Purpose: The increase in thyroid cancer incidence has inevitably led to an increase in thyroid cancer surgeries. This meta-regression analysis aimed to determine if the rate of post-thyroidectomy complications changes by year. Materials and Methods: PubMed and Embase databases were used to perform a systematic literature search of studies published from January 1, 2005, using the keywords “thyroidectomy” and “complication.” A meta-regression was performed for post-thyroidectomy hypocalcemia and bleeding. Results: This meta-analysis included 25 studies involving 927751 individuals. Through the years of publications in this study, there was no significant difference in the proportion of post-thyroidectomy hypocalcemia and bleeding (p=0.9978, 0.6393). Conclusion Although the number of thyroid surgeries has recently increased, the incidence of post-thyroidectomy hypocalcemia and bleeding did not significantly increase.

Purpose: Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. Methods: This survey was prepared to collect participants’ demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. Results: There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar’s length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). Conclusion Patients’ expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.

Background: This study aimed to investigate the changes of incidence and treatment of choice for hyperthyroidism from 2003 to 2018 and explore the treatment-related complications and concomitant comorbidities in South Korea using data from the National Health Insurance Service. Methods: This is a retrospective observational study. Hyperthyroidism was defined as a case having two or more diagnostic codes of thyrotoxicosis, with antithyroid drug intake for more than 6 months. Results: The average age-standardized incidence of hyperthyroidism from 2003 to 2018 was 42.23 and 105.13 per 100,000 men and women, respectively. In 2003 to 2004, hyperthyroidism was most often diagnosed in patients in their 50s, but in 2017 to 2018, people were most often diagnosed in their 60s. During the entire period, about 93.7% of hyperthyroidism patients were prescribed with antithyroid drugs, and meanwhile, the annual rates of ablation therapy decrease from 7.68% in 2008 to 4.56% in 2018. Antithyroid drug-related adverse events, mainly agranulocytosis and acute hepatitis, as well as complications of hyperthyroidism such as atrial fibrillation or flutter, osteoporosis, and fractures, occurred more often in younger patients. Conclusion In Korea, hyperthyroidism occurred about 2.5 times more in women than in men, and antithyroid drugs were most preferred as the first-line treatment. Compared to the general population, hyperthyroid patients may have a higher risk of atrial fibrillation or flutter, osteoporosis, and fractures at a younger age.

Purpose: This study aimed to identify the risk factors associated with the occurrence and prognosis of hypertrophic scarring following thyroidectomy. Materials and Methods: A total of 4238 patients who underwent thyroidectomy were included in this study. A multivariable logistic regression model was developed to identify the risk factors for hypertrophic scar development and its prognosis. Results: Our analysis revealed that hypertrophic scar development was associated with younger age [odds ratio (OR)=0.949, p<0.0001], male sex (OR=0.562, p<0.0001), higher body mass index (OR=1.137, p<0.0001), prominent sternocleidomastoid muscles (OR=2.522, p<0.0001), scarring located within 1 cm of the sternal notch (OR=4.345, p<0.0001), and a history of keloid development (OR=2.789, p=0.0031). Additionally, scar location within 1 cm of the sternal notch (beta=4.326, p=0.0429) and a history of keloid development (beta=23.082, p<0.0001) were found to be associated with the prognosis of hypertrophic scarring. Conclusion The findings of this study provide valuable insights into the risk factors associated with hypertrophic scarring following thyroidectomy. Clinicians can use this information to predict the occurrence of hypertrophic scarring and its prognosis, and take preventative measures accordingly.

Background and Objectives: Given the major changes in spread of COVID-19 and the contribution of technological innovation, the objective of the current study was to compare the educational needs of thyroid cancer patients between 2012 and 2020. Materials and Methods: The subject of this study were 159 patients in 2012 and 149 patients in 2020 who underwent thyroid cancer surgery. Data were collected from September 2020 to December 2020. Their responses were compared with response for the 2012 survey. The survey contained 36 questions regarding demographics and 5 areas of educational needs (Treatment plan after discharge, Management of the symptom and the complication after surgery, Medication management, Postoperative wound and dietary management, Daily life). Results: The most preferred teaching method for thyroid cancer surgery patients has changed from small group education to self-study with videos. The Internet accounted for the largest proportion of source of information and the preferred educator for the patient were doctors and nurses in both 2012 and 2020. ‘Current disease condition and surgical result’ was the highest ranked in both 2012 and 2020. Conclusion It is necessary to develop and utilize an educational method using video centered on medical team including doctors and nurses.

Papillary thyroid carcinoma is the most common type of thyroid cancer, for which surgery following preoperative staging and risk assessment is the standard treatment. Afatinib is an orally active irreversible ErbB-family inhibitor that binds to the kinase domain of epidermal growth factor receptors (EGFRs), HER2, and HER4, and has been approved as monotherapy for the treatment of locally advanced or metastatic non-small cell lung cancer with activated EGFR mutations. Recently, we observed an unexpected effect of afatinib administered to treat lung cancer on untreated papillary thyroid carcinoma.

