scholarly journals The role of Hashimoto thyroiditis in predicting radioiodine ablation efficacy and prognosis of low to intermediate risk differentiated thyroid cancer

Author(s):  
Domenico Albano ◽  
Francesco Dondi ◽  
Valentina Zilioli ◽  
Maria Beatrice Panarotto ◽  
Alessandro Galani ◽  
...  

Abstract Objective The baseline treatment of differentiated thyroid cancer (DTC) consists of thyroidectomy followed by postoperative risk-adapted radioiodine therapy (RAIT) when indicated. The choice of most appropriate RAI activities to administer with the aim to reach an efficient remnant ablation and reduce the risk of recurrence is yet an open issue and the detection of basal factors that may predict treatment response seems fundamental. The aim of this study was to investigate the potential role of Hashimoto thyroiditis (HT) in predicting 1-year and 5-year treatment response after RAIT and prognosis. Methods We retrospectively included 314 consecutive patients (174 low-risk and 140 intermediate-risk) who received thyroidectomy plus RAIT. One-year and 5-year disease status was evaluated according to 2015 ATA categories response based upon biochemical and structural findings. Results HT was reported histopathologically in 120 patients (38%). DTC patients with concomitant HT received a higher number of RAITs and cumulative RAI activities. Initial RAIT reached an excellent response in 63% after one year and 84% after 5 years. The rate of excellent response one year and 5-year after first RAIT was significantly lower in HT groups, compared to not HT (p < 0.001). Instead, HT did not have a prognostic role considering PFS and OS; while stimulate thyroglobulin (sTg) at ablation was significantly related to survival. Conclusions HT may affect the efficacy of RAIT in low to intermediate risk DTC, particularly reducing the successful rate of excellent response after RAIT. Instead, HT did not have a prognostic impact such as stimulated sTg.

2016 ◽  
Vol 144 (7-8) ◽  
pp. 397-401
Author(s):  
Gostimir Mikac ◽  
Sinisa Stankovic

Introduction. Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ablation of a potential remaining tissue. The measurement of thyroglobulin in the postoperative follow-up can serve as an indicator of tumor growth or recurrence of the disease. Objective. The aim of this paper is to examine the value of thyroglobulin in patients surgically treated for differentiated thyroid cancer who had metastases in the lymph nodes of the neck, as well as in operated on patients without any evident metastasis. Methods. Thyroglobulin values in the serum of 58 patients were analyzed. Two groups were formed. The thyroglobulin value was established with the use of IRMA-hTg (125I) system. Normal levels of thyroglobulin were from 2 ng/ml to 65 ng/ml. For all of 58 patients, thyroglobulin was determined three times. The first, so-called pre-ablation thyroglobulin was determined immediately before the application of 131I ablation dose. The second and the third measurements were conducted six to eight months and one year, respectively, after the application of the ablation dose respectively. Results. The first group consisted of 14 patients with histologically proven metastases in the lymph nodes of the neck, while the second group consisted of 44 patients without any evident metastases. The average thyroglobulin value of pre-ablation in the patients from the first group was 43.45 ng/ml, while in the second was 7.57 ng/ml. Levene?s test (with p = 0.00, i.e p < 0.05), demonstrated a statistically significant difference. Furthermore, in both groups, there was statistically significant difference between pre-ablation and post-ablation thyroglobulin values (Student?s t-test with p < 0.05). Conclusion It can be concluded that the average value of thyroglobulin was significantly higher in patients with lymph node metastases in the neck. We are of the opinion that the determination of thyroglobulin, despite individual variations, may serve as a good indicator to assist in monitoring of patients surgically treated for differentiated thyroid cancer.


2007 ◽  
Vol 204 (5) ◽  
pp. 764-773 ◽  
Author(s):  
Shawn D. Larson ◽  
Lindsey N. Jackson ◽  
Taylor S. Riall ◽  
Tatsuo Uchida ◽  
Robert P. Thomas ◽  
...  

2013 ◽  
Author(s):  
Emese Mezosi ◽  
Laszlo Bajnok ◽  
Karoly Rucz ◽  
Csaba Weninger ◽  
Erzsebet Schmidt ◽  
...  

Author(s):  
Blertina Dyrmishi ◽  
Taulant Olldashi ◽  
Ema Lumi ◽  
Entela Puca ◽  
Dorina Ylli ◽  
...  

Author(s):  
Michele Klain ◽  
Carmela Nappi ◽  
Emilia Zampella ◽  
Valeria Cantoni ◽  
Roberta Green ◽  
...  

Abstract Purpose We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. Methods A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. Conclusion In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control.


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