Browsing by Author "Solar A."

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    Active surveillance is a feasible and safe strategy in selected patients with papillary thyroid cancer and suspicious cervical lymph nodes detected after thyroidectomy
    (2024) Solorzano M.; Lustig N.; Mosso L.; Espinoza M.; Santana R.; Gonzalez H.; Montero P.H.; Cruz F.; Solar A.; Dominguez J.M.; NCD Risk Factor Collaboration (NCD-RisC)
    Objective: After initial treatment, up to 30% of patients with papillary thyroid cancer (PTC) have incomplete response, mainly cervical lymph node (LN) disease. Previous studies have suggested that active surveillance (AS) is a possible option for these patients. Our aim was to report the results of AS in patients with PTC and cervical LN disease. Materials and methods: In this retrospective observational study, we included adult patients treated and followed for PTC, who presented with cervical LN disease and were managed with AS. Growth was defined as an increase ≥ 3mm in either diameter. Results: We included 32 patients: 27 (84.4%) women, age of 39 ± 14 years, all initially treated with total thyroidectomy, and 22 (69%) with therapeutic neck dissection. Cervical LN disease was diagnosed 1 year (0.3-12.6) after initial management, with a diameter of 9.0 mm (6.0-19.0). After a median AS of 4.3 years (0.6-14.1), 4 (12.5%) patients had LNgrowth: 2 (50%) of whom were surgically removed, 1 (25%) was effectively treated with radiotherapy, and 1 (25%) had a scheduled surgery. Tg increase was the only predictive factor of LN growth evaluated as both the delta Tg (p < 0.0366) and percentage of Tg change (p < 0.0140). None of the included patients died, had local complications due to LN growth or salvage therapy, or developed distant metastases during follow-up. Conclusion: In selected patients with PTC and suspicious cervical LNs diagnosed after initial treatment, AS is a feasible and safe strategy as it allows effective identification and treatment of the minority of patients who progress.
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    An ultrasound score to predict the presence of papillary thyroid carcinoma. Preliminary reportDiseño de una escala ecográfica predictora de malignidad en nódulos tiroideos: Comunicación preliminar
    (2009) Domínguez J.M.; Baudrand R.; Arteaga E.; Campusano C.; González G.; Mosso L.; Fardella C.; Domínguez J.M.; Baudrand R.; Arteaga E.; Campusano C.; González G.; Mosso L.; Arias T.; Pizarro A.; Gómez M.; Fardella C.; Cruz F.; Torres J.; Solar A.; Cavada G.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: Thyroid nodules are common and associated to a low risk of malignancy. Their clinical assessment usually includes a fine neddle aspiration biopsy (FNAB). Aim: To identify ultrasonographic characteristics associated to papillary thyroid carcinoma (PTC) and generate a score that predicts the risk of PTC. Material and methods: Retrospective review of all fine needle aspiration biopsies of the thyroid performed in a lapse of two years. Biopsies that were conclusive for PTC were selected and compared with an equal amount of randomly selected biopsies that disclosed a benign diagnosis. Results: One hundred twenty two biopsies of a total of 1,498 were conclusive for PTC. Univariate analysis showed associations with PTC for the presence of micro-calcifications (Odds ratio (OR) 49.2: 95% confidence intervals (CI) 18.7-140.9), solid predominance (OR 25.1; 95% CI 6-220), hypoechogenicity (OR 23.5, 95% CI 6.5-122.6), irregular borders (OR 17, 95% CI 7.2-42.9), lymph node involvement (OR 12.3, 95% CI 2.7-112), central vascularization (OR 12.2, 95% CI 4.8-33.3), local invasion and hyperechogenicity (OR 0.2; CI 95% CI 0.03-0.6). Multivariate analysis disclosed microcalcifications (OR 28.1; CI 95% 8.9-89), hypoechogenicity (OR 9.4; 95% CI 1.5-59.5) and irregular borders (OR 4.7; CI 95% 1.5-15) as the variables independently associated with the presence of PTC. The prevalence of PTC in the presence of the three variables was 97.6% (Likelihood ratio (LR) 45) and 5.4% in their absence (LR 0.06). Conclusions: This scale predicts the presence or absence of PTC using simple ultrasound characteristics.
