BOOK
Endocrine Tumors, An Issue of Surgical Oncology Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue of Surgical Oncology Clinics of North America, guest edited by Dr. Douglas L. Fraker, is devoted to Endocrine Tumors. Dr. Fraker has assembled expert authors to review the following topics: Management of thyroid nodular disease: Current cytopathology classifications and genetic testing; Surgical management of lymph node compartments in papillary thyroid cancer; Current guidelines for post-operative treatment and follow-up of well differentiated thyroid cancer; Outpatient thyroid surgery – is it safe?; Asymptomatic hyperparathyroidism- diagnostic pitfalls and surgical intervention; Intra-operative PTH monitoring: optimal utilization; Minimally invasive parathyroidectomy vs bilateral neck exploration for primary hyperparathyroidism; Pheochromocytoma and paraganglioma: Diagnosis, genetics, and treatment; Minimally invasive adrenalectomy; Treatment of adrenocortical cancinoma: benefits of aggressive surgery; Biochemical diagnosis and pre-operative imaging of gastro-intestinal neuroendocrine tumors; Minimally invasive techniques for resection of pancreatic neuroendocrine tumors; and Treatment of metastatic neuroendocrine tumors to the liver.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Endocrine Tumors | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword | vii | ||
| Preface: Advances in Endocrine Surgery | vii | ||
| Management of Thyroid Nodular Disease: Current Cytopathology Classifications and Genetic Testing | vii | ||
| Surgical Management of Lymph Node Compartments in Papillary Thyroid Cancer | vii | ||
| Current Guidelines for Postoperative Treatment and Follow-Up of Well-Differentiated Thyroid Cancer | vii | ||
| Outpatient Thyroidectomy: Is it Safe? | viii | ||
| Asymptomatic Primary Hyperparathyroidism: Diagnostic Pitfalls and Surgical Intervention | viii | ||
| Intraoperative Parathyroid Hormone Monitoring: Optimal Utilization | viii | ||
| Minimally Invasive Parathyroidectomy Versus Bilateral Neck Exploration for Primary Hyperparathyroidism | viii | ||
| Pheochromocytoma and Paraganglioma: Diagnosis, Genetics, and Treatment | ix | ||
| Minimally Invasive Adrenalectomy | ix | ||
| Surgical Management of Adrenocortical Carcinoma: An Evidence-Based Approach | ix | ||
| Biochemical Diagnosis and Preoperative Imaging of Gastroenteropancreatic Neuroendocrine Tumors | ix | ||
| Minimally Invasive Techniques for Resection of Pancreatic Neuroendocrine Tumors | x | ||
| Treatment of Neuroendocrine Liver Metastases | x | ||
| SURGICAL ONCOLOGY\rCLINICS OF NORTH AMERICA | xi | ||
| FORTHCOMING ISSUES | xi | ||
| April 2016 | xi | ||
| July 2016 | xi | ||
| October 2016 | xi | ||
| RECENT ISSUES | xi | ||
| October 2015 | xi | ||
| July 2015 | xi | ||
| April 2015 | xi | ||
| Foreword | xiii | ||
| Preface: Advances in Endocrine Surgery | xv | ||
| Management of Thyroid Nodular Disease | 1 | ||
| Key points | 1 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 1 | ||
| CYTOPATHOLOGIC CLASSIFICATION | 2 | ||
| Bethesda Classification System | 2 | ||
| Background | 2 | ||
| The classification system | 2 | ||
| Class I: nondiagnostic or unsatisfactory | 2 | ||
| Class II: benign | 2 | ||
