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Cancers
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Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms
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Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 7571

Special Issue Editors

Prof. Dr. Pietro Giorgio Calò

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Guest Editor
Department of Surgical Sciences, University of Cagliari, 40-09124 Cagliari, Italy
Interests: thyroid; thyroidectomy; thyroid cancer; endocrine surgery; thyroid surgery; parathyroid; parathyroid surgery; parathyroidectomy; lymph node dissection; sentinel lymph node
Special Issues, Collections and Topics in MDPI journals
Dr. Salvatore Sorrenti

E-Mail Website
Guest Editor
Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: thyroid cancer; breast cancer; surgical oncology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Fabio Medas

E-Mail Website
Guest Editor
Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
Interests: endocrine surgery; thyroid; parathyroid; mini-invasive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endocrine neoplasm surgery has changed dramatically In the last few decades in light of the development of mini-invasive surgery, together with the principles of tailored and precision surgery and advances in the technology at our disposal (e.g., intraoperative nerve monitoring, near-infrared fluorescent imaging).

Nevertheless, many issues remain, for example, the indication and extent of surgery for thyroid carcinoma, the therapeutic options for poorly differentiated and anaplastic thyroid carcinoma, the management of patients with parathyroid carcinoma, the best surgical approach for patients with pheochromocytoma and paraganglioma, and research on novel biomarkers for neuroendocrine neoplasms.

For this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Thyroid carcinoma;
  • Parathyroid carcinoma;
  • Adrenal glands neoplasms;
  • Neuroendocrine neoplasms.

We look forward to receiving your contributions.

Prof. Dr. Pietro Giorgio Calò
Prof. Dr. Salvatore Sorrenti
Prof. Dr. Fabio Medas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • thyroid carcinoma
  • thyroidectomy
  • parathyroid carcinoma
  • parathyroidectomy
  • adrenal gland neoplasms
  • adrenalectomy
  • neuroendocrine neoplasms

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Published Papers (5 papers)

