scholarly journals Prognostic factors in children and adolescents with differentiated thyroid carcinoma treated with total thyroidectomy and RAI: a real-life multicentric study

2021 ◽  
Author(s):  
Angelina Cistaro ◽  
Natale Quartuccio ◽  
Maria Carmen Garganese ◽  
Maria Felicia Villani ◽  
Claudio Altini ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Treatment Response ◽  
Disease Status ◽  
Differentiated Thyroid Carcinoma ◽  
Multicentric Study ◽  
Persistent Disease ◽  
One Year

Abstract Purpose This multicentric study aimed to investigate the main prognostic factors associated with treatment response at 1 year after radioactive iodine therapy (RAIT) and the last disease status in pediatric patients affected by differentiated thyroid carcinoma (DTC). Materials and methods In the period 1990–2020, all consecutive patients ≤ 18 years from six different centers were retrospectively included. Patients were classified as low, intermediate, and high risk for persistence/recurrence. The response to RAIT was evaluated and scored 1 year later according to 2015 ATA guidelines. Moreover, at the last follow-up, the disease status was evaluated and dichotomized as no evidence of disease (NED) or persistent disease. Results Two hundred and eighty-five patients (197 female, 88 male; mean age 14.4 years) were recruited. All, except nine, underwent near-total thyroidectomy followed by RAIT. One-year after first RAIT, 146/276 (53%) patients had excellent response, 37/276 (14%) indeterminate response, and 91/276 (33%) incomplete response. One-year after RAIT, children with excellent response had significantly lower stimulated thyroglobulin (sTg) compared to not excellent group (median sTg 4.4 ng/ml vs 52.5 ng/ml, p < 0.001). ROC curve showed sTg higher than 27.2 ng/ml as the most accurate to predict 1-year treatment response. After a median follow-up of 133 months, NED was present in 241 cases (87%) while persistent disease in 35 (13%). At multivariate analysis, sTg and 1-year treatment response categories were both significantly associated with the last disease status (p value 0.023 and < 0.001). Conclusions In pediatric DTC, sTg is significantly associated with 1-year treatment response and final outcome. However, 1-year response is the principal prognostic factor able to predict pediatric DTCs outcome.

Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

2020 ◽  
Vol 33 (11) ◽  
pp. 1431-1441
Author(s):  
Montserrat Negre Busó ◽  
Amparo García Burillo ◽  
Marc Simó Perdigó ◽  
Pere Galofré Mora ◽  
Maria Boronat de Ferrater ◽  
...  
Keyword(s):  
Complete Remission ◽  
Thyroid Carcinoma ◽  
Children And Adolescents ◽  
Differentiated Thyroid Carcinoma ◽  
Radioiodine Treatment ◽  
Persistent Disease ◽  
Stage 4 ◽  
Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

scholarly journals Well-differentiated Thyroid Carcinoma of Childhood and Adolescence- A Long Term Experience at a Single Institute

2018 ◽  
Vol 20 (2) ◽  
pp. 99
Author(s):  
Faria Nasreen ◽  
Nurun Nahar ◽  
Sadia Sultana
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Childhood And Adolescence ◽  
Children And Adolescent ◽  
Number Of Patients ◽  
Well Differentiated ◽  
One Year