| Class III: atypia of undetermined significance/follicular lesion of undetermined significance | 4 | ||
| Class IV: follicular neoplasm/suspicious for follicular neoplasm | 4 | ||
| Class V: suspicious for malignancy | 4 | ||
| Class VI: malignant | 4 | ||
| Accuracy and efficacy of the Bethesda system | 4 | ||
| MOLECULAR TESTS | 5 | ||
| Afirma | 5 | ||
| Test procedures | 5 | ||
| Validity of the Afirma test | 6 | ||
| GENETIC MUTATIONS | 7 | ||
| BRAFV600E | 7 | ||
| RAS | 9 | ||
| RET/PTC | 10 | ||
| PAX8/PPARγ | 11 | ||
| Other Mutations | 11 | ||
| Mutation Panels | 11 | ||
| Barriers to Regular Testing | 12 | ||
| SUMMARY | 13 | ||
| REFERENCES | 13 | ||
| Surgical Management of Lymph Node Compartments in Papillary Thyroid Cancer | 17 | ||
| Key points | 17 | ||
| INTRODUCTION | 17 | ||
| NOMENCLATURE: PROPHYLACTIC VERSUS THERAPEUTIC | 18 | ||
| EPIDEMIOLOGY OF CENTRAL NECK METASTASES | 18 | ||
| CONTROVERSY REGARDING PROPHYLACTIC CENTRAL NECK DISSECTION | 18 | ||
| PREOPERATIVE ASSESSMENT OF THE CERVICAL NODAL COMPARTMENTS | 19 | ||
| Imaging Studies | 20 | ||
| Image-Guided Needle Biopsy | 21 | ||
| Implications for Surgical Planning | 22 | ||
| INTRAOPERATIVE ASSESSMENT OF LYMPH NODE STATUS | 22 | ||
| Intraoperative Inspection, Palpation, and Frozen Section | 23 | ||
| Intraoperative Assessment of the Lateral Compartments | 23 | ||
| COMPARTMENTAL ANATOMY | 24 | ||
| Definition of the Central Neck Compartment | 24 | ||
| Definition of the Lateral Neck Compartments | 26 | ||
| TECHNIQUE OF CENTRAL NECK DISSECTION | 27 | ||
| Timing and Indications for Central Neck Dissection | 27 | ||
| Surgical Technique of Central Neck Dissection | 27 | ||
| Complications of Central Neck Dissection | 28 | ||
| TECHNIQUE OF LATERAL NECK DISSECTION | 29 | ||
| Timing and Indications for Lateral Neck Dissection | 29 | ||
| General Principles of Incision and Exposure | 29 | ||
| Level IV Dissection | 30 | ||
| Level V Dissection | 30 | ||
| Level III Dissection | 31 | ||
| Level II Dissection | 31 | ||
| Complications of Lateral Neck Dissection | 31 | ||
| IMPACT OF NODAL CLEARANCE ON RECURRENCE AND SURVIVAL | 32 | ||
| Impact of Nodal Basin Clearance on Recurrence and Survival | 32 | ||
| RECURRENT NODAL METASTASES | 33 | ||
| A Comparison of Surveillance Strategies Recommended by the American Thyroid Association and National Comprehensive Cancer N ... | 33 | ||
| Ultrasound and Serum Thyroglobulin Measurement Are Highly Accurate at Detecting Recurrence | 33 | ||
| Surveillance Frequently Reveals Recurrent or Persistent Disease | 34 | ||
| Recommendations for Surveillance of the Lateral Neck | 34 | ||
| Establishing the Diagnosis of Recurrent or Persistent Disease | 34 | ||
| Is Positive Imaging Alone Ever Sufficient? | 34 | ||
| The Treatment of Recurrent or Persistent Nodal Disease | 35 | ||
| SUMMARY | 35 | ||
| ACKNOWLEDGMENTS | 36 | ||
| REFERENCES | 36 | ||
| Current Guidelines for Postoperative Treatment and Follow-Up of Well-Differentiated Thyroid Cancer | 41 | ||
| Key points | 41 | ||
| ASSIGNMENT OF RISK | 42 | ||
| THE INCIDENTAL PAPILLARY THYROID MICROCARCINOMA | 44 | ||
| COMPLETION THYROIDECTOMY | 45 | ||
| RADIOACTIVE IODINE TREATMENT | 45 | ||
| Recombinant Human Thyrotropin Versus LT4 Withdrawal in an Iodine Deficient State | 48 | ||