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Research

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12 pages, 606 KiB  
Article
The European Thyroid Imaging and Reporting Data System as a Remedy for the Overdiagnosis and Overtreatment of Thyroid Cancer: Results from the EUROCRINE Surgical Registry
by Andrzej Rafał Hellmann, Piotr Wiśniewski, Maciej Śledziński, Marco Raffaelli, Jarosław Kobiela and Marcin Barczyński
Cancers 2024, 16(12), 2237; https://doi.org/10.3390/cancers16122237 - 17 Jun 2024
Viewed by 1016
Abstract
Background: The European Thyroid Imaging and Reporting Data System (EU-TIRADS) aims to reduce the overdiagnosis of thyroid cancer (TC) by guiding the selection of nodules for fine-needle aspiration biopsy (FNAB). This study sought to validate EU-TIRADS nodule selection criteria using data from EUROCRINE, [...] Read more.
Background: The European Thyroid Imaging and Reporting Data System (EU-TIRADS) aims to reduce the overdiagnosis of thyroid cancer (TC) by guiding the selection of nodules for fine-needle aspiration biopsy (FNAB). This study sought to validate EU-TIRADS nodule selection criteria using data from EUROCRINE, an extensive international endocrine surgery registry. Method: We reviewed indications for FNAB among patients with TC compared to those with benign disease who underwent surgery between March 2020 and March 2022, considering preoperative EU-TIRADS scores and dominant nodule size (FNAB is recommended in Category 5 (˃10 mm or ˂10 mm with suspicious lymph nodes), 4 (˃15 mm), and 3 (˃20 mm)). Patients were categorized into three risk groups: minimal risk (patients with papillary microcarcinoma), high risk (patients with pT3b stage or higher, pN1b, or pM1), and low–moderate risk (all other patients). We conducted a Receiver Operating Characteristic (ROC) analysis to assess the diagnostic accuracy of the EU-TIRADS. Results: We analyzed 32,008 operations. Approximately 68% of the surgical records included EU-TIRADS classifications. The EU-TIRADS exhibited diagnostic accuracy across high-volume sites, with a median ROC Area Under the ROC Curve (AUC) of 0.752, indicating its effectiveness in identifying malignancy. Among the cases, 7907 patients had TC. Notably, 55% of patients with TC underwent FNAB despite not initially meeting the EU-TIRADS criteria. These patients were distributed across the minimal- (58%), low–moderate- (36%), and high-risk (5.8%) categories. Of the patients with TC recommended for FNAB, 78% were deemed low–moderate risk, 21% high risk, and only 0.7% minimal risk. Conclusion: The EU-TIRADS offers effective preoperative malignancy risk stratification. Promoting the proper use of the EU-TIRADS in clinical practice is essential to mitigate the overdiagnosis and overtreatment of low-risk TC. Full article
(This article belongs to the Special Issue Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms)
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14 pages, 1301 KiB  
Article
Correlation of pN Stage and Hypoechogenicity with Tumour Encapsulation and Vascular Invasion in Thyroid Cancer (TC): A Comprehensive Analysis and Clinical Outcomes
by Krzysztof Jurkiewicz, Michał Miciak, Szymon Biernat, Beata Wojtczak and Krzysztof Kaliszewski
Cancers 2024, 16(11), 2019; https://doi.org/10.3390/cancers16112019 - 26 May 2024
Viewed by 877
Abstract
In this retrospective study, the relationship between the pN stage of TC and the ultrasound hypoechogenicity of tumour encapsulation and vascular invasion was investigated. The data of a total of 678 TC patients were analysed. The goal of this study was to assess [...] Read more.
In this retrospective study, the relationship between the pN stage of TC and the ultrasound hypoechogenicity of tumour encapsulation and vascular invasion was investigated. The data of a total of 678 TC patients were analysed. The goal of this study was to assess the significance of the pTNM score and preoperative ultrasound features in predicting cancer prognosis and guiding therapeutic decisions in patients with TC. The main research methods included a retrospective analysis of patient data, mainly the pTNM score and presence of tumour encapsulation and vascular invasion obtained from histopathological results and preoperative ultrasound imaging. Patients with well-differentiated TCs (papillary and follicular) were extracted from TC patients to better unify the results because of similar clinical strategies for these TCs. Significant associations were observed between advanced pN stage and the presence of encapsulation and vessel invasion. The majority of pN1a patients exhibited encapsulation (77.71%; p < 0.0001) and vascular invasion (75.30%; p < 0.0001), as did the majority of pN1b patients (100%; p < 0.0001 and 100%; p < 0.0001, respectively). Less than half of the patients with hypoeghogenic patterns presented with encapsulation (43.30%; p < 0.0001) and vascular invasion (43.52%; p < 0.0001), while the vast majority of patients without hypoechogenicity did not present with encapsulation (90.97%; p < 0.0001) or vascular invasion (90.97%; p < 0.0001). Hypoechogenicity was found to be indicative of aggressive tumour behaviour. The results of this study underscore the importance of accurate N staging in TC and suggests the potential use of ultrasound features in predicting tumour behaviour. Further research is needed to confirm these findings and explore additional prognostic markers to streamline TC management strategies and improve patient outcomes. Full article
(This article belongs to the Special Issue Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms)
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9 pages, 417 KiB  
Article
Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study
by Gian Luigi Canu, Federico Cappellacci, Ahmed Abdallah, Islam Elzahaby, David Figueroa-Bohorquez, Eleonora Lori, Julie A. Miller, Sergio Zúñiga Pavia, Pilar Pinillos, Atcharaporn Pongtippan, Saleh Saleh Saleh, Salvatore Sorrenti, Chutintorn Sriphrapradang, Pietro Giorgio Calò and Fabio Medas
Cancers 2023, 15(15), 3996; https://doi.org/10.3390/cancers15153996 - 7 Aug 2023
Viewed by 1818
Abstract
Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. [...] Read more.
Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR). One high-volume thyroid centre was included for each region. Demographic, preoperative, and pathologic data were compared among the different regions. Overall, 5737 patients from five high-volume thyroid centres were included in this study. We found that the proportion of ITNs over the global activity for thyroid disease was higher in the EUR (37.6%) than in the other regions (21.1–23.6%). In the EMR, the patients were significantly younger (with a mean of 43.1 years) than in the other regions (range, 48.8–57.4 years). The proportion of lobectomy was significantly higher in the WPR, where 83.2% (114/137) of patients received this treatment, than in the other regions, where lobectomies were performed in 44.1–58.1% of patients. The pathological diagnosis of malignancy was significantly higher in the SEAR centre, being over 60%, than in centres of the other regions, where it ranged from 26.3% to 41.3%. The occurrence of lymph node metastases was higher in the WPR (27.8%), AMR (26.9%), and EMR (20%) centres than in the EUR and SEAR centres, where it was lower than 10%. In summary, we found in our study different approaches and outcomes in the diagnosis and treatment of ITNs among countries. Overall, almost 60% of patients with ITNs who underwent surgery actually presented a benign disease, potentially undergoing an unnecessary operation. Full article
(This article belongs to the Special Issue Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms)
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12 pages, 4740 KiB  
Article
US Evaluation of Topical Hemostatic Agents in Post-Thyroidectomy
by Vincenzo Dolcetti, Eleonora Lori, Daniele Fresilli, Giovanni Del Gaudio, Chiara Di Bella, Patrizia Pacini, Vito D’Andrea, Fabrizio Maria Frattaroli, Giulia Giordana Vallone, Piero Liberatore, Daniele Pironi, Gian Luigi Canu, Pietro Giorgio Calò, Vito Cantisani and Salvatore Sorrenti
Cancers 2023, 15(9), 2644; https://doi.org/10.3390/cancers15092644 - 7 May 2023
Cited by 2 | Viewed by 2018
Abstract
Background: the aim of this study was to describe the ultrasound appearance of topical hemostatics after thyroidectomy. Methods: we enrolled 84 patients who were undergoing thyroid surgery and were treated with two types of topical hemostats, 49 with an absorbable hemostat of oxidized [...] Read more.
Background: the aim of this study was to describe the ultrasound appearance of topical hemostatics after thyroidectomy. Methods: we enrolled 84 patients who were undergoing thyroid surgery and were treated with two types of topical hemostats, 49 with an absorbable hemostat of oxidized regenerated cellulose (Oxitamp®) and 35 with a fibrin glue-based hemostat (Tisseel®). All patients were examined using B-mode ultrasound. Results: In 39 patients of the first group (approximately 80%), a hemostatic residue was detected and in some cases confused with a native gland residue, or with cancer recurrence in oncological patients. No residue was detected in patients in the second group. The main ultrasound characteristics of the tampon were analyzed and arranged according to predefined patterns, and suggestions to recognize it and avoid wrong diagnoses were provided. A part of the group of patients with tampon residue was re-evaluated after 6–12 months, ensuring that the swab remained for months after the maximum resorption time declared by the manufacturer. Conclusions: with equal hemostatic effectiveness, the fibrin glue pad is more favorable in the ultrasound follow-up because it creates reduced surgical outcomes. It is also important to know and recognize the ultrasound characteristics of oxidized cellulose-based hemostats in order to reduce the number of diagnostic errors and inappropriate diagnostic investigations. Full article
(This article belongs to the Special Issue Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms)
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Review

