4.Meta-analysis of the clinical significance of thyroidectomy combined with central neck dissection in differentiated thyroid carcinoma at the first treatment.
Ronghao SUN ; Chao LI ; Jinchuan FAN ; Jifeng LIU ; Jianchao CHEN ; Bing ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(2):157-163
OBJECTIVETo compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.
METHODSThe literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis.
RESULTSTotal complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03.
CONCLUSIONCentral compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.
Humans ; Neck Dissection ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; pathology ; surgery
5.Exploration of translational medicine research in metastasis and invasion of malignant tumors.
Chinese Journal of Gastrointestinal Surgery 2014;17(1):1-5
Ninety percent of malignant tumor treatment failure is due to post-operative metastasis and recurrence. Paget's "seed and soil" in 1889 and Ewing's "tumor metastatic fluid dynamics" in 1928 are the basic scientific concepts of metastasis. With the advanced molecular biological technology combined with the translational medicine research, possible or potential metastatic "seed"-tumor stem cells or stemness cells can be screened. In recent years, study on the "tumor derived exosome" raised the concept of pre-metastatic niche and progenitor metastasis. On the other hand, associated methodology and technology for screening and detection of the exosome had been established, which provides feasible methods for screening, prediction and individual therapy. It will be the new era for cancer prevention and intervention in translational medicine area.
Humans
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Neoplasm Invasiveness
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Neoplasm Metastasis
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Neoplasm Recurrence, Local
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Neoplasms
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pathology
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Translational Medical Research
Result Analysis
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