| THYROID-STIMULATING HORMONE SUPPRESSION | 48 | ||
| POSTOPERATIVE ADJUNCTS FOR HIGH-RISK PATIENTS | 49 | ||
| SURVEILLANCE | 49 | ||
| TREATMENT OF RECURRENCE | 51 | ||
| RADIOACTIVE IODINE REFRACTORY DISEASE | 52 | ||
| SUMMARY | 52 | ||
| REFERENCES | 52 | ||
| Outpatient Thyroidectomy | 61 | ||
| Key points | 61 | ||
| BACKGROUND | 61 | ||
| DEFINITION OF OUTPATIENT THYROIDECTOMY | 62 | ||
| BENEFITS OF OUTPATIENT THYROIDECTOMY | 62 | ||
| Cost | 62 | ||
| Patient Satisfaction | 62 | ||
| Other Benefits | 63 | ||
| RISKS OF OUTPATIENT THYROIDECTOMY | 63 | ||
| Hematoma | 63 | ||
| Hypoparathyroidism | 68 | ||
| Recurrent Laryngeal Nerve Injury | 68 | ||
| APPROPRIATE PATIENT SELECTION FOR OUTPATIENT THYROIDECTOMY | 68 | ||
| TECHNIQUES TO IMPROVE SUCCESS OF OUTPATIENT THYROIDECTOMY | 71 | ||
| Anesthesia Techniques and Antinausea Medication | 71 | ||
| Postoperative instructions | 71 | ||
| Contacting Your Surgeon | 71 | ||
| Complications and symptoms you need to watch for | 71 | ||
| Bleeding in Your Neck | 71 | ||
| Low Calcium | 71 | ||
| Infection | 71 | ||
| Nerve Monitoring | 72 | ||
| Postoperative Parathyroid Hormone | 72 | ||
| SUMMARY | 73 | ||
| REFERENCES | 73 | ||
| Asymptomatic Primary Hyperparathyroidism | 77 | ||
| Key points | 77 | ||
| INTRODUCTION | 77 | ||
| BIOCHEMICAL DIAGNOSIS OF PRIMARY HYPERPARATHYROIDISM | 78 | ||
| Calcium | 78 | ||
| Parathyroid Hormone | 79 | ||
| Hypercalcemia with Inappropriately Normal Parathyroid Hormone: Nonclassic Primary Hyperparathyroidism | 79 | ||
| Vitamin D | 80 | ||
| Urinary Calcium Excretion | 80 | ||
| CONSIDERATIONS FOR DIFFERENTIAL DIAGNOSIS | 81 | ||
| Familial Hypocalciuric Hypercalcemia | 81 | ||
| Malignancy | 81 | ||
| Thiazides | 81 | ||
| Lithium | 81 | ||
| INDICATIONS, RISKS, AND BENEFITS OF PARATHYROIDECTOMY FOR PRIMARY HYPERPARATHYROIDISM | 82 | ||
| SURGICAL CRITERIA FOR ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM | 82 | ||
| Serum Calcium | 82 | ||
| Skeletal Criteria | 82 | ||
| Renal Criteria | 84 | ||
| Age | 85 | ||
| Atypical Symptoms | 85 | ||
| Cardiovascular | 85 | ||
| Neuropsychiatric and cognitive | 86 | ||
| SUMMARY | 86 | ||
| REFERENCES | 86 | ||
| Intraoperative Parathyroid Hormone Monitoring | 91 | ||
| Key points | 91 | ||
| INTRODUCTION | 91 | ||
| INTRAOPERATIVE PARATHYROID HORMONE: HISTORICAL PERSPECTIVE | 92 | ||
| OPERATIVE SUCCESS WITH INTRAOPERATIVE PARATHYROID HORMONE MONITORING | 92 | ||
| APPLICATION OF INTRAOPERATIVE PARATHYROID HORMONE MONITORING | 93 | ||
| INTRAOPERATIVE PARATHYROID HORMONE SAMPLING PROTOCOL | 93 | ||
| INTRAOPERATIVE PARATHYROID HORMONE CRITERIA FOR PREDICTING OPERATIVE SUCCESS | 94 | ||
| PREDICTING RECURRENCE WITH INTRAOPERATIVE PARATHYROID HORMONE | 95 | ||
| COST-EFFECTIVENESS OF INTRAOPERATIVE PARATHYROID HORMONE MONITORING | 96 | ||
| SUMMARY | 97 | ||
| REFERENCES | 97 | ||
| Minimally Invasive Parathyroidectomy Versus Bilateral Neck Exploration for Primary Hyperparathyroidism | 103 | ||
| Key points | 103 | ||
| INTRODUCTION | 103 | ||
| PATIENT EVALUATION | 104 | ||
| SURGICAL TREATMENT OPTIONS | 105 | ||
| Minimally Invasive Parathyroidectomy | 105 | ||
| Bilateral Neck Exploration | 107 | ||
| COMPARISON OF FOCUSED NECK EXPLORATION TO BILATERAL NECK EXPLORATION | 109 | ||
