Gland surgery最新文献

{"title":"Acute transient thyroid swelling following fine-needle aspiration: a case series and a systematic review.","authors":"Da-Kun Zhang, Xin-Yan Zhu, Jing-Bo Guan, Zhi-Xuan Li, Yun-Lin Li, Jie Gao","doi":"10.21037/gs-2025-66","DOIUrl":"10.21037/gs-2025-66","url":null,"abstract":"<p><strong>Background: </strong>Acute transient thyroid swelling (ATTS) is a rare complication of fine-needle aspiration (FNA) of thyroid nodules. Most cases were in spontaneous remission. However, it is fatal in rare cases. However, there are few literature reports, so it is of great significance to improve the clinical understanding of ATTS. Therefore, this study aimed to present 10 institutional cases and a systematic review of 18 literature cases to delineate clinical features, imaging findings, and management approaches.</p><p><strong>Methods: </strong>Twenty-eight clinical cases (10 cases from institutional archives and 18 cases from literature search) were included in the retrospective analysis. Data collection continued until August 1, 2024.</p><p><strong>Results: </strong>ATTS following FNA is a rare complication. Among the 28 total cases (10 institutional, 18 literature), 89% were female. Bilateral goiter occurred in 71%. Symptoms typically emerged within one hour following FNA, resolving spontaneously within 24 hours in 79% of cases. Neck pain/swelling (54%) was common; severe complications (dyspnea, cardiac arrest) were rare (3%). Ultrasound revealed unilateral/bilateral goiter with linear/patchy hypoechoic areas and preserved vascularity. Non-pharmacological management sufficed for most patients.</p><p><strong>Conclusions: </strong>ATTS following FNA is self-limiting, with distinct ultrasound findings. Clinicians should prioritize airway management in severe cases and avoid unnecessary interventions in mild presentations.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"888-896"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric nutritional risk index predicts postoperative outcomes in elderly patients with pancreatoduodenectomy: a propensity score-matched analysis.","authors":"Xiaofeng Liu, Kang Xue, Yi Zhang, Bole Tian","doi":"10.21037/gs-2024-541","DOIUrl":"10.21037/gs-2024-541","url":null,"abstract":"<p><strong>Background: </strong>The Geriatric Nutrition Risk Index (GNRI) serves as a straightforward screening tool for predicting the likelihood of postoperative complications and mortality in elderly patients. This study aimed to investigate the association between GNRI and postoperative outcomes in elderly patients undergoing pancreaticoduodenectomy (PD).</p><p><strong>Methods: </strong>We enrolled patients aged 65 years or older who underwent PD between January 2018 and March 2023. Patients were dichotomized into at-risk (GNRI ≤98) or no-risk (GNRI >98) groups. Propensity score matching was used to compare the baseline differences and postoperative outcomes between these two groups. Logistic regression analysis was conducted to assess the association between GNRI and major morbidity (Clavien-Dindo scale with ≥ grade 3b complications).</p><p><strong>Results: </strong>There were 392 eligible patients included. Following propensity score matching, patients in the at-risk GNRI group had higher rates of major complication (13.2% <i>vs.</i> 5.4%, P=0.03) and pulmonary infection (17.8% <i>vs.</i> 9.3%, P=0.046). Based on the multivariate analysis, at-risk group was an independent prognostic factor for major morbidity (odds ratio =2.698, 95% CI: 1.062-6.856, P=0.04). Subgroup analysis revealed that high-risk patients (GNRI <82) exhibited higher rates of preoperative jaundice and longer operative time in comparison to the moderate (GNRI =82-91) and low-risk (GNRI =92-98) groups. However, there were no statistically significant disparities in morbidity and mortality among these three groups.</p><p><strong>Conclusions: </strong>We demonstrated that nutritional status evaluated by GNRI predicts postoperative complications after PD in elderly patients.