- Email: [email protected]
27. Outcomes of surgery for primary Hyperaldosteronism
ABSTRACTS and it is not known whether the association is causal or co-incidental. It has been hypothesized that chronic Vitamin D deficiency may lead to four gland hyperplasia termed “quaternary” hyperparathyroidism. The aim of this study was to determine the relationship between vitamin D deficiency and multi gland disease (MGD) in patients from areas of high and low sunlight exposure. Methods: This retrospective study included patients who underwent parathyroidectomy for PHPT from 4 centres - 3 UK latitude 53e540N and 1 NZ latitude 360S. Data collected included symptoms, complications, serum calcium, parathyroid hormone and 25(OH)VitD level, surgical approach, number of glands removed, surgical outcome and histopathology. 25(OH)VitD was defined as normal >75nmol/L and low <75nmol/L. Results: 332 UK and 63 NZ patients were included in the analysis. There was a non-significantly higher incidence of MGD in the UK 63/ 232 (27.2%) compared to NZ 12/63 (19.0%) (p ¼ 0.124,Chi-squared test). 25(OH)VitD was significantly lower 28nmol/L vs 42nmol/L (p ¼ 0.01, Mann-Whitney U test) in the UK compared to NZ. There was no significant seasonal variation in 25(OH)VitD found. Thirty-one percent of patients with low 25(OH)VitD level had MGD as compared to 22.6% in those with normal 25(OH)VitD level (p ¼ 0.077, Chi-square test). Multiple logistic regression did not identify any factors that predicted MGD. Conclusion: The observation that the incidence of MGD is higher albeit statistically non-significant e (1) in patients from the UK and (2) in lower 25(OH)VitD levels suggests a possible causal association between vitamin D deficiency and MGD in PHPT. These results maybe partly explained by differences in referral practices in the UK and NZ. The limited sample size may have reduced our ability to detect a significant association between 25(OH)vitD and multi gland disease (type 2 error). http://dx.doi.org/10.1016/j.ejso.2015.08.101
26. A novel modulator of cellular invasion and metastasis N. Sharma, W. Imruetaicharoenchoke*, R.J. Watkins*, E. Gentillin, E. Bosseboeuf, P.K.K. Kwan, R. Fletcher, H. Mehanna, K. Boelaert, M.L. Read, J.C. Watkinson, V.E. Smith, C.J. McCabe School of Clinical and Experimental Medicine, University of Birmingham, UK Introduction: Metastasis is a vital process responsible for the majority of endocrine cancer deaths. Central to the ability of cells to move is the recruitment of actin fibres at the periphery of the cell by the cortical actin binding protein cortactin. A precise understanding of all of cortactin’s mechanisms is required to address metastatic cell activity. Materials and Methods: We used IP-MS to discover protein binding partners. We determined the interaction and co-localisation between cortactin and PBF through co-immunoprecipitation (Co-IP), immunofluorescence and Proximity Ligation Assays. Boyden chamber assays were used to quantify cell invasion. Western blotting and real-time PCR were used to study the levels of gene expression in papillary thyroid cancers (PTC). Results: We identify the proto-oncogene PBF as a new functional binding partner of cortactin, PBF has recently been correlated with thyroid and breast cancer metastasis. Cortactin and PBF co-localised and bound preferentially at the leading edge of migrating cells. Oncogenic expression of PBF induced potent cell invasion and migration in thyroid (p ¼ 0.01) and breast (p < 0.001) cancer cells, which was entirely abrogated by cortactin knockdown. In N ¼ 43 matched PTC, cortactin was significantly upregulated at the mRNA (p ¼ 0.022) and protein (p ¼ 0.045) levels, particularly in more aggressive tumours, and significantly correlated with PBF expression. We also demonstrate the interaction between PBF and cortactin through co-IP and reveal that artificially targeting PBF to the plasma membrane results in increased cortactin binding, blocking cellular invasion. Conclusion: Taken together, we identify a new modulator of cortactin function, and show for the first time that cortactin is over-expressed in )
Both authors contributed equally.
