_310&url=https%3A%2F%2Fdoi.org%2F10.11226%2Fjaesjsts.31.4_310&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(有)医学の世界社  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

本邦においても進行甲状腺癌に対する分子標的薬が承認され、放射性ヨウ素治療(RAI)抵抗性進行性分化型甲状腺癌に対する治療が新しい時代に入った。しかし、適応患者の選択に際しては、病理組織型、進行再発後の放射性ヨウ素(RAI)治療に対する反応などを適切に評価した上で判断することが重要であり、分子標的薬特有の有害事象に対する注意も必要である。分子標的薬の適正使用に際しては治療による恩恵と有害事象を十分に考慮した適応患者の選択が肝要である。また、未解決の問題に関しては、本邦での臨床試験による検討が必要と考えられる。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J06244&link_issn=&doc_id=20141222390011&doc_link_id=10.11226%2Fjaesjsts.31.4_310&url=https%3A%2F%2Fdoi.org%2F10.11226%2Fjaesjsts.31.4_310&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background. Our original system for risk group classification for predicting cause-specific death from papillary thyroid carcinoma (PTC) defined patients with distant metastasis and older patients &gt;= 50 years) with either massive extrathyroidal extension or large (&gt;= 3 cm) lymph node metastasis as high risk; all others are low risk. For unilateral, low-risk PTC, the extent of thyroidectomy (less-than-total thyroidectomy vs total or near-total thyroidectomy) has been determined based on the choice of the patient since 2005.
Patients. Of 1,187 patients who underwent initial thyroidectomy for PTC (tumor size IT] &gt;1 cm) between 1993 and 2010, 967 (82%) were classified as low risk. Among low-risk patients, 791 (82%) underwent less than total thyroidectomy.
Results. The 10-year cause-specific survival and disease-free survival rates did not differ between patients who underwent total thyroidectomy versus less than total thyroidectomy (cause-specific survival, 99% vs 99% [P = .61]; disease-free survival, 91% vs 87% [P = .90]). Age &gt;= 60 years, T &gt;= 3cm, and lymph node metastases &gt;3cm represented significant risk factors for distant recurrence.
Conclusion. The favorable overall survival of low-risk patients, regardless of the extent of thyroidectomy, supports patient autonomy in treatment-related decision making. Low-risk patients possessing risk factors for distant recurrence would be likely to benefit from total thyroidectomy followed by radioactive iodine.

DOI： 10.1016/j.surg.2014.08.060

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Papillary thyroid carcinoma (PTC) often metastasizes to the central and lateral neck lymph nodes, but rarely affects retropharyngeal nodes (RPN).
We retrospectively reviewed 12 patients (three men, nine women) with PTC who underwent dissection of RPN metastases between 1994 and 2012. Mean age at dissection was 65 years (range 23-77).
Dissection was performed with the initial surgery for PTC in eight patients, while the remaining four patients underwent dissection as secondary surgery. RPN metastases arose from an ipsilateral primary in nine patients, bilateral in two, and contralateral in one, with primaries located at the superior pole of the thyroid lobe in nine patients. All patients showed simultaneous or previous lymph node metastases in the upper jugular chain. A transcervical approach was applied for RPN dissection in 11 patients, while a transcervical-transparotid approach was applied in the remaining patient. No patients needed mandibulotomy or showed severe complications. Median duration of follow-up after RPN dissection was 48 months (range 3-206). No recurrences in the retropharyngeal space were identified. Two patients died of the disease, one died from other carcinoma, and five survived with distant metastases from PTC. The remaining four patients remain free of the disease as at the time of writing.
If lymph node metastases are identified in the upper jugular chain, the possibility of RPN metastases should be checked. Most RPN metastases from PTC can be dissected safely without mandibulotomy. In particular, low-risk patients can expect favorable outcomes.

