Endocrine Malignancies: Current Surgical Therapeutic Approaches

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (10 April 2024) | Viewed by 1964

Special Issue Editors


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Guest Editor
Department of Surgery "Pietro Valdoni", Sapienza, University of Rome, Rome, Italy
Interests: general and colorectal surgery; laparoscopy; robotic surgery

E-Mail Website
Guest Editor
Chief of the Surgical Oncology Unit, Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
Interests: general and colorectal surgery; laparoscopy; robotic surgery
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Special Issue Information

Dear Colleagues,

Thyroid cancer (TC) is the most common endocrine neoplasia and is known to have a favorable prognosis. Nevertheless, differentiated thyroid cancer has the potential to be metastatic and poorly differentiated thyroid cancer can present at an advanced clinical stage upon initial observation. This makes it difficult to assess the clinical characteristics and treatment outcomes after surgical intervention, and these patients subsequently have a low survival rate. Various diagnostic and treatment methodologies are currently being trialed to overcome these limitations and efforts are being made to improve both the patient's prognosis and outcome.

Adrenocortical carcinoma (ACC) is a rare endocrine malignancy and has a historically poor prognosis. Adjuvant therapy with mitotane, either alone or in combination with chemotherapy, is the standard of care treatment for ACC. Nevertheless, surgery remains the first line of curative treatment. Recently, several drugs targeting new pathways, such as insulin growth factor 2 (IGF2), beta-catenin pathway, and others, have entered clinical trials. Immunotherapy has also recently emerged as an important therapeutic option for several cancer models; however, the role of immunotherapy in the treatment cascade is not yet clear. Despite the recent advances in the development of novel treatment methods, ACC still has a poor prognosis.

This Special Issue encourages the submission of research articles which address how the pathophysiology of endocrine malignancy development drives both the current and novel emerging therapies that can be of benefit to patients, in addition to the refinement and advancement of surgical interventions. It is intended to present and discuss all the aspects of the currently available diagnostic and treatment methodologies, both surgical and non-surgical, of thyroid and adrenal malignancies via original research articles and reviews. For this Special Issue, we invite authors and researchers to publish original research and reviews highlighting the advancements in the diagnosis, prognosis, surgery, and therapeutics of endocrine malignancies, in particular, thyroid and adrenocortical cancer.

Potential topics may include, but are not limited to:

  • Thyroid cancer diagnosis and differentiation.
  • Clinical management and surgical treatment of TC patients.
  • Parathyroid pathologies: clinical and surgical management.
  • Adrenocortical cancer diagnosis: genetic, clinical, and radiological findings.
  • New pathways, targeted drugs, and immunotherapy for ACC patients.
  • Clinical management and surgical treatment of ACC patients.
  • Multiple endocrine neoplasia, genetic correlations, and therapeutic approaches.

Dr. Mariarita Tarallo
Prof. Dr. Enrico Fiori
Guest Editors

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Keywords

  • endocrine malignancies
  • thyroid cancer
  • adrenocortical cancer
  • parathyroid
  • men

Published Papers (1 paper)

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8 pages, 561 KiB  
Brief Report
Incidence and Clinical Relevance of Incidental Papillary Carcinoma in Thyroidectomy for Multinodular Goiters
by Aldo Bove, Roberto Manunzio, Gino Palone, Raffaella Marina Di Renzo, Giulia Valeria Calabrese, David Perpetuini, Mirko Barone, Stella Chiarini and Felice Mucilli
J. Clin. Med. 2023, 12(8), 2770; https://doi.org/10.3390/jcm12082770 - 07 Apr 2023
Cited by 2 | Viewed by 1343
Abstract
Introduction: Patients undergoing a total thyroidectomy for multinodular goiter typically have a long clinical history of the disease. They often come to surgery for compression symptoms, with no suspicion of neoplastic disease. For these patients, the incidence of microcarcinomas is high, even though [...] Read more.
Introduction: Patients undergoing a total thyroidectomy for multinodular goiter typically have a long clinical history of the disease. They often come to surgery for compression symptoms, with no suspicion of neoplastic disease. For these patients, the incidence of microcarcinomas is high, even though we know that this does not affect subsequent therapies and long-term survival. On the other hand, when a true incidental carcinoma is present, the patient requires specific therapy and long-term follow-up. The purpose of the study was to identify the incidence of incidental carcinomas in the high prevalence region of goiter, the clinical-pathological characteristics of the tumor, and the therapeutic implications. Method: This is a retrospective study, from January 2010 to December 2020, on a case series of 1435 total thyroidectomies for goiters. All patients had a preoperative diagnosis of a benign disease. Gender, mean age, and mean duration from the initial diagnosis of goiter were evaluated along with the number and frequency of fine needle aspirations carried out. On the basis of the histological examination, the incidence of incidental carcinoma was then assessed (diameter ≥ 10 mm) as well as the incidence of microcarcinoma (diameter < 10 mm), the pathological characteristics (multifocality, capsular invasion), and the subsequent prescribed therapies. Results: Patients with incidental carcinoma numbered 41 (2.8%%), 34 women and 7 men. The mean age was 53.5 years, while the patients diagnosed with microcarcinoma were 88 (6.1%). The mean duration of the disease from initial diagnosis was 7.8 years. On average, these patients underwent 1.8 fine needle aspirations during the course of the disease, almost exclusively in the first four years. The mean diameter of the tumor was 1.35 cm (±0.3). Multifocality was present in six patients, while only one patient presented capsular invasion. The chi-square test delivered a significant dependence on gender in terms of the incidental diagnosis after Yates correction (chi-stat = 5.064; p = 0.024), highlighting a higher incidence in the female population. All patients underwent subsequent metabolic radiotherapy. The mean follow-up was 6.3 years and in the 35 patients examined, none displayed any recurrence of the disease. Conclusions: Incidental carcinoma is not uncommon in patients who have undergone total thyroidectomy for goiters. It must be differentiated from microcarcinoma for its therapeutic implications and the follow-up of the patient. Statistical analysis has shown that the only significant variable is gender. In a goiter area, the careful monitoring of patients is required to highlight suspicious clinical–instrumental aspects that may appear even several years after the initial diagnosis. Full article
(This article belongs to the Special Issue Endocrine Malignancies: Current Surgical Therapeutic Approaches)
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