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7. A high Ki‐67 labeling index and high thyroglobulin doubling rate are significant predictors of excision‐site recurrence of papillary thyroid carcinoma following airway resection for locally curative surgery.

Author

Ito, Yasuhiro, Miyauchi, Akira, Hirokawa, Mitsuyoshi, Kawakami, Makoto, Kihara, Minoru, Onoda, Naoyoshi, and Miya, Akihiro

Subjects
EXTERNAL beam radiotherapy, PAPILLARY carcinoma, THYROID cancer, POSTOPERATIVE period, MULTIVARIATE analysis
Abstract

Background: Papillary thyroid carcinoma (PTC) occasionally invades the trachea and requires airway resection. Tracheal excision site recurrence (ESR) is a serious problem. We investigated predictors of ESR in patients with PTC who underwent airway resection for locally curative surgery. Methods: We enrolled 149 patients with PTC who underwent airway resection (median age at the initial surgery: 67 years), including partial‐thickness resection (n = 73) or full‐thickness resection (n = 76), for grossly curative surgery. The median postoperative follow‐up period was 93 months. Results: To date, 11 patients (6.7%) underwent ESR: 6 underwent full‐thickness resection and 5 underwent partial‐thickness resection. The time to ESR ranged from 14 to 113 months (median: 57 months) after the initial surgery. None of the 11 ESR patients underwent adjuvant external beam radiotherapy (EBRT) and none of the 4 airway resection patients who underwent EBRT developed ESR. The 5‐ and 10‐year ESR rates were 4.3% and 11.3%, respectively. In the multivariate analysis (forward–backward stepwise selection method), a Ki‐67 labeling index (LI) ≥5% (p = 0.048) and the thyroglobulin doubling rate (Tg‐DR) >0.33/year (p = 0.009) (for Tg‐antibody negative cases) were independent predictors of ESR. Nine of the 11 patients underwent ESR resection and only one developed a second recurrence. Conclusions: A high Ki‐67 LI was a static predictor, and high Tg‐DR was a dynamic predictor, of ESR in patients with PTC following airway resection. In such patients, careful postoperative monitoring for ESR is necessary and adjuvant therapies, such as EBRT, may be considered. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Prognostic significance of T3b in papillary thyroid carcinoma: Appropriateness of classifying T3bN0M0 in patients aged 55 years or older into stage II.

Author

Ito, Yasuhiro, Miyauchi, Akira, Kawakami, Makoto, Kihara, Minoru, and Miya, Akihiro

Subjects
RECURRENT laryngeal nerve, TRACHEAL cartilage, BRACHIOCEPHALIC veins, STERNOCLEIDOMASTOID muscle, PAPILLARY carcinoma
Abstract

Background: Papillary thyroid carcinoma (PTC) often extends to adjacent organs. According to the 8th Tumor‐Node‐Metastasis Classification, extension to the strap muscles was graded as T3b. We investigated the prognostic impact of T3b and the appropriateness of T3b in patients aged ≥55 years who were classified as stage II. Methods: We enrolled 7811 patients with M0 PTC who underwent initial surgery at the Kuma Hospital (Kobe, Japan) between January 2007 and December 2016. Tumor extension was divided into T3b, T4a1 (extension to the tracheal adventitia, tracheal cartilage, esophageal muscle layer, recurrent laryngeal nerve, cricothyroid, and inferior constrictor muscles), and sT4a2 (extension to the subcutaneous soft tissues, tracheal mucosa, esophageal mucosa, internal jugular vein, brachiocephalic vein, larynx, pharynx, and sternocleidomastoid muscle). Results: In patients ≥55 years, the local recurrence‐free survival (LR‐FS), distant recurrence‐free survival (DR‐FS), and cause‐specific survival (CSS) rates of T3bN0M0 were significantly poorer than those of T1/T2N0M0 but did not significantly differ from those of T3aN0M0. The LR‐FS, DR‐FS, and CSS rates of T3b stage II patients did not differ from those of T4a1 stage III patients but were significantly better than those of T4a2 stage III patients. T3b was an independent predictor of local recurrence and distant recurrence but not of death due to carcinoma in the multivariate analysis. In patients aged <55 years with M0 PTC, T3b had no prognostic value in both analyses. Conclusions: T3bM0 patients are appropriate to be classified as stage II in patients ≥55 years but be kept in stage I in patients <55 years. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Ansa Cervicalis External Branch Anastomosis to Restore High Tone Voice in Thyroid Surgery.