DOI： 10.1007/s00268-014-2707-8

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)文光堂  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

DOI： 10.1093/annonc/mdu435.41

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Anaplastic thyroid carcinoma (ATC) is occasionally found on postoperative pathological examination of patients with differentiated thyroid carcinoma (DTC). There is no general consensus on how we should treat these incidentally diagnosed ATC (incidental ATC).
A total of 675 patients with ATC were registered with the ATC Research Consortium of Japan. These patients were treated between 1995 and 2008 in 38 registered institutions. About 81 % of the ATC patients had common-type ATC and about 14 % had ATC co-existing with a metastatic DTC lesion. The remaining 5 % had incidental ATC. Among the patients with incidental ATC, we investigated 25 patients whose clinical data were fully available. We examined the clinical profile of incidental ATC, and the relationships between treatment and outcome in patients with incidental ATC.
The tumor size was clearly smaller, and patients with extrathyroid invasion or distant metastasis were significantly fewer in incidental ATC than in common-type ATC. Most incidental ATC coexisted with papillary carcinoma. While the clinical course of incidental ATC was favorable compared with common-type ATC, half of the patients had disease-related deaths. The prognostic factors of incidental ATC were nearly the same as those of common-type ATC, but the tumor size alone was an independent factor on multivariate analysis. Regarding treatments, the outcome was more favorable in those who underwent curative resection, and the clinical course showed a slight improvement by the addition of external beam radiotherapy and/or chemotherapy after curative resection, but it did not reach statistical significance.
Incidental ATC is the only curable type of ATC, and further studies are needed to establish the effectiveness of additional postoperative radiotherapy and/or chemotherapy in incidental ATC.

DOI： 10.1007/s00268-014-2536-9

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Familial medullary thyroid carcinoma (FMTC) is an autosomal dominant inherited disease that has highly characteristic clinical features, including medullary thyroid carcinoma (MTC). Mutation of the RET proto-oncogene is known to be responsible for development of FMTC and for multiple endocrine neoplasia types 2A and 2B. Hirschsprung's disease is the most common form of structural intestinal obstructive disease in human newborns. Hirschsprung's disease is defined by the absence of neural crest-derived enteric ganglia along a variable length of the bowel that invariably involves the rectoanal junction. Co-segregation of FMTC and Hirschsprung's disease is uncommon; nevertheless, in 3 generations of 1 family, we observed 5 patients with FMTC, 2 patients with Hirschsprung's disease, and 1 patient with characteristics of both FMTC and Hirschsprung's disease. Moreover, a Cys620Ser mutation in RET was identified in 4 of the 8 patients. This mutation had both activating and inactivating effects on the RET (REarranged during Transfection) protein. There were individual differences in the penetrance of Hirschsprung's disease due to the RET mutation, but the penetrance of MTC was uniform and high. Genetic testing is important for making decisions about treatment and follow-up in families of this kind.

DOI： 10.1272/jnms.81.64

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

DOI： 10.1002/hed.23295

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Background Thyrotropin (TSH) is a known thyroid growth factor. Several studies have suggested its potential role in carcinogenesis and the progression of differentiated thyroid carcinoma. We have been conducting a prospective trial of nonsurgical observation for asymptomatic papillary thyroid microcarcinoma (PMC) since 1995. The aim of this study was to investigate whether serum TSH concentrations can be used to predict PMC growth.
Methods This study examined 415 asymptomatic PMCs. Three hundred twenty-two patients decided to undergo nonsurgical observation by ultrasonography and were followed for &gt;= 2 years.
Results After a mean of 6.5 years of observation (range 2-22 years), 25 lesions (6 %) had increased in size, 377 (91 %) showed no change and 13 (3 %) had decreased in size. Both baseline TSH and mean TSH during follow-up for PMC that increased in size did not differ significantly from those lesions that were unchanged or decreased in size. Increases in size were seen in 0 of 18 (0 %), 15 of 260 (6 %), 10 of 126 (8 %), and 0 of 11 (0 %) for PMCs with baseline TSH &lt;0.50, 0.50-1.99, 2.00-3.99, and &gt;= 4.00 mIU/L, respectively. A logistic regression model analyzing the association between baseline TSH and outcome showed an odds ratio of 1.01 (95 % confidence interval [CI], 0.66-1.29). No significant correlations were apparent between mean TSH during follow-up and change in PMC volume (r = 0.019, p = 0.70).
Conclusions No significant association between TSH and tumor progression was verified during the nonsurgical observation trial for PMC. TSH is not a good predictor of PMC growth.