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"807-817"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The triple-plane technique: a surgical technique for subpectoral implant-based breast reconstruction.","authors":"Yue He, Wenfei He, Mingzhi Xia, Zhihua Liu, Zhaoyang Zhu, Frederik Thørholm Andersen, Paulo P Piccolo, Isobel Yeap, Jolie Jingyi Hwee, Zhaoyun Wu, Xiaobo Hu","doi":"10.21037/gs-2025-116","DOIUrl":"10.21037/gs-2025-116","url":null,"abstract":"<p><p>Breast reconstruction surgery is an important part of breast cancer treatment. However, implant-based breast reconstruction is associated with a number of complications, such as infection, seroma, prosthesis exposure, and skin erythema. In this study, we propose a novel surgical technique for implant-based breast reconstruction-the triple-plane technique. This technique positions the prosthesis in a complete submuscular plane. Medially, it is subpectoral, and inferolaterally it is covered by a flap of serratus anterior and latissimus dorsi fascia. As such, the prosthesis is not in contact with the skin, thereby reducing postoperative complications. This article reports on the breast reconstruction results of 96 breast cancer patients who underwent unilateral breast reconstruction surgery using the triple-plane technique at Hunan Cancer Hospital. The results show that breast appearance after surgery was rated as excellent by 92 (95.83%) patients, and good by 4 (4.17%) patients. The average operation time, surgical incision, intraoperative blood loss, and hospitalization time of patients were 88.40±12.13 minutes, 12.24±4.01 cm, 46.40±10.73 mL, and 7.23±1.00 days, respectively. Skin necrosis at the edge of the incision was observed in 1 (1.04%) patient, which healed normally after debridement and closure. The scores of BREAST-Q patient-reported outcome measure ranged from 80 to 100 points for all of the patients. These results demonstrate that the triple-plane technique offers a novel and safe technique for breast reconstruction surgery.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"958-967"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based integration of clinicopathological factors with the risk of papillary thyroid carcinoma lateral cervical lymph node metastasis: systematic review and meta-analysis and subgroup study.","authors":"Rongyi Hu, Qianlang Ren, Tiebin Li, Chunyan Lv, Jie Yang, Yanxin Ren, Fusheng Lin, Xiaojiang Li","doi":"10.21037/gs-2025-60","DOIUrl":"10.21037/gs-2025-60","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid carcinoma (PTC) is characterised by a high incidence and high burden. Although surgery combined with adjuvant radioiodine therapy can significantly improve the prognosis of PTC patients, the indication of prophylactic lateral neck lymph node dissection is still controversial. In addition, the sensitivity of preoperative ultrasound for lateral cervical lymph node metastasis (LLNM) is low, so it is important to identify the independent risk factors for LLNM. This study aimed to investigate lateral lymph node metastasis in PTC. A systematic review and meta-analysis of risk factors for clinicopathological, ultrasound, and related features of LLNM were performed.</p><p><strong>Methods: </strong>The clinical pathological, ultrasonic, and related risk factors of LLNM in PTC were studied by database search, and the risk factors of LLNM in PTC were analyzed by RevMan5.2 software.</p><p><strong>Results: </strong>Among a total of 40,190 patients, 4,991 had LLNM in 24 studies. Gender [odds ratio (OR) =1.51; 95% confidence interval (CI): 1.34-1.70; P<0.001], extrathyroidal extension (ETE) (OR =4.16; 95% CI: 2.82-6.14; P<0.001), tumor size (OR =0.35; 95% CI: 0.20-0.59; P<0.001), multifocality (OR =1.94; 95% CI: 1.50-2.52; P<0.001), central lymph node metastasis (CLNM) (OR =5.38; 95% CI: 2.62-11.07; P<0.001), capsular invasion (OR =0.07; 95% CI: 0.05-0.08; P<0.001), tumor location (OR =1.84; 95% CI: 1.63-2.09; P<0.001), calcification (OR =1.97; 95% CI: 1.34-2.91; P<0.001), and echogenicity (OR =1.55; 95% CI: 1.16-2.08; P<0.001) were significantly associated with LLNM.</p><p><strong>Conclusions: </strong>The following clinicopathological and ultrasonic features were significantly correlated with lateral neck lymph node metastasis, such as male, ETE, tumor size >2 cm, multifocality, CLNM, capsular invasion, high tumor location, calcification, and hyperechoic. It is suggested that for suspected metastatic lymph nodes, lateral neck lymph node dissection can be considered in patients with the above risk factors to reduce the recurrence and distant metastasis of PTC. However, this study has some limitations, such as no new biomarkers were included, high heterogeneity, and geographic bias.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"912-928"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and regional trends in male breast cancer burden: a comparative analysis of incidence, prevalence, mortality, and disability-adjusted life years in China and worldwide (1990-2021).","authors":"Shaopei Zou, Canxuan Li","doi":"10.21037/gs-2025-10","DOIUrl":"10.21037/gs-2025-10","url":null,"abstract":"<p><strong>Background: </strong>Male breast cancer (MBC), though accounting for a minimal proportion of all breast cancer cases, has emerged as a growing public health concern. Its global burden has expanded steadily over recent decades, necessitating comprehensive analyses to explore its epidemiological characteristics and associated trends. This study aims to analyze and compare trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of MBC in China and globally from 1990 to 2021, highlighting age-specific variations, key risk factor contributions, and the impact of advancements in healthcare and treatment practices.