S87 thyroid cancer. Modulation of PBF subcellular localisation may present a novel mechanism of addressing tumour cell invasion and migration. http://dx.doi.org/10.1016/j.ejso.2015.08.077
27. Outcomes of surgery for primary Hyperaldosteronism Tarek Ezzat Abdel-Aziz, Dahlia Murad, Tom Kurzawinski Centre for Endocrine surgery, University College London Hospital, UK Introduction: Primary Hyperaldosteronism (PA) is one of the most common causes of secondary hypertension (HT). It accounts for 5e18% of hypertensive adults. The primary end-point of this study was to evaluate the effect of surgery on blood pressure (BP) control. Methods: Data on patients with a diagnosis of benign PA who were surgically treated in a tertiary referral centre was retrieved from case notes and computer records Results: Between 2000e2014, 56 patients (F ¼ 24, M ¼ 32), with a diagnosis of PA were operated. Patients were divided into three groups preoperatively based on potassium (K+) levels (HTN with normal K+ ¼ 15, HTN with low K+ ¼ 40, p < 0.001), one patient presented with low K+ and no HT. All patients had cross-sectional imaging (CT ¼ 32, CT+MRI ¼ 12, and MRI ¼ 7). Adrenal venous sampling was performed in 18(32%) patients to assist in localization. Left adenoma was detected in 28(50%), right in 27(48%) and bilateral 1(2%). Laparoscopic adrenalectomy was performed in 55(98%) patients with no conversions. One patient had an open adrenalectomy. Length of hospital stay was 3(1e12) days. Final histology report showed (cortical nodular hyperplasia ¼ 9, solitary adenoma ¼ 47). Median size of the adenoma was 1.5(04e3.5) cm. Postoperative potassium levels normalised in all patients (4.5 0.5 mmol/L vs. 2.75 0.37 mmol/, postoperative vs. preoperative, respectively,p < 0.001). Regarding BP control, 18(32%) stopped all medications, 21(38%) were maintained on 1 medication, 8(14%) on 2 and, 4(7%) on 3. 5(9%) of patients had no drop in medications. One patient was had recurrent disease due to bilateral adrenal hyperplasia. Only three patients had complications; two patients had chest infections treated with antibiotics and one patient had low postoperative cortisol. Conclusion: Laparoscopic adrenalectomy is a safe and effective operation for treatment of PA. The majority of patients have significantly reduced the number or the dosage of the BP medications achieving a better control of their blood pressure. http://dx.doi.org/10.1016/j.ejso.2015.08.103
28. Does variation in central neck dissection and radioactive iodine performance influence the outcome of papillary carcinoma? Comparison of two European experienced centres. Leyre Lorente-Poch1,2, Mahmud Saedon1, Ioannis Christakis1, German Mateu2, Tarek Ezzat Abdel-Aziz1, Joan Sancho2, Tom Kurzawinski1, Antonio Sitges-Serra2 1 University College London Hospital NHS Foundation Trust, London, UK 2 Hospital del Mar, Universitat Autonoma de Barcelona, Barcelona, Spain Introduction: The role of central lymphadenectomy and use of radioactive iodine in patients with papillary carcinoma confined to thyroid without evidence of lymphnode metastasis is uncertain. We aimed to evaluate whether the variation of surgical practice and post-operative radioiodine ablation influence the outcome of papillary carcinoma between 2 tertiary referral centres. Methods: We reviewed a total of 262 patients who underwent surgery for non-distant-metastatic papillary carcinoma between 2000 and 2014. Demographical, disease-related, and surgical variables from 142 patients from Hospital del Mar (HM) and 120 from University College London Hospital (UCLH) from the local database were analyzed. The primary end-point is the rate of disease recurrence (biochemical and radiology criteria). X2 test and t-test were used for categorical and continuous data.
26. A novel modulator of cellular invasion and metastasis N. Sharma, W. Imruetaicharoenchoke*, R.J. Watkins*, E. Gentillin, E. Bosseboeuf, P.K.K. Kwan, R. Fletcher, H. Mehanna, K. Boelaert, M.L. Read, J.C. Watkinson, V.E. Smith, C.J. McCabe School of Clinical and Experimental Medicine, University of Birmingham, UK Introduction: Metastasis is a vital process responsible for the majority of endocrine cancer deaths. Central to the ability of cells to move is the recruitment of actin fibres at the periphery of the cell by the cortical actin binding protein cortactin. A precise understanding of all of cortactin’s mechanisms is required to address metastatic cell activity. Materials and Methods: We used IP-MS to discover protein binding partners. We determined the interaction and co-localisation between cortactin and PBF through co-immunoprecipitation (Co-IP), immunofluorescence and Proximity Ligation Assays. Boyden chamber assays were used to quantify cell invasion. Western blotting and real-time PCR were used to study the levels of gene expression in papillary thyroid cancers (PTC). Results: We identify the proto-oncogene PBF as a new functional binding partner of cortactin, PBF has recently been correlated with thyroid and breast cancer metastasis. Cortactin and PBF co-localised and bound preferentially at the leading edge of migrating cells. Oncogenic expression of PBF induced potent cell invasion and migration in thyroid (p ¼ 0.01) and breast (p < 0.001) cancer cells, which was entirely abrogated by cortactin knockdown. In N ¼ 43 matched PTC, cortactin was significantly upregulated at the mRNA (p ¼ 0.022) and protein (p ¼ 0.045) levels, particularly in more aggressive tumours, and significantly correlated with PBF expression. We also demonstrate the interaction between PBF and cortactin through co-IP and reveal that artificially targeting PBF to the plasma membrane results in increased cortactin binding, blocking cellular invasion. Conclusion: Taken together, we identify a new modulator of cortactin function, and show for the first time that cortactin is over-expressed in )
Both authors contributed equally.