DOI： 10.1007/s00268-013-2335-8

Web of Science

PubMed

researchmap

記述言語：日本語  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Metastatic thyroid tumors (MTT) are rare and have a poor prognosis. The aim of this retrospective study was to determine the diagnostic features and clinical outcomes of MTT.
The study subjects comprised 29 patients (age range, 37-78 years) diagnosed with MTT and treated during a 22-year period between 1987 and 2008 at a single tertiary oncology referral center.
The primary cancer was breast cancer in 10 patients, lung cancer in six, digestive tract in six, kidney in three, head and neck in three and sarcoma in one patient. In seven patients, the diagnoses of primary cancer and MTT were synchronous. In 22 patients, the mean latency between the diagnosis of the primary cancer and MTT was 66 months (range 7 months-16 years). Based on ultrasonography (US), MTTs were classified into two categories: diffuse type (DT) (n = 9) and nodular type (NT) (n = 18). Eight patients who underwent thyroid surgery showed no survival benefit, but none needed tracheostomy.
MTT should be considered for patients with a history of malignant disease. The findings from US are useful to diagnose MTT. Careful preoperative evaluation can avoid unnecessary thyroidectomy.

DOI： 10.1007/s00595-013-0492-x

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)医事出版社  

researchmap

記述言語：日本語   出版者・発行元：日本家族性腫瘍学会  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Cancer and Chemotherapy Publishers Inc.  

Surgery results in improved outcomes for most patients with thyroid cancer, but there are no effective treatment options for patients with locally advanced/metastatic medullary thyroid cancer (MTC), differentiated thyroid cancer (DTC) refractory to radioiodine therapy, or highly malignant anaplastic thyroid cancer (ATC). Recent studies have shown that tumorigenesis and dedifferentiation of thyroid cancer cells are caused by the activation of several major signaling pathways and the related molecular aberrations, as well as by angiogenesis mediated by the vascular endothelial growth factor receptor (VEGFR) and epidermal growth factor receptor (EGFR). The efficacy of using molecular targeted agents for thyroid cancer treatment is under investigation in Western countries. In April 2011, the Food and Drug Administration (FDA) approved the use of vandetanib for the treatment of advanced MTC based on the results of phase III clinical trials. At the 2013 American Society of Clinical Oncology (ASCO) meetings, investigators reported that sorafenib improved progression-free survival in patients with advanced DTC, according to a phase III trial. FDA approved the use of sorafenib for the treatment of advanced DTC in November 2013. A multicenter clinical trial for ATC is also currently underway. Further research is required in order to characterize the mechanisms of the therapeutic response, to delineate the optimal management of drug-related adverse effects, and to identify biomarkers that can predict the efficacy of therapy. A clinical trial of these novel molecular agents has just begun in Japan, but in the near future, this new treatment strategy could become standard treatment for patients with advanced thyroid cancer.

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

乳頭癌のリスクに応じた取扱いが推奨される中，甲状腺腫瘍診療ガイドライン2010年版では，乳頭癌のリスク分類法としてTNMステージングを推奨したうえで，T1N0M0の低リスク癌には葉切除を，T＞５cm，高度のN1，高度のEx，M1などの高リスク癌には全摘を推奨した。中間のグレーゾーンに対する方針は術後合併症の発生頻度と予後のバランスをもとに，個々の症例について決定することが求められた。癌研式乳頭癌の癌死危険度分類では，M1，50歳以上で高度のExまたは３cm以上のNを認めるものが高危険度群で，それ以外はすべて低危険度群とした。低危険度群の82％に甲状腺温存手術が行われたが，術式による予後の差はなく，疾患特異的10年生存率は99％以上であった。再発率は８％で，再発危険因子として，年齢60歳以上，T＞３cm，Ex2，２cm以上のNが有意であった。これらに該当する症例をグレーゾーンとして，甲状腺全摘・放射性ヨウ素内用療法を推奨すべきかどうかは今後の検討課題である。

