Waltraud Eichhorn

Publications (3)9.76 Total impact

• Source

  Available from: knowledgetranslation.ca

  Article: Detection of papillary thyroid carcinoma by analysis of BRAF and RET/PTC1 mutations in fine-needle aspiration biopsies of thyroid nodules.

  Thomas J Musholt, Christian Fottner, Matthias M Weber, Waltraud Eichhorn, Joachim Pohlenz, Petra B Musholt, Erik Springer, Arno Schad
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  ABSTRACT: Activating mutations of the oncogene BRAF or rearrangements of the tyrosine kinase receptor RET are observed in up to 80% of papillary thyroid carcinomas (PTCs). The predominant BRAF V600E mutation has not been detected in benign thyroid tissue so far, so consequently, this assumedly pathognomonic alteration is qualified to improve the preoperative diagnosis of PTC. Two hundred ninety preoperatively harvested fine-needle aspiration biopsies (FNABs) underwent routine cytologic assessment. BRAF V600E mutation analysis was performed by mutation-specific PCR using the same cell material; a hybrid-specific RT-PCR assay was used for detection of RET/PTC1 rearrangements. Detected genetic alterations were verified by direct sequencing. Definitive histopathology was obtained in 93/290 lesions following surgery of the respective thyroid nodule. While cytology alone diagnosed 13/30 malignancies (22 PTCs, 4 FTCs, 1 MTC, 1 UTC, 2 metastases), five additional malignancies were identified by supplementary mutation analysis. Cytology classified eight FNABs as benign, while postoperative histology demonstrated a thyroid malignancy (6 PTCs, 1 FTC, 1 metastasis). In four of these eight cases, the genetic analysis detected a BRAF V600E mutation or a RET/PTC1 rearrangement. Classifying both suspicious and malignant FNAB results as positive cytology results, supplementary genetic testing increased the overall sensitivity of FNAB from 70.4 to 85.7%, the positive predictive value (PPV) from 59.4 to 64.9%, and the negative predictive value (NPV) from 84.0 to 91.3%. Supplementary mutation analysis of RET and especially of the BRAF V600E mutation in FNABs is a fast and probably cost-effective assay in routine diagnostic setting. Mutation analyses of PTC-specific genetic alterations improve the preoperative identification and prognostic assessment of thyroid malignancies and therefore enable an optimized surgical strategy.
  World Journal of Surgery 11/2010; 34(11):2595-603. · 2.36 Impact Factor
• Article: Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma.

  Thomas Borschitz, Waltraud Eichhorn, Christian Fottner, Torsten Hansen, Arno Schad, Simin Schadmand-Fischer, Matthias M Weber, Mathias Schreckenberger, Hauke Lang, Thomas J Musholt
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  ABSTRACT: Apart from regional lymph node metastases, systemic metastases occur sporadically in papillary thyroid carcinomas (PTC). The lung and bones are the most frequent localizations. Additionally known but extremely rare locations are metastases of the skeletal muscles, ovaries, submandibular gland, sphenoidal sinus, brain, adrenals, and, as shown in only two previously published cases to date, the pancreas. In this article we report about two additional patients with pancreatic metastases from PTC. There is almost no prior experience about therapeutic approaches to this type of metastases. In both patients distant metastases within the pancreas were successfully removed. Postoperative histology confirmed the diagnoses. Supplemental genetic analysis did not demonstrate a BRAF V600E mutation or expression of a RET/PTC1 rearrangement in one case, but revealed a BRAF V600E mutation in the second case. Surgery avoided impending complications maintaining quality of life. One patient had a tumor-specific survival of 42 months. The other patient has occult disease. Our two patients benefited of a calculated aggressive surgical action. Thus, if low perioperative mortality and morbidity can be warranted, surgical measures are justifiable in selected cases.
  Thyroid: official journal of the American Thyroid Association 12/2009; 20(1):93-8. · 2.60 Impact Factor
• Article: Prognostic factors determining long-term survival in well-differentiated thyroid cancer: an analysis of four hundred eighty-four patients undergoing therapy and aftercare at the same institution.

  Waltraud Eichhorn, Harry Tabler, Rainer Lippold, Matthias Lochmann, Mathias Schreckenberger, Peter Bartenstein
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  ABSTRACT: Identification of the prognostic factors relevant for long-term survival in differentiated thyroid cancer in a homogenously treated patient cohort in order to allow a better initial risk stratification. Four hundred eighty-four (358 females/126 males) patients with differentiated thyroid cancer (330 papillary [68.2%]; 154 follicular [31.8%]) were included. Inclusion criteria consisted of treatment with a uniform therapy scheme and continuous aftercare in the same institution. Initial diagnosis was between 1975-1995 (age at diagnosis, 14-84 years, median, 49.7). Tumor stage: pT1, n = 92; pT2, 211; pT3, 58; pT4, 123. Low-risk: <or=pT3 NX M0, 331; high-risk pT4 and/or M1, 153. After thyroidectomy all patients had at least two (131)I therapies (4-month interval; first, 2-4 GBq; second, 3.7-8 GBq). The median follow-up was 7.6 years (range, 0.2-23.9). The role of eight variables as prognostic factors was tested by regression analysis. The corrected cause-specific 5-, 10-, and 20-year survival rates in the whole cohort were 0.95, 0.90, 0.83, respectively; for the low risk-category of papillary cancer, 0.99, 0.97, 0.89; for follicular cancer, 0.98, 0.89, 0.89 (difference papillary/follicular p = 0.0004). The cause-specific survival rates in the high-risk category of papillary cancer were 0.89, 0.85, and 0.85; for follicular cancer, 0.88, 0.73 and 0.52 (p = 0.0016). Variables with significant negative influence on survival were distant metastases, persisting elevated human thyroglobulin levels after one (131)I therapy, age greater than 45 and gender in follicular cancer. Locoregional external radiotherapy did not improve survival but was associated with comorbidity. The aggressiveness of the initial operative resection was also not a prognostic factor for survival. pT4 NX M0 patients of our patient cohort did not exert significant differences in long-term survival compared to pT13 NX M0. This was also true for patients older than 45 years, where the 5- and 10-year survival rates for pT4 NX M0 were 0.93 and 0.90. Our therapy and aftercare strategy results in a high long-term survival rate especially for high-risk patients. In our patient sample radical initial lymph node resection did not extend long-term survival.
  Thyroid 10/2003; 13(10):949-58. · 4.79 Impact Factor