Author

Miyauchi, Akira, Fujishima, Makoto, Masuoka, Hiroo, Sasaki, Takahiro, Miya, Akihiro, Ishisaka, Tomo, Adachi, Shiori, Kawano, Shiori, Matsunaga, Akihide, Yamamoto, Masashi, Higashiyama, Takuya, Ito, Yasuhiro, Onoda, Naoyoshi, and Kihara, Minoru

Abstract

Objectives: Injury to the external branch of the superior laryngeal nerve (EBSLN) causes low‐pitch voice and voice fatigue, particularly in female subjects, and available treatments are limited. Here, we assess a novel surgical procedure to restore a high‐tone voice: ansa cervicalis to EBSLN anastomosis (A‐E anastomosis). Methods: Between November 2012 and April 2022, 13 patients (12 female) underwent unilateral EBSLN resection and A‐E anastomosis, while 20 (16 female) underwent EBSLN resection during thyroid surgery. Patients (4494 women and 1025 men) with normal laryngoscopy scheduled for thyroid surgery served as normal controls. Phonatory function was examined using a Phonation Analyzer PA‐1000 preoperatively and intermittently postoperatively. Results: In patients who underwent A‐E anastomosis, high‐tone voice pitch decreased significantly postoperatively (673.9–471.5 Hz, p = 0.047), with restoration achieved within 5 months. The mean voice pitch in female patients who underwent A‐E anastomosis, EBSLN resection, and controls were 580.4, 522.8, and 682.0 Hz, respectively, indicating a significant decrease in EBSLN resection patients than controls (p = 0.002). The (mean – 1SD) of high‐tone voice pitch in female controls was 497 Hz; exceeding this may indicate recovery to a high‐tone voice. Overall, 73% (8/11) of A‐E anastomosis patients exceeded this value, which was marginally larger than the 43% (6/14) who underwent EBSLN resection. Data on male subjects are limited. There were no cases of adverse functional or cosmetic events. Conclusions: A‐E anastomosis, a novel simple procedure, restored high‐tone voice to some extent without any adverse events and thus warrants further investigation. Level of Evidence: 3 Laryngoscope, 134:3868–3873, 2024 [ABSTRACT FROM AUTHOR]

Published
2024
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14. Antiviral humoral immunity against SARS-CoV-2 omicron subvariants induced by XBB.1.5 monovalent vaccine in infection-naive and XBB-infected individuals

Author

Kosugi, Yusuke, primary, Kaku, Yu, additional, Hinay, Alfredo A, additional, Guo, Ziyi, additional, Uriu, Keiya, additional, Kihara, Minoru, additional, Saito, Fumitake, additional, Uwamino, Yoshifumi, additional, Kuramochi, Jin, additional, Shirakawa, Kotaro, additional, Takaori-Kondo, Akifumi, additional, and Sato, Kei, additional

Published
2024
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21. Long-term outcomes of active surveillance and immediate surgery for adult patients with low-risk papillary thyroid microcarcinoma: 30-year experience

Author

Miyauchi, Akira, primary, Ito, Yasuhiro, additional, Fujishima, Makoto, additional, Miya, Akihiro, additional, Onoda, Naoyoshi, additional, Kihara, Minoru, additional, Higashiyama, Takuya, additional, Masuoka, Hiroo, additional, Kawano, Shiori, additional, Sasaki, Takahiro, additional, Nishikawa, Mitsushige, additional, Fukata, Shuji, additional, Akamizu, Takashi, additional, Ito, Mitsuru, additional, Nishihara, Eijun, additional, Hisakado, Mako, additional, Kohsaka, Kazuyoshi, additional, Hirokawa, Mitsuyoshi, additional, and Hayashi, Toshitetsu, additional

Published
2023
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