Clinicopathological Characteristics and Long-term Outcome in Patients with Distant Metastases from Differentiated Thyroid Cancer

Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.

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Long-Term Outcome of Patients with Persistent Differentiated Thyroid Cancer Following the Initial Management.

10.1210/endo-meetings.2010.part1.p12.p1-565 ◽

2010 ◽

pp. P1-565-P1-565

Author(s):

Ali S. Alzahrani ◽

Rafif Farhat ◽

Omalkhaire Al-Shaikh ◽

Sameerah Al-Shehri ◽

Mohammed Al-Harthy ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Term Outcome ◽

Long Term Outcome ◽

Initial Management

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Response to Initial Therapy of Differentiated Thyroid Cancer Predicts the Long-Term Outcome Better than Classical Risk Stratification Systems

International Journal of Endocrinology ◽

10.1155/2014/591285 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Albert Cano-Palomares ◽

Ignasi Castells ◽

Ismael Capel ◽

Maria Rosa Bella ◽

Santi Barcons ◽

...

Keyword(s):

Thyroid Cancer ◽

Risk Stratification ◽

Roc Curve ◽

Differentiated Thyroid Cancer ◽

Predictive Ability ◽

Initial Therapy ◽

Term Outcome ◽

Long Term Outcome ◽

Better Than

Objective. Although differentiated thyroid cancer (DTC) usually has an indolent course, some cases show a poor prognosis; therefore, risk stratification is required. The objective of this study is to compare the predictive ability of classical risk stratification systems proposed by the European Thyroid Association (ETA) and American Thyroid Association (ATA) with the system proposed by Tuttle et al. in 2010, based on the response to initial therapy (RIT).Methods. We retrospectively reviewed 176 cases of DTC with a median follow-up period of 7.0 years. Each patient was stratified using ETA, ATA, and RIT systems. Negative predictive value (NPV) and positive predictive value (PPV) were determined. The area under receiver operating characteristic (ROC) curve was calculated in order to compare the predictive ability.Results. RIT showed a NPV of 97.7%, better than NPV of ETA and ATA systems (93.9% and 94.9%, resp.). ETA and ATA systems showed poor PPV (40.3% and 41%, resp.), while RIT showed a PPV of 70.8%. The area under ROC curve was 0.7535 for ETA, 0.7876 for ATA, and 0.9112 for RIT, showing statistical significant differencesP<0.05.Conclusions. RIT predicts the long-term outcome of DTC better than ETA/ATA systems, becoming a useful system to adapt management strategies.

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