Background: Postoperative hypoparathyroidism (hypoPT) is a common complication following thyroid surgery. However, current research findings on the risk factors for post-thyroid surgery hypoPT are not entirely consistent, and the same risk factors may have different impacts on transient and permanent hypoPT. Therefore, there is a need for a comprehensive study to summarize and explore the risk factors for both transient and permanent hypoPT after thyroid surgery. Materials and methods: Two databases (PubMed and Embase) were searched from inception to 2024. The Newcastle–Ottawa Scale was used to rate study quality. Pooled odds ratios were used to calculate the relationship of each risk factor with transient and permanent hypoPT. Subgroup analyses were conducted for hypoPT with different definition-time (6 or 12 months). Publication bias was assessed using Begg’s test and Egger’s test. Results: A total of 19 risk factors from the 93 studies were included in the analysis. Among them, sex and parathyroid autotransplantation were the most frequently reported risk factors. Meta-analysis demonstrated that sex (female vs. male), cN stage, central neck dissection, lateral neck dissection, extent of central neck dissection (bilateral vs. unilateral), surgery [total thyroidectomy (TT) vs. lobectomy], surgery type (TT vs. sub-TT), incidental parathyroidectomy, and pathology (cancer vs. benign) were significantly associated with transient and permanent hypoPT. Preoperative calcium and parathyroid autotransplantation were only identified as risk factors for transient hypoPT, while preoperative PTH was a protective factor. Additionally, node metastasis and parathyroid in specimen were associated with permanent hypoPT. Conclusion: The highest risk of hypoPT occurs in female thyroid cancer patients with lymph node metastasis undergoing TT combined with neck dissection. The key to preventing postoperative hypoPT lies in the selection of surgical approach and intraoperative protection.
15 February 2024 in Cancer Immunology, Immunotherapy
Background: Hypopharyngeal and laryngeal squamous cell carcinoma (SCC) account for 25–30% of head and neck SCC. Total laryngectomy, while effective, compromises the quality of life. Immune checkpoint inhibitors such as Camrelizumab offer potential in laryngeal preservation. The study investigated Camrelizumab combined with TP regimen as a neoadjuvant therapy for laryngeal preservation in advanced hypopharyngeal and laryngeal SCC. Methods: A retrospective study was conducted at Sun Yat-sen University Cancer Center on patients diagnosed with locally advanced SCC of the hypopharynx and larynx from October 1, 2019, to October 25, 2022. The efficacy of a first-line treatment combining Camrelizumab (200 mg) and TP regimen (Albumin-bound paclitaxel at 260 mg/m2 and Cisplatin at 60 mg/m2) was evaluated using RECIST 1.1 criteria. Outcomes included overall survival (OS), progression-free survival (PFS), laryngectomy-free survival (LFS), and response rates. Results: Of the 71 included patients, the median age was 60.7 years. Post the first-line treatment, 90.1% demonstrated an overall response. The one-year and two-year OS rates were 91.5% and 84.3%, respectively. One-year and two-year PFS rates were 92.9% and 83.9%, respectively, with LFS at 85.6% and 73.2%. The initial T4 stage as significantly associated with reduced OS and LFS. Skin reaction was the predominant adverse event. Conclusion: The Camrelizumab-TP regimen demonstrated promising results for advanced hypopharyngeal/laryngeal SCC patients, exhibiting high response rates, OS, and LFS, positioning it as a potential primary option for laryngeal preservation. Further comprehensive, randomized controlled studies are imperative to validate these initial observations and elucidate the regimen's full clinical efficacy in optimizing laryngeal outcomes.
3 January 2026 in Cancer Immunology, Immunotherapy
Background Locally advanced head and neck squamous cell carcinoma (LA HNSCC) remains a disease with a challenging prognosis. Concurrent chemoradiotherapy has long been the standard of care, yet efforts to enhance outcomes through the addition of induction or adjuvant therapies have largely failed. Recently, immune checkpoint inhibitors, particularly PD-1 inhibitors, have demonstrated efficacy in managing HNSCC, becoming a first-line treatment for recurrent/metastatic cases. This study aims to evaluate whether adding PD-1 inhibitors to induction chemotherapy can improve long-term outcomes in newly diagnosed LA HNSCC patients. Patients and methods This retrospective analysis included 204 newly diagnosed LA HNSCC patients treated between February 2012 and February 2023. Patients were divided into two cohorts: TPI group (n=115), who received induction chemotherapy including PD-1 inhibitors, and TP group (n=89), who received induction chemotherapy alone. The primary outcome was overall survival (OS), while secondary outcomes included progression-free survival (PFS) and objective response rate (ORR). Baseline characteristics were balanced using overlap propensity score weighting. Survival analyses were conducted using the Kaplan-Meier method, and subgroup analyses employed Cox proportional hazards models. Results With a median follow-up of 29.23 months, baseline characteristics were balanced after weighting. The addition of PD-1 inhibitors significantly improved OS (HR: 0.11, 95% CI: 0.03–0.37, p<0.001) and PFS (HR: 0.43, 95% CI: 0.20–0.89, p=0.024). Furthermore, the TPI group showed a significant improvement in the best radiological responses (p=0.02). Subgroup analyses identified specific factors associated with enhanced PFS and OS. Conclusions The addition of PD-1 inhibitors to induction chemotherapy significantly improves overall survival in patients with LA HNSCC, underscoring the potential for further clinical trials to refine and optimize treatment strategies.
Although lacking high-quality clinical evidence, the use of thermal ablation for papillary thyroid carcinoma (PTC) is increasing. Emerging evidence suggest