DOI： 10.11226/jaesjsts.31.4_261

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JLC/20005126772?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

A case of thyroidal mucosa-associated lymphoid tissue (MALT) lymphoma mimicking IgG4-related disease is described. A 54-year-old male presented with acute swelling of the anterior neck. Anaplastic thyroid carcinoma (ATC), malignant lymphoma (ML), or acute deterioration of Hashimoto's thyroiditis were initially suspected, and an emergent tracheostomy was required for progressive airway obstruction; a simultaneous biopsy from the thyroid tissue was performed. Histopathologically, the lesion consisted of sclerotic fibrosis and diffuse and dense infiltration by small lymphoid cells without atypia and plasma cells, many of which were IgG4-positive. Blood examination also revealed high serum IgG4 levels. Riedel's thyroiditis was suspected. However, despite medical treatments, a firm swelling of the thyroid still remained. In an in situ hybridization study, IgG4-negative plasma cells showed immunoglobulin light-chain restriction (kappa-monotype), and immunoglobulin heavy (IgH) chain gene monoclonal re-arrangement was detected by polymerase chain reaction. The lesion was finally diagnosed as MALT lymphoma. When IgG4-related disease is suspected, it is important to thoroughly exclude other possibilities. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2012.12.004

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ases.12058

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Carcinoma showing thymus-like differentiation (CASTLE) is a rare tumor of the thyroid gland or soft tissues of the head and neck. To our knowledge, there have been only a few reports concerning imaging findings of CASTLE. We report herein the sonographic appearances of three cases of CASTLE. Two tumors were located at the lower part of the thyroid and one had spread throughout the thyroid. Sonograms showed heterogeneously solid tumors without cystic components or calcification. The central part of the tumor was slightly hyperechoic compared with the peripheral part of the tumor. Histologically, the tumors were composed of a mixture of fibrous stroma and epithelial nests. (c) 2012 Wiley Periodicals, Inc. J Clin Ultrasound41:574-578, 2013.

DOI： 10.1002/jcu.21997

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本甲状腺学会  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014026710

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

近年，筋電図電極を装着した気管内挿管チューブが開発され，甲状腺・副甲状腺手術の際の，反回神経の探査，同定，状態の監視および健全性確認を目的とした術中神経モニタリング（IONM）が普及してきた。ガイドラインが発行されるなど，手技の標準化が進むにつれて信頼性も向上しており，とくに術後反回神経麻痺のリスクが高い症例での有用性が認められている。反回神経喉頭外分枝から声帯運動枝を同定する場合や非反回下喉頭神経の分岐部同定，上喉頭神経外枝（EBSLN）の確認温存などに役立つうえ，反回神経麻痺の部位や原因を特定しうることで，手術手技向上につながる可能性もある。最近では，手術中に迷走神経を持続的に刺激する方法が報告されており，IONM反応が低下する瞬間をとらえることにより，反回神経損傷の危険を察知し，術後麻痺の危険を回避できるという。現在，保険適応外のため，使用コストが普及の壁となっており，近い将来の保険収載が期待される。