Background/Aims: Using an appropriate guidewire can increase the success rate of selective cannulation in endoscopic retrograde cholangiopancreatography. The purpose of this technical study was to investigate the characteristics of each guidewire type and to evaluate its efficiency and rapidity of insertion. Methods: We conducted a three-point bending test using a universal testing machine to investigate the flexibility and bending features of each guidewire. 3D-printed silicone tubes with various types of stricture and a hand-made biliary tree silicone model with six-stranded intrahepatic ducts were used to evaluate the success rate and insertion time of each guidewire. Results: In the three-point bending test, the characteristics of each guidewire were classified. We found that the bending strengths and times were independent of shaft thickness. Using two in vitro biliary duct models, we determined that the success rate and total insertion time were better for guidewires with a resilient shaft and angled tip than for other types of guidewires (p<0.001). Although thickness of the guidewire affected the success rate (p<0.05), it did not affect the total insertion time (p≥0.05). Conclusions Among several types of guidewire, some factors (resilient shaft, highly flexible, and angled tip) appeared to be associated with the efficiency and rapidity of the guidewire insertion.

Background and Objectives: Many patients with thyroid cancer are participating in the online community. Thyroid cancer patients write and read a variety of posts in the online community, and there is a great deal of data generated in the digital environment. However, few studies have analyzed the online community of thyroid cancer patients. The purpose of this study is to analyze the online community to understand the interests and information seeking behavior of thyroid cancer patients. Materials and Methods: Data were collected from August 2017 to September 2019 using statistics from an online community of thyroid cancer patients. The frequency analysis was performed by collecting the members’ gender, age, average usage time, time-of-day views, average monthly visits, device distribution, online community inflow query, query within online community, and content of a post with more than 1000 views per month. Results: Analyzing the online community of thyroid cancer patients, women accounted for 80.4% of the total, and the age group of people in their 30s and 40s accounted for 77.5%. Online community subscribers averaged 0.7 visits a day using mobile, with the most frequent use time between 10pm and 12pm. Frequently used queries are medical staff names, surgery, recurrence and scar. Posts showed informational and emotional exchanges. Conclusion Patients with thyroid cancer have searched for a lot of information about surgery and recurrence. Analyzing the online community will help to understand the experience of thyroid cancer patients and contribute to the development of online community intervention.

BACKGROUND AND OBJECTIVES: Most thyroid cancers progress slowly, have high survival rates, and have good prognosis. Therefore, the management of patients with thyroid cancer should be viewed from a long-term perspective, taking into account a return to normal social life. Cancer patients have a higher risk of unemployment than the general population, and so unemployment can be an economic problem for thyroid cancer patients. However, there have been few studies on factors affecting return to work in thyroid cancer patients. The purpose of this study is to investigate occupational changes and the period of leave of absence for patients with thyroid cancer and to identify factors that affect the return to work after surgery.MATERIALS AND METHODS: A total of 427 questionnaires of thyroid cancer patients were used for the analysis. The occupational changes and sick leave periods were analyzed according to general characteristics, disease-related characteristics, and side effects.RESULTS: The factors related to occupational change and leave of absence in thyroid cancer patients were sex and type of occupation. Women had more occupational changes and longer leave of absence than men, office workers had the least change in occupation, and professional workers had a longer period of sick leave. Fatigue was the primary side effect that affected the leave of absence.CONCLUSION: Occupation is very important in the life of a thyroid cancer patient. Informing the patient of possible complications and planning proper leave of absence will help the patient return to work and improve the quality of life.
Fatigue ; Female ; Humans ; Male ; Occupations ; Prognosis ; Quality of Life ; Return to Work ; Sick Leave ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms ; Unemployment

BACKGROUND/OBJECTIVES: Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the deadliest forms of thyroid cancer. The fatality rate for ATC is high, and the survival rate at one year after diagnosis is <20%. The present study aimed to investigate the anti-tumor activities of paclitaxel, radiation, and tyrosine kinase inhibitor (TKI) combined therapy in anaplastic thyroid cancer cells both in vitro and in vivo and explore its effects on apoptotic cell death pathways.MATERIALS #SPCHAR_X0026; METHODS: ATC cell line was exposed to TKI, lenvatinib in the presence or absence of paclitaxel with radiation, and cell viability was determined by MTT assay. Effects of the combined treatment on cell cycle and intracellular signaling pathways were assessed by flow cytometry and western blot analysis. The ATC cell line xenograft model was used to examine the anti-tumor activity in vivo.RESULTS: Our data revealed that the combined administration of paclitaxel, TKI, and radiation decreased cell viability in ATC cells, and also significantly increased apoptotic cell death in these cells, as demonstrated by the cleavage of caspase-3 and DNA fragmentation. This combination therapy reduced anti-apoptotic factor levels in ATC cells, while significantly decreasing tumor volume and increasing survival in ATC xenografts.CONCLUSION: These results indicate that administering the combination of paclitaxel, TKI, and radiation therapy may exert significant anticancer effects in preclinical models, potentially suggesting a new clinical approach for treating patients with ATC.
Blotting, Western ; Caspase 3 ; Cell Cycle ; Cell Death ; Cell Line ; Cell Survival ; Diagnosis ; DNA Fragmentation ; Flow Cytometry ; Heterografts ; Humans ; In Vitro Techniques ; Paclitaxel ; Protein-Tyrosine Kinases ; Survival Rate ; Thyroid Carcinoma, Anaplastic ; Thyroid Neoplasms ; Tumor Burden