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58 pages, 1552 KiB  
Review
Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach
by Mara Carsote, Mihai-Lucian Ciobica, Oana-Claudia Sima, Adrian Ciuche, Ovidiu Popa-Velea, Mihaela Stanciu, Florina Ligia Popa and Claudiu Nistor
Cancers 2024, 16(10), 1868; https://doi.org/10.3390/cancers16101868 - 14 May 2024
Viewed by 1028
Abstract
We aimed to analyze the management of the ectopic mediastinal thyroid (EMT) with respect to EMT-related cancer and non-malignant findings related to the pathological report, clinical presentation, imaging traits, endocrine profile, connective tissue to the cervical (eutopic) thyroid gland, biopsy or fine needle [...] Read more.
We aimed to analyze the management of the ectopic mediastinal thyroid (EMT) with respect to EMT-related cancer and non-malignant findings related to the pathological report, clinical presentation, imaging traits, endocrine profile, connective tissue to the cervical (eutopic) thyroid gland, biopsy or fine needle aspiration (FNA) results, surgical techniques and post-operatory outcome. This was a comprehensive review based on revising any type of freely PubMed-accessible English, full-length original papers including the keywords “ectopic thyroid” and “mediastinum” from inception until March 2024. We included 89 original articles that specified EMTs data. We classified them into four main groups: (I) studies/case series (n = 10; N = 36 EMT patients); (II) malignant EMTs (N = 22 subjects; except for one newborn with immature teratoma in the EMT, only adults were reported; mean age of 62.94 years; ranges: 34 to 90 years; female to male ratio of 0.9). Histological analysis in adults showed the following: papillary (N = 11/21); follicular variant of the papillary type (N = 2/21); Hürthle cell thyroid follicular malignancy (N = 1/21); poorly differentiated (N = 1/21); anaplastic (N = 2/21); medullary (N = 1/21); lymphoma (N = 2/21); and MALT (mucosa-associated lymphoid tissue) (N = 1/21); (III) benign EMTs with no thyroid anomalies (N = 37 subjects; mean age of 56.32 years; ranges: 30 to 80 years; female to male ratio of 1.8); (IV) benign EMTs with thyroid anomalies (N = 23; female to male ratio of 5.6; average age of 52.1 years). This panel involved clinical/subclinical hypothyroidism (iatrogenic, congenital, thyroiditis-induced, and transitory type upon EMT removal); thyrotoxicosis (including autonomous activity in EMTs that suppressed eutopic gland); autoimmune thyroiditis/Graves’s disease; nodules/multinodular goiter and cancer in eutopic thyroid or prior thyroidectomy (before EMT detection). We propose a 10-item algorithm that might help navigate through the EMT domain. To conclude, across this focused-sample analysis (to our knowledge, the largest of its kind) of EMTs, the EMT clinical index of suspicion remains low; a higher rate of cancer is reported than prior data (18.8%), incident imagery-based detection was found in 10–14% of the EMTs; surgery offered an overall good outcome. A wide range of imagery, biopsy/FNA and surgical procedures is part of an otherwise complex personalized management. Full article
(This article belongs to the Special Issue Advances in Diagnosis, Treatment and Management of Endocrine Neoplasms)
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