DOI： 10.11226/jaesjsts.30.3_197

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JALC/10025143439?from=CiNii

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)東京都臨床検査技師会  

researchmap

記述言語：日本語  

researchmap

記述言語：日本語  

researchmap

記述言語：英語   出版者・発行元：SPRINGER  

The aim of this study is to evaluate the specificity of diagnosing PTC by fine needle aspiration (FNA) cytology.
This study retrospectively reviewed the cytopathological reports of 1066 patients that underwent thyroidectomy based on a diagnosis of PTC by FNA between January 1993 and December 2008. This study re-evaluated the cytology and histopathology of the patients that received false positive diagnoses of PTC by FNA.
Ten patients (0.9 %) received false positive diagnoses of PTC by FNA. Three patients were overdiagnosed as having PTC by FNA cytology. In contrast, the nuclear features of PTC in the other seven cases were confirmed by the retrospective reviews of the patients' FNA cytology. Three of the seven patients showed follicular structures in their resection specimens, thus resulting in a diagnosis of either adenomatous goiter or follicular adenoma. However, PTC could not be diagnosed by histopathology in the remaining four patients, even though the histopathology showed the nuclear features of PTC.
Most cases of PTC can be easily diagnosed by cytological and morphological atypia with certain limitations. The difficulty in diagnosing PTC by cytology is because the pathological features of PTC also occur in some benign thyroid tumors. Therefore, immunohistochemical or molecular biological approaches must be combined with current cytological diagnostic techniques for the diagnosis of PTC.

DOI： 10.1007/s00595-012-0362-y

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会 ; 2012-  

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014040881

記述言語：日本語  

researchmap

記述言語：日本語   出版者・発行元：(株)文光堂  

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

症例は36歳女性，健康診断にて前頸部腫瘤を指摘され，甲状腺腫瘍疑いにて当科を紹介受診した。頸部超音波検査にて甲状腺左葉下極に27×22×18mm大の辺縁分葉状の低エコー結節を認めた。穿刺吸引細胞診では，細胞質内に多数の好酸性顆粒を認めた。甲状腺腫瘍あるいは甲状腺外迷入病変を考え，甲状腺左葉切除術を施行した。病理学的所見では，腫瘍は甲状腺外軟部組織を中心に存在し，甲状腺組織にも浸潤性に増殖していた。腫瘍細胞は好酸性，顆粒状の豊かな細胞質を持つ類円形細胞よりなり，核異型は認めなかった。免疫染色の結果，腫瘍細胞はS100陽性であった。以上より，顆粒細胞腫と診断した。顆粒細胞腫の大部分は良性腫瘍と考えられているが，稀に遠隔転移や悪性症例の報告もされており，経過観察に注意を要する。

DOI： 10.11226/jaesjsts.30.2_152

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

症例は、甲状腺乳頭癌の38歳、女性。甲状腺癌(T4aN0M1、stage II)の診断で、34歳7ヵ月時点に甲状腺全摘、気管合併切除(気管輪1-5、端々吻合)、中心領域郭清術が施行された。術後、多発肺転移に対し内照射療法を計4回施行しているが、肺転移巣は徐々に増多、増大した。38歳4ヵ月時点で軽い上気道炎を契機に呼吸苦が出現した。入院の上全身管理を行ったが呼吸不全のため永眠された。甲状腺乳頭癌は、非常に予後が良いことで知られ、特に若年で発症した場合は更に高い治癒率のため本疾患で亡くなることは稀有である。また、本疾患は腫瘍増殖速度が非常に緩徐である。疾患特異的治療として内照射療法が有効である、などの他の悪性腫瘍とは異なる特徴がある。これら本来治療する上で利点と言える特性は、がん終末期においては反対にその対策を困難にする。今回、生命予後が予測できず対応に苦慮した症例を経験したので報告した。(著者抄録)

DOI： 10.11226/jaesjsts.29.4_322

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2013010225

記述言語：日本語   出版者・発行元：日本臨床社  

PubMed

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2013010225

記述言語：日本語   出版者・発行元：(一社)日本超音波検査学会  

DOI： 10.11272/jss.37.433

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2012373321

記述言語：日本語   出版者・発行元：(株)日本医事新報社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