</p><p><strong>Methods: </strong>Utilizing data from the Global Burden of Disease (GBD) 2021 database-which integrates information from national cancer registries, cohort studies, vital registration systems, and health surveys-this study applied Joinpoint regression analysis to calculate age-standardized rates (ASRs) for incidence, prevalence, mortality, and DALYs, alongside both annual percentage changes (APCs) and the estimated annual percentage change (EAPC) to quantify temporal trends. Detailed sensitivity analyses were conducted using Disease Modeling-MetaRegression (DisMod-MR) for non-fatal estimates and the Cause of Death Ensemble model (CODEm) approach for cause-of-death estimates. Additionally, trends across different age groups and the proportional contributions of key risk factors such as high alcohol use, diets high in red meat, and secondhand smoke were thoroughly examined.</p><p><strong>Results: </strong>The burden of MBC increased significantly in China and globally over the study period. In China, total incident cases and the age-standardized incidence rate (ASIR) showed substantial increases, with a marked rise in prevalence reflecting improved detection and survival. Similar upward trends were observed globally, although regional heterogeneities were evident. Mortality rates remained relatively stable, with the age-standardized mortality rate (ASMR) fluctuating slightly in China and modestly increasing on a global scale, while DALY rates exhibited a slight decline globally after 2012-indicative of enhanced disease management and treatment outcomes. Age-specific analyses consistently revealed the greatest burden among men aged 60 years and older, underscoring the roles of population aging and shifting risk factor profiles.</p><p><strong>Conclusions: </strong>The growing burden of MBC, coupled with notable regional disparities and evolving risk factor contributions, highlights the importance of targeted interventions. These include early detection, public awareness campaigns, and continued advancements in treatment and healthcare policies that are tailored to specific demographic and regional needs, in order to bridge gaps in access and improve outcomes.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"818-833"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of continuous vagal neuromonitoring in thyroid and parathyroid gland surgery: a retrospective study of 500 cases.","authors":"Ana Baeza Carrión, Carmen Zaragoza Zaragoza, Antonio Picó Alfonso, Ana Carrión Tomás, José Manuel Ramia Ángel","doi":"10.21037/gs-2025-53","DOIUrl":"10.21037/gs-2025-53","url":null,"abstract":"<p><strong>Background: </strong>Injury to the recurrent laryngeal nerve (RLN) during thyroid and parathyroid surgery can cause vocal cord paralysis (VCP), with severe consequences, particularly in bilateral cases. Intraoperative neuromonitoring (IONM) is useful for identifying the nerve, but there are discrepancies regarding its effectiveness in preventing neural damage. Continuous monitoring, which provides real-time information, could improve postoperative outcomes, yet its adoption has been modest. Although over 90% of endocrine surgeons use some form of monitoring, this procedure has not been fully standardized. This study aims to evaluate the utility of continuous IONM (CIONM) to determine its effectiveness in clinical practice and justify its standardized adoption in other centers within our field.</p><p><strong>Methods: </strong>This is a retrospective observational study with 500 patients who underwent thyroid and parathyroid surgery with CIONM at the General University Hospital of Alicante, Spain. Patients undergoing hemithyroidectomy, total thyroidectomy, and parathyroidectomy were included, excluding those with neurological diseases or under 18 years of age. Laryngeal morbidity data were analyzed using the IBM SPSS® statistical software, version 29.0.