Browsing by Author "Tausanovic, K. (55623602100)"

Background: Rates of thyroid cancer in patients with multinodular goitre (MNG) vary widely, from 3 per cent in older studies to 35 per cent in more recent studies. The purpose of the present study was to evaluate the prevalence of thyroid cancer in patients operated on for MNG, and to determine risk factors for incidental thyroid malignancy. Methods: A prospectively developed database of all patients who underwent thyroidectomy for a benign MNG at the high-volume endocrine surgery unit of a tertiary referral university hospital was interrogated. Results: A total of 3233 patients were analysed, separated into three groups according to their functional thyroid status (hypothyroid, hyperthyroid or euthyroid). There were 2788 women (86.2 per cent); the mean patient age was 56.4 years and mean preoperative disease duration was 106.2 months. Incidental thyroid cancer was identified in 1026 patients (31.7 per cent), of which 917 (89.4 per cent) were papillary cancers. Multivariable regression analysis identified functional thyroid status, younger age, male sex, smaller adenoma size, smaller thyroid glands, Hashimoto s thyroiditis and chronic non-specific thyroiditis as independent risk factors for thyroid cancer. Conclusion: MNG was associated with a considerable rate of incidental thyroid cancer, which has been underestimated. A variety of factors should be taken into account when considering the malignant potential of a presumed benign MNG. © 2021 John Wiley and Sons Inc.. All rights reserved.

Background: Clinically isolated adrenal metastases are rare and therefore present a therapeutic challenge. We report our experience with surgery of adrenal metastases and analyze factors that may influence postoperative survival. Methods: A consecutive series of 31 patients (16 male, 15 female) underwent adrenal surgery for metastases at a single institution over 10-year period (1999-2008). The Kaplan-Meier method and log-rank test were used to determine overall survival. Potential prognostic factors were identified by univariate and multivariate Cox regression analysis. Results: The primary tumor diagnoses were non-small-cell lung carcinoma (NSCLC) 20, colorectal carcinoma 5, renal cell carcinoma (RCC) 2, malignant melanoma and breast carcinoma, one each. The median survival was 12 months, with one year and five year survival of 21% and 3.4% respectively. According to multivariate analysis independent prognostic factors of favorable survival were disease free interval (DFI) longer than 12 months (Hazard ratio (HR) = 0.28, 95%CI = 0.09-0.90), potentially curative resection (Hazard ratio (HR) = 0.35, 95%CI = 0.12-1.00) and postoperative radiotherapy of adrenal bed (Hazard ratio (HR) = 0.33, 95%CI = 0.12-0.91). Conclusions: Overall survival after surgery for adrenal metastases is poor. In multivariate analyses, survival is influenced by DFI, curative resection, and postoperative radiotherapy.