| Outcomes | 109 | ||
| Cost | 109 | ||
| Consensus Guidelines | 110 | ||
| Advantages and Disadvantages of Focused Neck Exploration Versus Bilateral Neck Exploration | 111 | ||
| SUMMARY | 111 | ||
| REFERENCES | 112 | ||
| Pheochromocytoma and Paraganglioma | 119 | ||
| Key points | 119 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 119 | ||
| EPIDEMIOLOGY | 120 | ||
| PATHOPHYSIOLOGY | 120 | ||
| CLINICAL PRESENTATION AND DIAGNOSIS | 121 | ||
| Clinical Presentation | 121 | ||
| Biochemical Evaluation | 121 | ||
| Imaging | 123 | ||
| Computed tomography | 123 | ||
| MRI | 123 | ||
| Functional imaging | 124 | ||
| Metaiodobenzylguanidine with single-photon emission computed tomography | 124 | ||
| Octreotide scan | 125 | ||
| PET/computed tomography scan | 125 | ||
| Genetic Testing | 125 | ||
| PREOPERATIVE MANAGEMENT | 128 | ||
| Nonselective Alpha-Blocking Agent | 129 | ||
| Selective Alpha-Blocking Agents | 129 | ||
| Beta-Blockers | 130 | ||
| Calcium Channel Blockers | 130 | ||
| Metyrosine | 130 | ||
| Fluid Management | 130 | ||
| SURGICAL TREATMENT OF THE PRIMARY TUMOR | 131 | ||
| POSTOPERATIVE MANAGEMENT, OUTCOMES, AND FOLLOW-UP | 132 | ||
| SUMMARY | 133 | ||
| REFERENCES | 133 | ||
| Minimally Invasive Adrenalectomy | 139 | ||
| Key points | 139 | ||
| INTRODUCTION | 139 | ||
| PATIENT EVALUATION AND INDICATIONS FOR ADRENALECTOMY | 140 | ||
| Imaging of Adrenal Masses | 140 | ||
| Biochemical Evaluation of Adrenal Tumors | 141 | ||
| METASTASES TO THE ADRENAL GLAND | 141 | ||
| PREOPERATIVE PREPARATION | 143 | ||
| APPROACHES TO SURGERY: LAPAROSCOPIC TRANSABDOMINAL VERSUS POSTERIOR RETROPERITONEOSCOPIC ADRENALECTOMY | 143 | ||
| SURGICAL TECHNIQUE: LAPAROSCOPIC TRANSABDOMINAL ADRENALECTOMY | 144 | ||
| Patient Positioning | 144 | ||
| Right Laparoscopic Transabdominal Adrenalectomy | 144 | ||
| Left Laparoscopic Transabdominal Adrenalectomy | 145 | ||
| SURGICAL TECHNIQUE: POSTERIOR RETROPERITONEOSCOPIC ADRENALECTOMY | 146 | ||
| OTHER APPROACHES TO ADRENALECTOMY | 148 | ||
| INDICATIONS FOR OPEN SURGERY | 148 | ||
| SUMMARY | 149 | ||
| REFERENCES | 149 | ||
| Surgical Management of Adrenocortical Carcinoma | 153 | ||
| Key points | 153 | ||
| INTRODUCTION | 153 | ||
| WHAT IS THE APPROPRIATE DIAGNOSTIC AND IMAGING WORKUP FOR PATIENTS WITH SUSPECTED ADRENOCORTICAL CARCINOMA? | 154 | ||
| WHAT ARE THE PATHOLOGIC DETERMINANTS OF MALIGNANCY? WHAT FACTORS ARE PROGNOSTIC IN RESECTED ADRENOCORTICAL CARCINOMA? | 155 | ||
| WHAT ARE THE PRINCIPLES OF SURGICAL AND PERIOPERATIVE MANAGEMENT FOR PRIMARY TUMORS? HOW SHOULD PATIENTS WHO HAVE UNDERGONE ... | 157 | ||
| IS THERE BENEFIT TO ROUTINE EN BLOC RESECTION OF ADJACENT ORGANS OR AGGRESSIVE REGIONAL LYMPHADENECTOMY? | 159 | ||
| IS THERE EVIDENCE TO SUPPORT MINIMALLY INVASIVE RESECTION FOR KNOWN OR SUSPECTED MALIGNANCY? | 160 | ||
| IS THERE A ROLE FOR AN AGGRESSIVE SURGICAL APPROACH IN LOCALLY RECURRENT OR METASTATIC DISEASE? | 161 | ||
| WHAT ARE THE CURRENT AND EMERGING OPTIONS FOR MULTIMODALITY MANAGEMENT OF ADRENOCORTICAL CARCINOMA? | 163 | ||
| PROPOSED APPROACH TO THE MULTIMODAL MANAGEMENT OF LOCALIZED ADRENOCORTICAL CARCINOMA | 164 | ||
| SUMMARY | 165 | ||
| REFERENCES | 165 | ||