</p><p><strong>Results: </strong>Of 477 patients who underwent CIONM, conduction blocks were observed in 92 cases, resulting in 27.6% of transient VCP and 1.1% permanent paralysis. Severe blocks were more frequent in patients with neoplasia and intrathoracic thyroid extension, and most temporary paralysis cases resolved within the first six months. The surgical plan was altered in 31.3% of severe block cases, with traction being the most frequent mechanism of injury. IONM demonstrated high diagnostic accuracy, with a negative predictive value (NPV) of 99% for permanent paralysis and 93% for transient paralysis. Surgical duration over 120 minutes and lymphadenectomy were independent risk factors for nerve injury.</p><p><strong>Conclusions: </strong>CIONM helps reduce recurrent nerve injuries by facilitating their identification and correction during complex surgeries. Additionally, continuous electromyography (EMG) is useful for assessing the functional prognosis of paralysis and allows for early initiation of rehabilitative treatments. However, standardized guidelines and meta-analysis methodology are needed to validate its effectiveness and cost-effectiveness.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"877-887"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative phosphorus levels may serve as a predictor of recurrent/persistent lesions after surgery for primary hyperparathyroidism: a cross-sectional study.","authors":"Zhiyong Yu, Jie Zhou, Xiaojun Xie, Xuan Li, Yijun Wu","doi":"10.21037/gs-2025-156","DOIUrl":"10.21037/gs-2025-156","url":null,"abstract":"<p><strong>Background: </strong>Surgery is the definitive treatment for primary hyperparathyroidism (PHPT). However, surgical outcomes can be affected by numerous factors, some of which are still a matter of debate. We examined cases at the First Affiliated Hospital of Zhejiang University, and assessed the risk factors affecting surgical success and postoperative recurrence.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the clinical data of patients who underwent surgery for PHPT without intraoperative parathyroid hormone (IOPTH) monitoring at the First Affiliated Hospital of Zhejiang University between August 2017 and June 2022. We analyzed the surgical success rates, recurrence rates, and persistent disease rates, and performed univariate and multivariate analyses to identify the risk factors associated with surgical success and postoperative recurrence/persistent lesions.</p><p><strong>Results: </strong>The overall surgical success rate was 97.8%, and the postoperative recurrence rate was 8.2%. Univariate analysis confirmed that a higher level of preoperative parathyroid hormone (PTH) and blood calcium is associated with a lower success rate of surgery (P<0.05). However, the multivariate analysis did not reveal any significance in them. The univariate analysis identified preoperative target organ damage, urolithiasis, and preoperative alkaline phosphatase (ALP), PTH, and phosphorus levels as risk factors for postoperative recurrence/persistent lesions (P<0.05). The multivariate analysis revealed that only the phosphorus level was a significant risk factor for postoperative recurrence/persistent lesions (P<0.05). The receiver operating characteristic (ROC) curve analysis indicated that phosphorus levels below 0.865 mmol/L were associated with a higher incidence of recurrence/persistent lesions, and had a sensitivity of 0.718 and a specificity of 0.67.</p><p><strong>Conclusions: </strong>In PHPT, satisfactory surgical success rates can be achieved without IOPTH monitoring. The blood phosphorus level is a significant predictor of postoperative recurrence or persistent lesions, and thus could guide clinical decision making.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"938-946"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New emerging data on adjuvant systemic therapy for stage I HER2 positive breast cancer.","authors":"Hossameldin Abdallah, Susanne Crocamo, Bruno de Paula","doi":"10.21037/gs-2025-41","DOIUrl":"10.21037/gs-2025-41","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"803-806"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological metastatic lymph node density (ND) predicts early recurrence in papillary thyroid cancer patients after curative resection.","authors":"Riku Okamoto, Hiroshi Katoh, Kanako Naito, Tomoya Mitsuma, Yuka Ozawa, Takaaki Tokito, Mariko Kikuchi, Keishi Yamashita, Takafumi Sangai","doi":"10.21037/gs-2025-36","DOIUrl":"10.21037/gs-2025-36","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research has recently suggested a high ratio of metastatic lymph nodes-to-harvested lymph nodes (LNR) as a robust prognostic factor in multiple solid cancers including papillary thyroid cancer (PTC). However, the clinical impact is still elusive. Accordingly, we assessed the clinical significance of LNR to select high-risk patients for recurrence. Here, LNR is described using the term \"node density (ND)\".