S87 thyroid cancer. Modulation of PBF subcellular localisation may present a novel mechanism of addressing tumour cell invasion and migration. http://dx.doi.org/10.1016/j.ejso.2015.08.077
27. Outcomes of surgery for primary Hyperaldosteronism Tarek Ezzat Abdel-Aziz, Dahlia Murad, Tom Kurzawinski Centre for Endocrine surgery, University College London Hospital, UK Introduction: Primary Hyperaldosteronism (PA) is one of the most common causes of secondary hypertension (HT). It accounts for 5e18% of hypertensive adults. The primary end-point of this study was to evaluate the effect of surgery on blood pressure (BP) control. Methods: Data on patients with a diagnosis of benign PA who were surgically treated in a tertiary referral centre was retrieved from case notes and computer records Results: Between 2000e2014, 56 patients (F ¼ 24, M ¼ 32), with a diagnosis of PA were operated. Patients were divided into three groups preoperatively based on potassium (K+) levels (HTN with normal K+ ¼ 15, HTN with low K+ ¼ 40, p < 0.001), one patient presented with low K+ and no HT. All patients had cross-sectional imaging (CT ¼ 32, CT+MRI ¼ 12, and MRI ¼ 7). Adrenal venous sampling was performed in 18(32%) patients to assist in localization. Left adenoma was detected in 28(50%), right in 27(48%) and bilateral 1(2%). Laparoscopic adrenalectomy was performed in 55(98%) patients with no conversions. One patient had an open adrenalectomy. Length of hospital stay was 3(1e12) days. Final histology report showed (cortical nodular hyperplasia ¼ 9, solitary adenoma ¼ 47). Median size of the adenoma was 1.5(04e3.5) cm. Postoperative potassium levels normalised in all patients (4.5 0.5 mmol/L vs. 2.75 0.37 mmol/, postoperative vs. preoperative, respectively,p < 0.001). Regarding BP control, 18(32%) stopped all medications, 21(38%) were maintained on 1 medication, 8(14%) on 2 and, 4(7%) on 3. 5(9%) of patients had no drop in medications. One patient was had recurrent disease due to bilateral adrenal hyperplasia. Only three patients had complications; two patients had chest infections treated with antibiotics and one patient had low postoperative cortisol. Conclusion: Laparoscopic adrenalectomy is a safe and effective operation for treatment of PA. The majority of patients have significantly reduced the number or the dosage of the BP medications achieving a better control of their blood pressure. http://dx.doi.org/10.1016/j.ejso.2015.08.103
28. Does variation in central neck dissection and radioactive iodine performance influence the outcome of papillary carcinoma? Comparison of two European experienced centres. Leyre Lorente-Poch1,2, Mahmud Saedon1, Ioannis Christakis1, German Mateu2, Tarek Ezzat Abdel-Aziz1, Joan Sancho2, Tom Kurzawinski1, Antonio Sitges-Serra2 1 University College London Hospital NHS Foundation Trust, London, UK 2 Hospital del Mar, Universitat Autonoma de Barcelona, Barcelona, Spain Introduction: The role of central lymphadenectomy and use of radioactive iodine in patients with papillary carcinoma confined to thyroid without evidence of lymphnode metastasis is uncertain. We aimed to evaluate whether the variation of surgical practice and post-operative radioiodine ablation influence the outcome of papillary carcinoma between 2 tertiary referral centres. Methods: We reviewed a total of 262 patients who underwent surgery for non-distant-metastatic papillary carcinoma between 2000 and 2014. Demographical, disease-related, and surgical variables from 142 patients from Hospital del Mar (HM) and 120 from University College London Hospital (UCLH) from the local database were analyzed. The primary end-point is the rate of disease recurrence (biochemical and radiology criteria). X2 test and t-test were used for categorical and continuous data.