<p><strong><em>Background:</em></strong> Thyroid carcinoma is rare in childhood and adolescence. The presentation is more advanced in case of children as compared to adults. However, the prognosis for survival in children is reportedly excellent. The aim of the study was to see the outcome of patients with well differentiated thyroid carcinoma during childhood and adolescence treated at a single institute.</p><p><strong><em>Patients and methods:</em></strong> A retrospective study of 61 children and adolescent patients (age ≤18years) with well differentiated thyroid carcinoma (DTC) enrolled in the National Institute of Nuclear Medicine and Allied Sciences, Dhaka during the period of  January1986  up to December 2007 was carried out. To allow for a theoretical follow up of at least 5 years the last inclusion year was 2007 and follow up was carried on up to June 2013. All patients were treated by thyroidectomy followed by radioiodine ablation therapy. Whole body scans, Tg, anti Tg Ab and neck ultrasound findings were recorded six months to one year after initial therapy to classify patients into remission, persistent or recurrent disease. Status on last follow up was noted to estimate the survival rate.</p><p><strong><em>Results:</em></strong> A total of 40 patients had papillary carcinoma, 18 had follicular variant of papillary carcinoma (FVPCT) and three had follicular carcinoma. Age range at diagnosis was nine to 18 years with a mean of 15± 2 years. The number of patients ≤10 years were five and &gt; 10 years were 56. There were 12 males and 49 females giving a M: F ratio of about 1:4. Among the 61 patients 30 patients had lymph node metastases and two had both nodal and lung metastases at initial presentation. After one year follow up from the initial radioiodine therapy, 30 patients were in remission and 31 patients had persistent disease. Eventually recurrence occurred in five patients. Three patients died during the whole observation period and all of them were cancer related giving a cancer specific mortality ratio of 0.049%, 95% CI 0 to 0.105%. Cancer specific survival by Kaplan-Meier curve was 98.2%, 98.2% and 66% at 5, 10 and 15 years respectively.</p><p><strong><em>Conclusion:</em></strong> DTC in children and adolescent has a good prognosis in the presence of neck and distant metastases. Awareness of the patient and regular follow up with life long surveillance is essential to obtain a favorable outcome.</p><p>Bangladesh J. Nuclear Med. 20(2): 99-104, July 2017</p>

scholarly journals Pediatric Differentiated Thyroid Carcinoma: Outcome in Response to Initial Treatment

2019 ◽  
Vol 24 (2) ◽  
pp. 143-148
Author(s):  
Md Mosleh Uddin ◽  
Syed Farhan Ali Razib ◽  
Kazi Shameemus Salam ◽  
Mohd Abdus Sattar ◽  
Belayat Hossain Siddiquee
Keyword(s):  
Adverse Effects ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Initial Treatment ◽  
Differentiated Thyroid Carcinoma ◽  
Good Prognosis ◽  
Imaging Studies ◽  
Patients Experience ◽  
Longterm Outcome

Introduction: Though the differentiated thyroid carcinoma in children is a common pediatric endocrine malignancy, its prognosis is excellent with a proper initial treatment. Objectives: This is to evaluate the initial treatment patern for a good prognosis with longterm outcome in pediatric DTC patients. Methods: This study is a prospective one done in BSMMU during a period of 10 years in 52 post-operative pediatric DTC patients after excluding the follow-up missing patients. These patients are yet in a regular follow-up were outcome evaluated with clinical, pathological & imaging studies. Results: All the patients got initial treatment of total thyroidectomy. About half of the group had undergone neck dissection along with total thyroidectomy. Forty six patients had taken 131-I therapy. The survival is 100%. Conclusion: The life expectancy for children with DTC is excellent. However, many patients experience adverse effects from thyroid surgery, resulting in life long complications.  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 143-148

Prognostic factors and follow-up of patients with differentiated thyroid carcinoma with false negative or nondiagnostic FNAC before surgery. Comparison with a control group

Endocrine ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Luis García-Pascual ◽  
Montserrat Balsells ◽  
Matteo Fabbi ◽  
Carlos del Pozo ◽  
María-Teresa Valverde ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
False Negative ◽  
Differentiated Thyroid Carcinoma ◽  
Control Group

scholarly journals Prediction of Disease Status by Recombinant Human TSH-Stimulated Serum Tg in the Postsurgical Follow-Up of Differentiated Thyroid Carcinoma

2001 ◽  
Vol 86 (12) ◽  
pp. 5686-5690 ◽  
Author(s):  
Furio Pacini ◽  
Eleonora Molinaro ◽  
Francesco Lippi ◽  
Maria Grazia Castagna ◽  
Laura Agate ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Disease Status ◽  
Differentiated Thyroid Carcinoma ◽  
Recombinant Human Tsh

scholarly journals Prognostic Value of Serum Thyroglobulin and Anti-Thyroglobulin Antibody in Thyroid Carcinoma Patients following Thyroidectomy