PubMed

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

PubMed

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2012331732

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Anaplastic thyroid carcinoma (ATC) accounts for only 1 to 2% of all thyroid carcinomas, but it is one of the most lethal neoplasms in humans. To date, most findings about ATC have been derived from single-institution studies with limited numbers of cohorts. To obtain further insights into this "orphan disease," we have established a multicenter registry, the ATC Research Consortium of Japan (ATCCJ). We analyzed prognostic factors and treatment outcomes using the large cohort database of the ATCCJ.
Most of the Japanese centers involved in the treatment of thyroid cancer were invited to join the ATCCJ and have provided information on ATC patients treated between 1995 and 2008. The database includes 677 cases from 38 registered institutions. Survival curves were determined using Kaplan-Meier methods and were compared using the log-rank test. Cox's proportional hazards model was used for multivariate analysis.
Clinical varieties of ATC were classified into four types: common type ( = 547); incidental type ( = 29); anaplastic transformation at the neck ( = 95); anaplastic transformation at a distant site ( = 6). The incidental type followed by anaplastic transformation at the neck showed better outcomes than the other types. Anaplastic transformation at a distant site showed the worst outcomes. The 6-month and 1-year cause-specific survival (CSS) rates for common-type ATC were 36 and 18%, respectively. In all, 84 (15%) achieved long-term (&gt; 1 year) survival. Multivariate analysis identified age a parts per thousand yen70 years, presence of acute symptoms, leukocytosis (white blood cell count a parts per thousand yen10,000/mm(3)), large tumor &gt; 5 cm, T4b tumor, and distant metastasis as significant risk factors for lower survival. CSS rates also differed significantly depending on UICC stages, with 6-month CSSs of 60% for stage IVA, 45% for IVB, and 19% for IVC. For 36 of 69 (52%) stage IVA patients who underwent radical surgery, adjuvant therapies, including radiation therapy (RTX) and chemotherapy (CTX) did not show additional benefit statistically. Conversely, among 242 stage IVB patients, 80 (33%) underwent radical surgery. For those patients, therapies combining RTX with CTX significantly improved CSS.
Long-term survival is possible for selected patients with ATC. To determine the treatment strategy, UICC stage (disease extent) and other prognostic factors (e.g., biologic malignancy grade) should be considered.

DOI： 10.1007/s00268-012-1437-z

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

日本内分泌外科学会・日本甲状腺外科学会共同編集による『甲状腺腫瘍診療ガイドライン』では、甲状腺乳頭癌(PTC)に対する甲状腺切除術式について、「甲状腺全摘術が、甲状腺葉切除術に比べて、再発・生命予後を向上させるというエビデンスは弱いが、ハイリスクと評価したPTCに対して甲状腺全摘術を推奨する」と述べ、低危険度癌に対しては甲状腺温存切除を容認している。当科における経験では低危険度群の治療成績は甲状腺切除範囲にかかわらず良好であり、最近では患者のインフォームド・デシジョンを重視して治療方針を決定している。一方、高危険度群の治療成績は甲状腺全摘・放射性ヨード内用療法によっても劇的な改善は見込めそうになく、他臓器合併切除なども含めた局所根治手術に加え、新たな治療法の開発が期待される。PTCのリンパ節郭清については予防的側頸部郭清を行わない方針により良好な治療成績が得られている。(著者抄録)

DOI： 10.11226/jaesjsts.29.2_135

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014052710

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Extrathyroidal invasion is one of the most significant risk factors for patients with papillary thyroid carcinoma (PTC). The purpose of this study was to evaluate a novel definition of extrathyroidal invasion for patients with PTC as a method for predicting a patient's prognosis.
The prospective study was conducted for consecutive 930 patients with primary PTC who received surgery during 1993-2009. We defined only patients who had preoperative recurrent laryngeal nerve palsy or patients in whom the tumor had invaded to the mucosa of the trachea and/or esophagus as Ex3. Patients with minimal invasion were classified as Ex1, and patients with massive invasion, when we could shave off the tumors, were classified as Ex2. Patients without extrathyroidal invasion were classified as Ex0.
Patients classified Ex3 showed significantly shorter disease-free survival ( = 0.03) and disease-specific survival ( = 0.007) than patients classified Ex2. The time to recurrence at resection sites was shorter in patients classified Ex3 than in patients classified Ex2 ( = 0.02). The time to death due to distant metastasis of patients classified Ex3 was significantly shorter than that of patients classified Ex2 ( = 0.02). Within the patients classified Ex3, disease-specific survival of patients with invasion to other nearby structures was shorter than that of patients with invasion to only recurrent laryngeal nerve ( = 0.008).
The degree and site of invasion is an important prognostic factor for PTC. Our novel classification of extrathyroidal invasion is valuable in predicting the prognosis of PTC.