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    Clinical features of 17 patients with familial non medullary thyroid carcinomaCarcinoma familiar del tiroides no medular (CFTNM): Características de presentación en 17 casos
    (2007) Mosso G. L.; Velasco S.; Cardona B.; Fardella C.; González G.; López J.M.; Rodríguez J.A.; Arteaga E.; Salazar I.; Solar A.; González H.; Cruz F.; Mosso G. L.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: Papillary thyroid carcinoma can have familial aggregation. Aim: To compare retrospectively familial non medullary thyroid carcinoma (FNMTC) with sporadic papillary thyroid carcinoma (PTC). Material and methods: Retrospective analysis of medical records of patients with thyroid carcinoma. An index case was defined as a subject with the diagnosis of differentiated thyroid carcinoma with one or more first degree relatives with the same type of cancer. Seventeen such patients were identified and were compared with 352 subjects with PTC. Results: The most common affected relatives were sisters. Patients with FNMTC were younger than those with PTC. No differences were observed in gender, single or multiple foci, thyroid capsule involvement, surgical border involvement, number of affected lymph nodes and coexistence of follicular hyperplasia. Patients with FNMTC had smaller tumors and had a nine times more common association with lymphocytic thyroiditis. Five patients with FNMTC had local recurrence during 4.8 years of follow up. Conclusions: Patients with FNMTC commonly have an associated chronic thyroiditis, are younger and have smaller tumors than patients with PTC.
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    Lobectomy in patients with differentiated thyroid cancer: experience of a Chilean tertiary center
    (2024) Fuentes I.; Santana R.; Espinoza M.; Arteaga E.; Uslar T.; Baudrand R.; Gonzalez G.; Guarda F.J.; Lustig N.; Mosso L.; Nilo F.; Valenzuela F.; Dominguez F.; Gonzalez H.E.; Montero P.H.; Cruz F.; Solar A.; Dominguez J.M.; NCD Risk Factor Collaboration (NCD-RisC)
    © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.Purpose: Thyroid lobectomy (TL) is an appropriate treatment for up to 4 cm intrathyroidal differentiated thyroid cancer (DTC). There is scarce data regarding TL outside first-world centers. Our aim is to report a cohort of patients with DTC treated with TL in Chile. Methods: We included DTC patients treated with TL, followed for at least 6 months, characterized their clinicopathological features and classified their risk of recurrence and response to treatment. Results: Eighty-two patients followed for a median of 2.3 years (0.5–7.0). Seventy-three (89%) patients had papillary, 8 (9.8%) follicular and 1 (1.2%) high-grade DTC. The risk of recurrence was low in 56 (68.3%) and intermediate in 26 (31.7%). Eight (9.8%) patients required early completion thyroidectomy and radioiodine. At last follow-up, 52 (70.3%) had excellent, 19 (25.7%) had indeterminate, and 1 (1.4%) had structural incomplete response. Conclusion: In a developing country, TL is an adequate option for appropriately selected DTC patients.
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    ThyroidPrint®: clinical utility for indeterminate thyroid cytology
    (2023) Olmos R.; Dominguez J.M.; Vargas-Salas S.; Mosso L.; Fardella C.E.; Gonzalez G.; Baudrand R.; Guarda F.; Valenzuela F.; Arteaga E.; Forenzano P.; Nilo F.; Lustig N.; Martinez A.; Lopez J.M.; Cruz F.; Loyola S.; Leon A.; Droppelmann N.; Montero P.; Dominguez F.; Camus M.; Solar A.; Zoroquiain P.; Roa J.C.; Munoz E.; Bruce E.; Gajardo R.; Miranda G.; Riquelme F.; Mena N.; Gonzalez H.E.; NCD Risk Factor Collaboration (NCD-RisC)
    Molecular testing contributes to improving the diagnosis of indeterminate thyroid nodules (ITNs). ThyroidPrint® is a ten-gene classifier aimed to rule out malignancy in ITN. Post-validation studies are necessary to determine the real-world clinical benefit of ThyroidPrint® in patients with ITN. A single-center, prospective, noninterventional clinical utility study was performed, analyzing the impact of ThyroidPrint® in the physicians' clinical decisions for ITN. Demographics, nodule characteristics, benign call rates (BCRs), and surgical outcomes were measured. Histopathological data were collected from surgical biopsies of resected nodules. Of 1272 fine-needle aspirations, 109 (8.6%) were Bethesda III and 135 (10.6%) were Bethesda IV. Molecular testing was performed in 155 of 244 ITN (63.5%), of which 104 were classified as benign (BCR of 67.1%). After a median follow-up of 15 months, 103 of 104 (99.0%) patients with a benign ThyroidPrint® remained under surveillance and one patient underwent surgery which was a follicular adenoma. Surgery was performed in all 51 patients with a suspicious for malignancy as per ThyroidPrint® result and in 56 patients who did not undergo testing, with a rate of malignancy of 70.6% and 32.1%, respectively. A higher BCR was observed in follicular lesion of undetermined significance (87%) compared to atypia of undetermined significance (58%) (P < 0.05). False-positive cases included four benign follicular nodules and six follicular and four oncocytic adenomas. Our results show that, physicians chose active surveillance instead of diagnostic surgery in all patients with a benign ThyroidPrint® result, reducing the need for diagnostic surgery in 67% of patients with preoperative diagnosis of ITN.