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Ward MC, Adelstein DJ, Bhateja P, et al. Severe late dysphagia and cause of death after
concurrent chemoradiation for larynx cancer in patients eligible for RTOG 91-11.
Oral
Oncol
. 2016; 57:21-26. EBM level 3................................................................................65-70
Summary
: This paper reports on the results of a retrospective cohort study of all patients treated for
larynx cancer at a single institution who would have met criteria for the 91-11 trial. Patients were
carefully followed for the development of severe late dysphagia that developed after 5 years of follow
up and therefore not reported in that trial. They identified that 26% of patients developed severe late
dysphagia as a result of therapy after 5 years of follow up.
IV.
Management of Thyroid Nodules and Thyroid Malignancy
Ito Y, Miyauchi A, Inoue H, et al. An observational trial for papillary thyroid
microcarcinoma in Japanese patients.
World J Surg
. 2010; 34(1):28-35. EBM
level 2..................................................................................................................................71-78
Summary
: This is a prospective case-controlled study comparing observation versus surgical
intervention for patients with papillary thyroid microcarcinoma. The results show that observation is
adequate for many, and that progression during observation does not adversely affect survival or
salvage rates.
Lang BH, Ng SH, Lau LL, et al. A systematic review and meta-analysis of prophylactic
central neck dissection on short-term locoregional recurrence in papillary thyroid carcinoma
after total thyroidectomy.
Thyroid
. 2013; 23(9):1087-1098. EBM level 1......................79-90
Summary
: This is a meta-analysis of the locoregional recurrence and complications in patients who
underwent prophylactic central neck dissection compared to those who did not. Evidence shows the
benefit of the prophylactic central neck dissection in patients with N0 neck. Locoregional recurrence
was reduced in patients undergoing central neck dissection.
Lang BH, Wong IO, Wong KP, et al. Risk of second primary malignancy in differentiated
thyroid carcinoma treated with radioactive iodine therapy.
Surgery
. 2012; 151(6):844-850.
EBM level 2........................................................................................................................91-97
Summary
: Retrospective study of all patients treated with radioactive iodine (RAI) for differentiated
thyroid cancer (DTC) within a single healthcare system in China. The 895 patients identified for study
were followed for a minimum of 2 years; 645 patients received RAI as part of their treatment, while
249 patients did not. Controlling for other factors, RAI-positive and RAI-negative patients were
compared the subsequent developments of second primary malignancies (SPMs). A statistically
significant deference in the incidence of SPMs was noted in the RAI group, while the RAI-negative
group had baseline levels of SPM development (13.5% vs 3.1%;
p
= 0.015). This study is one of
several that strongly suggest that RAI therapy can have significant long-term effects on patients
receiving this therapy and indirectly argues that RAI should be given selectively.
Morris LG, Sikora AG, Tosteson TD, Davies L. The increasing incidence of thyroid cancer:
the influence of access to care.
Thyroid
. 2013; 23(7):885-891. EBM level 1...............98-104
Summary
: This study uses the SEER database and correlates the well-recognized increased incidence
of papillary thyroid cancer (PTC) diagnosis in the U.S. to the availability of and access to healthcare
among the more affluent population. The study, in conjunction with others, shows that the majority of
the increased cases of PTC are from small, likely indolent, PTCs, and is driven by increased detection
in an already existing pool of patients with subclinical disease.