DOI： 10.1007/s00268-012-1518-z

Web of Science

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本頭頸部癌学会  

症例が少なく予後不良な甲状腺未分化癌(ATC)の治療成績向上を究極の目的として、2009年1月、多施設共同研究機構である甲状腺未分化癌研究コンソーシアムが設立された。本邦におけるATCの現状を把握するため、多数症例の情報を集積したデータベースを作成することを最初の仕事とした。2011年7月までに38施設721症例から成るデータベースができ、これまでにATCの予後因子、治療法、病理組織学的特徴、偶発型ATC、ATCに特徴的な石灰化像、拡大根治切除の意義などについて報告を行った。2012年5月には、医師主導型前向き臨床試験として、「ATCに対するweekly-paclitaxelによる化学療法の認容性、安全性に関する前向き研究」(通称:アタックJ)がスタートした。(著者抄録)

DOI： 10.5981/jjhnc.38.285

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background. The influence of thyrotropin (thyroid-stimulating hormone [TSH]) suppressive therapy on bone mineral density (BMD) remains contentious. We have conducted a randomized controlled trial evaluating the effects of postoperative TSH suppressive therapy on disease-free survival for papillary thyroid carcinoma (PTC) since 1996, while prospectively verifying the effects of TSH suppression on BMD.
Methods. Lumbar spine BMD as expressed by T-score was examined annually in female patients randomly assigned to receive TSH suppressive therapy (group A; n = 144) or no therapy (group B; n = 127).
Results. The mean TSH level was 0.07 +/- 0.10 mU/L in group A and 3.14 +/- 1.69 mU/L in group B. Group B did not show any significant decrease in T-score until 5 years postoperatively, whereas group A had a-significant deterioration from 1 year postoperatively. Among group A patients, significant decreases in T-score within 1 year were seen in patients &gt;= 50 years of age, but not in those &lt;50 years of age. After 5 years of TSH suppression, 20 patients had T-scores below -2.0 and 100 patients did not. These former patients were significantly older and had lower preoperative BMD measurements than the latter.
Conclusion. This prospective controlled trial suggests that TSH suppression after surgery for PTC has adverse effects on BMD in women &gt;= 50 years of age. (Surgery 2011;150:1250-7.)

DOI： 10.1016/j.surg.2011.09.013

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: We have previously performed retrospective analysis of patients with anaplastic thyroid carcinoma (ATC) treated between April 1976 and March 1999, revealing acute symptoms, large tumor (&gt
5 cm), distant metastasis, and leukocytosis ≥10,000/mm 3 as the most important prognostic factors. We devised a novel prognostic index (PI) as the total number of these 4 factors present, giving a PI of 0-4. Methods: We have adopted this PI since April 1999. In principle, multimodal treatment has been encouraged for a PI of ≤1, whereas aggressive treatment has been avoided to maintain quality of life for a PI of ≥3. The validity of this therapeutic strategy was prospectively investigated in 74 patients with ATC. Results: Six-month survival rates for PI ≤ 1 and PI ≥ 3 were 72% and 12%, respectively. Among patients with a PI of ≤1,11 (42%) underwent multimodal treatment and showed significantly better survival than previous cases. Survival rates did not differ between stages. For patients with a PI of ≥3, survival rates were equally dismal, regardless of stage. Numbers of patients who underwent tracheostomy or died from local disease were significantly decreased compared with previous cases. Conclusion: Our PI is valid for anticipating prognosis and aiding timely decisions on treatment policy for ATC patients. © 2011 Published by Mosby, Inc.