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2080
Author(s):  
Hashem O. Zahra ◽  
Gamal A. Omran ◽  
Ahmed G. Gewely ◽  
Ahmed Fathy Eldehn ◽  
Walied Abdo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Whole Body ◽  
Control Group ◽  
Whole Body Imaging ◽  
Serum Thyroglobulin ◽  
Cutoff Value ◽  
Ablation Therapy

Well-differentiated thyroid cancer (WDTC) is a malignant head and neck tumor with a very high incidence. Thyroidectomized WDTC patients have been referred to nuclear medicine for radioactive iodine (RAI) ablation therapy and/or annual follow-up with diagnostic whole-body imaging. Serum thyroglobulin (TG) and thyroglobulin antibodies (TGAb) are biochemical tumor markers used to monitor WDTC. A global rise in the prevalence of WDTC is increasing the number of thyroidectomized patients requiring lifelong monitoring for persistent or recurrent diseases. The present study aimed to identify the most successful prognostic factors in well-defined thyroid carcinoma patients following total thyroidectomy and RAI therapy, followed by an estimation of the cutoff value of TG and TGAb. In this context, a total of 100 subjects were recruited and classified as follows: 60 thyroid carcinoma patients underwent total thyroidectomy and successful RAI therapy, while 40 normal healthy individuals matched for age, sex, and socioeconomic status constituted the control group. Interestingly, the levels of TG did not differ significantly between the relapsed and non-relapsed cases, but the levels of TGAb differed significantly between the relapsed and non-relapsed cases. Collectively, TG and TGAb are considered the most successful prognostic factors in well-defined thyroid carcinoma patients after total thyroidectomy and RAI therapy. The present study also concluded that the TGAb determination was better than that of the TG level, with a cutoff value of 10 ng/mL. These findings provide baseline information for follow-up and lifelong monitoring of thyroidectomized WDTC patients. Further research is warranted to explore more about serum TG and TGAb in thyroid carcinoma patients on a larger scale.

scholarly journals Duration of Parathyroid Function Recovery in Patients With Protracted Hypoparathyroidism After Total Thyroidectomy for Papillary Thyroid Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuxuan Qiu ◽  
Zhichao Xing ◽  
Qiao Xiang ◽  
Qianru Yang ◽  
Anping Su ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Parathyroid Glands ◽  
Permanent Hypoparathyroidism ◽  
Papillary Thyroid ◽  
Parathyroid Function ◽  
Function Recovery ◽  
One Year

PurposeThe aim of the present study is to investigate the time to recovery of parathyroid function in patients with protracted hypoparathyroidism at 1 month after total thyroidectomy of papillary thyroid carcinoma.Materials and MethodsAdult patients who underwent total thyroidectomy for papillary thyroid cancer were included. Cases of long-term hypoparathyroidism were studied for recovery of parathyroid function during the follow-up. The duration of recovery and associated variables were recorded.ResultsOut of the 964 patients, 128 (13.28%) developed protracted hypoparathyroidism and of these, 23 (2.39%) developed permanent hypoparathyroidism and 105 (10.89%) recovered: 86 (8.92%) before 6 months, 11 (1.14%) within 6 and 12 months and 8 (0.83%) after 1 year follow-up. Variables significantly associated with the time to parathyroid function recovery were number of autotransplanted parathyroid glands (HR, 1.399; 95% CI, 1.060 – 1.846; P = 0.018), serum calcium concentration &gt;2.07 mmol/L (Hazard ratio [HR], 1.628; 95% confidence interval [CI], 1.009 – 2.628; P = 0.046) and PTH level &gt; 1.2 pmol/L (HR, 1.702; 95% CI, 1.083 – 2.628; P = 0.021) at 1 month postoperatively.ConclusionPermanent hypoparathyroidism should not be diagnosed easily by time, since up to one-fifth of the patients will experience recovery after a period of 6 months and a few patients even beyond one year. The number of autotransplanted parathyroid glands is positively associated with the time to parathyroid function recovery.

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