| Biochemical Diagnosis and Preoperative Imaging of Gastroenteropancreatic Neuroendocrine Tumors | 171 | ||
| Key points | 171 | ||
| INTRODUCTION | 171 | ||
| BIOCHEMICAL MARKERS FOR GASTROENTEROPANCREATIC NEUROENDOCRINE TUMORS | 172 | ||
| Gastrointestinal Neuroendocrine Tumors | 172 | ||
| LABORATORY TESTS AND BIOMARKERS FOR GASTROINTESTINAL NEUROENDOCRINE TUMORS | 174 | ||
| CURRENT RECOMMENDATIONS FOR BIOCHEMICAL TESTING IN GASTROINTESTINAL NEUROENDOCRINE TUMORS | 175 | ||
| Pancreatic Neuroendocrine Tumors | 176 | ||
| Gastrinomas | 176 | ||
| Insulinoma | 177 | ||
| VIPomas | 177 | ||
| Glucagonoma | 178 | ||
| Somatostatinoma | 178 | ||
| Pancreatic polypeptide-secreting tumors and nonfunctional tumors | 179 | ||
| CURRENT RECOMMENDATIONS FOR BIOCHEMICAL TESTING IN PANCREATIC NEUROENDOCRINE TUMORS | 179 | ||
| BIOMOLECULAR DIAGNOSTICS IN NEUROENDOCRINE TUMORS | 179 | ||
| WREN Assay | 179 | ||
| Biotheranostics Test | 180 | ||
| Gene Expression Classifiers and Immunohistochemistry to Differentiate Small Bowel Neuroendocrine Tumors from Pancreatic Neu ... | 180 | ||
| IMAGING TESTS FOR DIAGNOSIS AND STAGING OF GASTROENTERICPANCREATIC NEUROENDOCRINE TUMORS | 181 | ||
| Computed Tomography | 181 | ||
| MRI | 181 | ||
| Ultrasound | 183 | ||
| Endoscopy | 183 | ||
| 18-Fluorodeoxyglucose PET | 183 | ||
| Somatostatin Receptor Imaging | 184 | ||
| OctreoScan | 184 | ||
| 68Ga-PET | 185 | ||
| SUMMARY | 187 | ||
| REFERENCES | 187 | ||
| Minimally Invasive Techniques for Resection of Pancreatic Neuroendocrine Tumors | 195 | ||
| Key points | 195 | ||
| INTRODUCTION | 195 | ||
| DIAGNOSIS | 196 | ||
| Insulinoma | 196 | ||
| Gastrinoma | 196 | ||
| Glucagonoma | 197 | ||
| Vasoactive Intestinal Peptideoma | 197 | ||
| Somatostatinoma | 197 | ||
| PREOPERATIVE EVALUATION | 198 | ||
| Localization | 198 | ||
| Patient Selection and Choice of Procedure | 200 | ||
| SURGICAL TECHNIQUE | 201 | ||
| Enucleation (Head) | 201 | ||
| Enucleation (Body and Tail) | 201 | ||
| Laparoscopic Distal Pancreatectomy (Spleen-preserving with Splenic Vessel Preservation) | 202 | ||
| Laparoscopic Distal Pancreatectomy (Spleen-preserving Distal Pancreatectomy Without Splenic Vessel Preservation) | 203 | ||
| Laparoscopic Distal Pancreatectomy with Splenectomy | 203 | ||
| Laparoscopic Central Pancreatectomy | 203 | ||
| Laparoscopic Pancreaticoduodenectomy | 203 | ||
| Robotic Surgery | 204 | ||
| Radiofrequency Ablation for Pancreatic Neuroendocrine Tumors | 204 | ||
| Endoscopic Ultrasonography-directed Alcohol Ablation | 205 | ||
| OUTCOMES | 205 | ||
| Laparoscopic Pancreatic Resections | 205 | ||
| Robotic Pancreaticoduodenectomy | 207 | ||
| Robotic Distal Pancreatectomies | 208 | ||
| Robotic Central Pancreatectomies | 209 | ||
| Overall Prognosis | 210 | ||
| SUMMARY | 210 | ||
| REFERENCES | 210 | ||
| Treatment of Neuroendocrine Liver Metastases | 217 | ||
| Key points | 217 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 217 | ||
| TREATMENT OPTIONS: LIVER RESECTION AND DEBULKING | 217 | ||
| LIVER RESECTION AND DEBULKING: REVIEW OF THE LITERATURE | 218 | ||
| TREATMENT OPTIONS: RADIOFREQUENCY ABLATION | 221 | ||
| SURGICAL TECHNIQUE | 221 | ||
| TREATMENT OPTIONS: INTRA-ARTERIAL THERAPIES | 222 | ||
| SUMMARY | 223 | ||
| REFERENCES | 224 |