DOI： 10.1016/j.surg.2011.09.005

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background. The influence of thyrotropin (thyroid-stimulating hormone [TSH]) suppressive therapy on bone mineral density (BMD) remains contentious. We have conducted a randomized controlled trial evaluating the effects of postoperative TSH suppressive therapy on disease-free survival for papillary thyroid carcinoma (PTC) since 1996, while prospectively verifying the effects of TSH suppression on BMD.
Methods. Lumbar spine BMD as expressed by T-score was examined annually in female patients randomly assigned to receive TSH suppressive therapy (group A; n = 144) or no therapy (group B; n = 127).
Results. The mean TSH level was 0.07 +/- 0.10 mU/L in group A and 3.14 +/- 1.69 mU/L in group B. Group B did not show any significant decrease in T-score until 5 years postoperatively, whereas group A had a-significant deterioration from 1 year postoperatively. Among group A patients, significant decreases in T-score within 1 year were seen in patients &gt;= 50 years of age, but not in those &lt;50 years of age. After 5 years of TSH suppression, 20 patients had T-scores below -2.0 and 100 patients did not. These former patients were significantly older and had lower preoperative BMD measurements than the latter.
Conclusion. This prospective controlled trial suggests that TSH suppression after surgery for PTC has adverse effects on BMD in women &gt;= 50 years of age. (Surgery 2011;150:1250-7.)

DOI： 10.1016/j.surg.2011.09.013

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(株)文光堂  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Objective: Although anaplastic thyroid carcinoma has a dismal prognosis, some patients show favorable survival following multimodal treatment with surgery, external irradiation and chemotherapy. However, no regimen has yet been established. We reviewed outcomes for patients who underwent a unique chemoradiotherapy regimen between 1998 and 2007.
Methods: The regimen consists of external irradiation (40 Gy at 2 Gy/day) combined with concurrent low-dose cisplatin at 5 mg/m(2) on Days 1-5, 8-12, 15-19 and 22-26, 5-fluorouracil at 200 mg/m(2) on Days 1-26 and doxorubicin at 20 mg/m(2) on Days 1 and 15. This regimen was performed on 21 patients (13 men, 8 women) with anaplastic thyroid carcinoma. Median age at the time of treatment was 66 years (range, 54-81 years).
Results: The treatment regimen was completed in 19 patients (90%) and was interrupted in 2 (10%) due to progressive distant metastases. After excluding 10 patients who underwent complete resection before chemoradiotherapy, 1 patient (11%) showed partial response, 7 (78%) showed stable disease and 1 (11%) had progressive disease on the basis of Response Evaluation Criteria in Solid Tumors. Overall, 6-month survival rate for patients treated with chemoradiotherapy was 57%. With this novel chemoradiotherapy, death from loco-regional disease was seen in only two patients (11%). Grade 3-4 toxicities were observed in 12 patients (63%), but no treatment-related deaths were encountered.
Conclusions: Our new chemoradiotherapy is effective for loco-regional control of anaplastic thyroid carcinoma, particularly when combined with radical surgery. This regimen could not prevent distant metastases, but offers acceptable toxicity while maintaining patient quality of life.

DOI： 10.1093/jjco/hyr095

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

甲状腺・内分泌外科として、耳鼻咽喉科・頭頸部外科の先生方には、進行甲状腺癌に対する拡大手術や術後反回神経麻痺に対する音声改善手技といった場面でお世話になってきた。境界領域の診療での適切な協力体制は、疾患の性質に関する共通理解の上に築かれなければならないが、甲状腺癌は頭頸部扁平上皮癌とは生物学的性質が大きく異なっているため注意が必要である。また、甲状腺腫瘍診療におけるエビデンスはいまだ十分とはいえない。最近の日本甲状腺外科学会・日本内分泌外科学会による専門医制度発足やガイドライン発行を契機に、学会間の連携をいっそう深めたうえで、さらに質の高いエビデンスを協力して発信していくことが求められている。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：日本医師会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2011158795

記述言語：日本語   出版者・発行元：(株)インターメルク  

J-GLOBAL

researchmap