Browsing by Author "Baudrand R."

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    An ultrasound score to predict the presence of papillary thyroid carcinoma. Preliminary report
    (2009) Domínguez J.M.; Baudrand R.; Arteaga E.; Campusano C.; González G.; Mosso L.; Fardella C.; Domínguez J.M.; Baudrand R.; Arteaga E.; Campusano C.; González G.; Mosso L.; Arias T.; Pizarro A.; Gómez M.; Fardella C.; Cruz F.; Torres J.; Solar A.; Cavada G.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: Thyroid nodules are common and associated to a low risk of malignancy. Their clinical assessment usually includes a fine neddle aspiration biopsy (FNAB). Aim: To identify ultrasonographic characteristics associated to papillary thyroid carcinoma (PTC) and generate a score that predicts the risk of PTC. Material and methods: Retrospective review of all fine needle aspiration biopsies of the thyroid performed in a lapse of two years. Biopsies that were conclusive for PTC were selected and compared with an equal amount of randomly selected biopsies that disclosed a benign diagnosis. Results: One hundred twenty two biopsies of a total of 1,498 were conclusive for PTC. Univariate analysis showed associations with PTC for the presence of micro-calcifications (Odds ratio (OR) 49.2: 95% confidence intervals (CI) 18.7-140.9), solid predominance (OR 25.1; 95% CI 6-220), hypoechogenicity (OR 23.5, 95% CI 6.5-122.6), irregular borders (OR 17, 95% CI 7.2-42.9), lymph node involvement (OR 12.3, 95% CI 2.7-112), central vascularization (OR 12.2, 95% CI 4.8-33.3), local invasion and hyperechogenicity (OR 0.2; CI 95% CI 0.03-0.6). Multivariate analysis disclosed microcalcifications (OR 28.1; CI 95% 8.9-89), hypoechogenicity (OR 9.4; 95% CI 1.5-59.5) and irregular borders (OR 4.7; CI 95% 1.5-15) as the variables independently associated with the presence of PTC. The prevalence of PTC in the presence of the three variables was 97.6% (Likelihood ratio (LR) 45) and 5.4% in their absence (LR 0.06). Conclusions: This scale predicts the presence or absence of PTC using simple ultrasound characteristics.
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    Lobectomy in patients with differentiated thyroid cancer: experience of a Chilean tertiary center
    (2024) Fuentes I.; Santana R.; Espinoza M.; Arteaga E.; Uslar T.; Baudrand R.; Gonzalez G.; Guarda F.J.; Lustig N.; Mosso L.; Nilo F.; Valenzuela F.; Dominguez F.; Gonzalez H.E.; Montero P.H.; Cruz F.; Solar A.; Dominguez J.M.; NCD Risk Factor Collaboration (NCD-RisC)
    © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.Purpose: Thyroid lobectomy (TL) is an appropriate treatment for up to 4 cm intrathyroidal differentiated thyroid cancer (DTC). There is scarce data regarding TL outside first-world centers. Our aim is to report a cohort of patients with DTC treated with TL in Chile. Methods: We included DTC patients treated with TL, followed for at least 6 months, characterized their clinicopathological features and classified their risk of recurrence and response to treatment. Results: Eighty-two patients followed for a median of 2.3 years (0.5–7.0). Seventy-three (89%) patients had papillary, 8 (9.8%) follicular and 1 (1.2%) high-grade DTC. The risk of recurrence was low in 56 (68.3%) and intermediate in 26 (31.7%). Eight (9.8%) patients required early completion thyroidectomy and radioiodine. At last follow-up, 52 (70.3%) had excellent, 19 (25.7%) had indeterminate, and 1 (1.4%) had structural incomplete response. Conclusion: In a developing country, TL is an adequate option for appropriately selected DTC patients.
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    ThyroidPrint®: clinical utility for indeterminate thyroid cytology
    (2023) Olmos R.; Dominguez J.M.; Vargas-Salas S.; Mosso L.; Fardella C.E.; Gonzalez G.; Baudrand R.; Guarda F.; Valenzuela F.; Arteaga E.; Forenzano P.; Nilo F.; Lustig N.; Martinez A.; Lopez J.M.; Cruz F.; Loyola S.; Leon A.; Droppelmann N.; Montero P.; Dominguez F.; Camus M.; Solar A.; Zoroquiain P.; Roa J.C.; Munoz E.; Bruce E.; Gajardo R.; Miranda G.; Riquelme F.; Mena N.; Gonzalez H.E.; NCD Risk Factor Collaboration (NCD-RisC)
    Molecular testing contributes to improving the diagnosis of indeterminate thyroid nodules (ITNs). ThyroidPrint® is a ten-gene classifier aimed to rule out malignancy in ITN. Post-validation studies are necessary to determine the real-world clinical benefit of ThyroidPrint® in patients with ITN. A single-center, prospective, noninterventional clinical utility study was performed, analyzing the impact of ThyroidPrint® in the physicians' clinical decisions for ITN. Demographics, nodule characteristics, benign call rates (BCRs), and surgical outcomes were measured. Histopathological data were collected from surgical biopsies of resected nodules. Of 1272 fine-needle aspirations, 109 (8.6%) were Bethesda III and 135 (10.6%) were Bethesda IV. Molecular testing was performed in 155 of 244 ITN (63.5%), of which 104 were classified as benign (BCR of 67.1%). After a median follow-up of 15 months, 103 of 104 (99.0%) patients with a benign ThyroidPrint® remained under surveillance and one patient underwent surgery which was a follicular adenoma. Surgery was performed in all 51 patients with a suspicious for malignancy as per ThyroidPrint® result and in 56 patients who did not undergo testing, with a rate of malignancy of 70.6% and 32.1%, respectively. A higher BCR was observed in follicular lesion of undetermined significance (87%) compared to atypia of undetermined significance (58%) (P < 0.05). False-positive cases included four benign follicular nodules and six follicular and four oncocytic adenomas. Our results show that, physicians chose active surveillance instead of diagnostic surgery in all patients with a benign ThyroidPrint® result, reducing the need for diagnostic surgery in 67% of patients with preoperative diagnosis of ITN.