</p><p><strong>Methods: </strong>Clinicopathological analyses were retrospectively conducted including pathological ND on 936 PTC patients who underwent curative resection. The clinical impact of ND was assessed based on the area and the extent of lymph node dissection. The cutoffs for variables were determined using receiver operating characteristic (ROC) curves. The cutoffs for ND were also determined using the X-tile software. Prognostic analysis was performed using Kaplan-Meier and Cox's proportional hazard models. The correlation assay was performed using multivariable logistic regression analysis.</p><p><strong>Results: </strong>Patients with recurrence had significantly higher ND than their counterparts. Patients with ND ≥17.4% showed significantly poor 10-year recurrence-free survival compared to those with lower ND (79.4% <i>vs.</i> 91.4%, P<0.001). Multivariate prognostic analysis revealed that ND ≥17.4% was an independent predictor of recurrence (hazard ratio =2.20, P=0.03). ND ≥17.4% was independently associated with younger age, male gender, gross extrathyroidal extension, and a large lymph node. Even in subgroup analysis by age or gender, ND ≥17.4% predicted a significantly poor prognosis, particularly in younger patients. ND levels were significantly higher in patients with recurrence in both the central (ND1a) and lateral lymph nodes (ND1b). The two peaks of best cutoffs (around 17% and 35%) were suggested as the optimal cutoffs; 17.4% was best across patients with high specificity, while 38.9% or 34.2% were best in patients with only central neck dissection, or patients with lateral neck dissection, respectively (both are around 35%). High ND than both cutoffs predicted recurrence despite the extent of lymph node dissection. Notably, recurrence occurred earlier in patients with high ND than in their counterparts in both cutoffs.</p><p><strong>Conclusions: </strong>A high pathological ND strongly predicts an early recurrence in both early and locally advanced PTC. Thus, ND would be considered a legitimate high-risk factor in PTC patients after curative resection.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"897-911"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential higher malignancy of nonfunctional parathyroid carcinoma: a case series study.","authors":"Zhiyong Yu, Jie Zhou, Xiaojun Xie, Xuan Li, Marie-Laure Matthey Gié, Michael Bouvet, Marti Manyalich-Blasi, Yijun Wu","doi":"10.21037/gs-2025-187","DOIUrl":"10.21037/gs-2025-187","url":null,"abstract":"<p><strong>Background: </strong>Parathyroid carcinoma is a rare endocrine malignancy. The majority of cases are functional parathyroid carcinoma, while a very small percentage are nonfunctional parathyroid carcinoma. The prognosis for patients with nonfunctional parathyroid carcinoma is generally poorer than that for those with functional parathyroid carcinoma. This is typically due to the insidious nature of nonfunctional parathyroid carcinoma, which often results in late detection and diagnosis.</p><p><strong>Case description: </strong>Between May 2011 and November 2022, the First Affiliated Hospital of Zhejiang University conducted surgical treatment on six patients diagnosed with parathyroid carcinoma. Of these, two were male and four were female, with ages spanning from 53 to 83 years. The tumors were situated on the right neck in two cases and on the left neck in four cases. The smallest tumor measured 2.5 cm in diameter, whereas the largest measured 11.4 cm. Two cases were exceptionally rare nonfunctional parathyroid carcinomas, and four were functional parathyroid carcinomas. All six patients underwent surgery. Pathological types comprised the chief-cell type in two cases, the mixed-cell type in two cases, the oxyphil-cell type in one case, and the clear-cell type in one case. The follow-up duration ranged from 1 to 151 months. Five patients remained alive, while one patient died. Both patients with nonfunctional parathyroid carcinoma experienced recurrence and metastasis, with Ki-67 levels of 30% and 20%, respectively. In contrast, none of the four patients with functional parathyroid carcinoma recurred, with one case having a Ki-67 level of 20% and three cases with a Ki-67 level of 5%.</p><p><strong>Conclusions: </strong>The poor prognosis of patients with nonfunctional parathyroid carcinoma may reflect biological behavior and a potentially higher malignant potential. The Ki-67 level is positively correlated with the malignant potential of parathyroid carcinoma. These speculations still need to be validated through large-scale clinical studies.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 5","pages":"947-957"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}