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F H Straus

Publications and source records attributed to F H Straus.

69 records · Page 4Linked to original sources
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Does the method of management of papillary thyroid carcinoma make a difference in outcome?

We have analyzed data on a group of 269 patients with papillary thyroid carcinoma followed on average for 12 years to determine (1) if a prognostic classification scheme can be used to predict an appropriate surgical approach; (2) the effect of treatment on prognosis; and (3) if patients with a "excellent" prognosis benefit from more extensive surgical resection and 131I ablation. Prognostic classification schemes developed by the American Joint Commission, Cady et al., Hay et al., the European Thyroid Association, and our own clinical class scheme each appropriately divided patients into risk category groups. With each system, some patients classified in the low risk group eventually died of the tumor. Considering the excellent but not perfect precision of the prognostic schemes, the need for detailed pathologic analysis, and ideally postoperative thyroid scanning, we conclude that the prognostic classification schemes do not allow the decision at the operating table regarding the appropriate extent of surgery. Patients followed at our institution, operated on by one of three experienced surgeons, and usually given 131I ablation were compared to other patients in the follow-up group operated on by other surgeons and not routinely ablated. There were significantly fewer deaths and recurrences among the patients managed by our method. However, when the groups were restricted to those considering only patients who had more extensive surgery, postoperative 131I ablation, or both, the differences between the groups became insignificant. This finding indicates that the difference in prognosis, comparing patients treated at our institution and those initially treated elsewhere, was primarily due to the routine use of more extensive surgery and postoperative radioactive iodide ablation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

The value of measurement of ras oncogenes and nuclear DNA analysis in the diagnosis of Hürthle cell tumors of the thyroid.

Hürthle cell tumors (HCT) remain difficult to treat because some which appear non-malignant on light microscopy later metastasize. In order to improve diagnostic accuracy, the value of ras mutations and nuclear DNA analysis was determined in 65 patients with HCT. Rapid nuclear DNA cytometry (MicroTICAS system) was performed. Mutations of H-ras, K-ras, and N-ras genes were analyzed by oligonucleotide probe hybridizations to polymerase chain reaction (PCR) amplified DNA. HCT were classified by light microscopy as benign (n = 22), intermediate (n = 30), and malignant (n = 13). After a mean follow-up of 7 years, 1 (4.5%) of 22 benign tumors and 4 (13%) of 30 intermediate tumors had metastasized, leading to tumor death in 3 of these 5 patients. Six of the 13 cancers diagnosed by light microscopy also resulted in tumor-related deaths. Aneuploidy was found in 83% of all Hürthle cell cancers, including 3 (60%) of the 5 cancers not diagnosed microscopically. However, 49% of non-malignant HCT also demonstrated aneuploidy. A nuclear area of less than 55 square microns was found in 83% of all Hürthle cell cancers and in 100% of those cancers not diagnosed by light microscopy. However, 47% of non-malignant HCT also demonstrated a "small" nuclear area. Aneuploidy correctly identified 8 of 9 cancers that resulted in tumor death and each of 3 other tumors that developed metastases. However, 1 patient with a diploid tumor died of metastatic cancer. A nuclear area of less than 55 square microns identified each cancer that resulted in a tumor death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