Outcomes of Patients with Differentiated Thyroid Cancer Risk-Stratified According to the American Thyroid Association and Latin American Thyroid Society Risk of Recurrence Classification Systems

Thyroid ◽  
2013 ◽  
Vol 23 (11) ◽  
pp. 1401-1407 ◽  
Author(s):  
Fabián Pitoia ◽  
Fernanda Bueno ◽  
Carolina Urciuoli ◽  
Erika Abelleira ◽  
Graciela Cross ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Risk ◽  
Latin American ◽  
Differentiated Thyroid Cancer ◽  
Classification Systems ◽  
American Thyroid Association ◽  
Risk Of Recurrence ◽  
Thyroid Cancer Risk ◽  
Recurrence Classification

scholarly journals BRAF V600E Status and Stimulated Thyroglobulin at Ablation Time Increase Prognostic Value of American Thyroid Association Classification Systems for Persistent Disease in Differentiated Thyroid Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Andrea Repaci ◽  
Valentina Vicennati ◽  
Alexandro Paccapelo ◽  
Ottavio Cavicchi ◽  
Nicola Salituro ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Risk Stratification ◽  
Prognostic Value ◽  
Differentiated Thyroid Cancer ◽  
Risk Classification ◽  
Classification Systems ◽  
Braf V600e ◽  
American Thyroid Association ◽  
Persistent Disease ◽  
Ablation Time

Background. Stimulated thyroglobulin levels measured at the time of remnant ablation (A-hTg) and BRAFV600E mutation had shown prognostic value in predicting persistent disease in differentiated thyroid cancer (DTC). The aim of this study was to evaluate the prognostic role of A-hTg combined with the BRAFV600E status in association with the revised American Thyroid Association (ATA) risk stratification. Material and Methods. 620 patients treated for a DTC were included in this study with a median follow-up duration of 6.1 years. All patients underwent total thyroidectomy followed by radioiodine ablation. Patients with positive anti-thyroglobulin antibodies were excluded. The predictive value of A-hTg was calculated by receiver operating characteristic curve (ROC curve) analysis. The Cox proportional hazard regression model, including the BRAF status, A-hTg, and ATA classification system, was assessed to evaluate the existing persistent disease risk. Results. Taken together, the BRAF status and A-hTg levels improve the ATA risk classification in all categories. In particular, in the low-risk ATA classification, only the combination of BRAFV600E+A-hTg>8.9ng/ml was associated with persistent disease (P=0.001, HR 60.2, CI 95% 5.28-687). In the intermediate-risk ATA classification, BRAFWT+A-hTg>8.9ng/ml was associated with persistent disease (P=0.029, HR 2.71, CI 95% 1.106-6.670) and BRAFV600E+A-hTg>8.9ng/ml was also associated with persistent disease (P<0.001, HR 5.001, CI 95% 2.318-10.790). In the high-risk ATA classification, both BRAFV600E+A-hTg<8.9ng/ml and BRAFV600E+A-hTg>8.9 ng/ml were associated with persistent disease (P=0.042, HR 5.963, CI 95% 1.069-33.255 and P=0.002, HR 11.564, CI 95% 2.543-52.576, respectively). Conclusions. The BRAF status and stimulated thyroglobulin levels at ablation time improve the ATA risk stratification of differentiated thyroid cancer; therefore, even A-hTg could be included in risk classification factors.

scholarly journals Novel Genome-Wide Association Study–Based Candidate Loci for Differentiated Thyroid Cancer Risk

2014 ◽  
Vol 99 (10) ◽  
pp. E2084-E2092 ◽  
Author(s):  
Gisella Figlioli ◽  
Aleksandra Köhler ◽  
Bowang Chen ◽  
Rossella Elisei ◽  
Cristina Romei ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Risk ◽  
Association Study ◽  
Differentiated Thyroid Cancer ◽  
Genome Wide Association Study ◽  
Genome Wide Association ◽  
Genome Wide ◽  
Thyroid Cancer Risk ◽  
Candidate Loci

scholarly journals Impact of Gross Strap Muscle Invasion on Outcome of Differentiated Thyroid Cancer: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Li Zhang ◽  
Jia Liu ◽  
Peisong Wang ◽  
Shuai Xue ◽  
Jie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
American Thyroid Association ◽  
Strap Muscle ◽  
Risk Of Recurrence ◽  
Muscle Invasion ◽  
The Impact

Gross strap muscle invasion (gSMI) in patients with differentiated thyroid cancer (DTC) was defined as high-risk recurrent group in the 2015 American Thyroid Association guidelines. However, controversy persists because several studies suggested gSMI had little effect on disease outcome. Herein, a systematic review and meta-analysis was conducted to investigate impact of gSMI on outcome of DTC. Methods: A systematic search of electronic databases (PubMed, EMBASE, Cochrane Library, and MEDLINE) for studies published until February 2020 was performed. Case-control studies and randomized controlled trials that studied the impact of gSMI on outcome of DTC were included. Results: Six studies (all retrospective studies) involving 13639 patients met final inclusion criteria. Compared with no extrathyroidal extension (ETE), patients with gSMI were associated with increased risk of recurrence (P=0.0004,OR, 1.46; 95% CI: 1.18 to 1.80) and lymph node metastasis (LNM) (P&lt;0.00001,OR 4.19;95% CI. 2.53 to 6.96). For mortality (P=0.34,OR 1.47;95% CI:0.67 to 3.25), ten-year disease-specific survival (P=0.80, OR 0.91;95% CI:0.44 to 1.88) and distant metastasis (DM) (P=0.21, OR 2.94;95% CI. 0.54 to 15.93), there was no significant difference between gSMI and no ETE group. In contrast with maximal ETE, patients with gSMI were associated with decreased risk of recurrence (P&lt;0.0001,OR, 0.58; 95% CI: 0.44 to 0.76) , mortality (P=0.0003,OR 0.20;95% CI:0.08 to 0.48), LNM (P=0.0003,OR 0.64;95% CI. 0.50 to 0.81) and DM (P=0.0009,OR 0.28;95% CI. 0.13 to 0.59). Conclusions: DTC patients with gSMI had a higher risk of recurrence and LNM than those without ETE. However, in contrast with maximal ETE, a much better prognosis was observed in DTC patients with only gSMI. The findings of our meta-analysis provide supportive evidence for the validity of the T category changes in the 8th edition American Joint Committee on Cancer system. The actual impact of gSMI should be re-evaluated and revised in the recurrent risk stratification system in the future.

scholarly journals Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4338
Author(s):  
Michele Klain ◽  
Emilia Zampella ◽  
Leandra Piscopo ◽  
Fabio Volpe ◽  
Mariarosaria Manganelli ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Differentiated Thyroid Cancer ◽  
Response To Therapy ◽  
Whole Body ◽  
American Thyroid Association ◽  
Neck Ultrasound ◽  
Risk Of Recurrence

This study assessed the long-term predictive value of the response to therapy, evaluated by serum thyroglobulin (Tg) determination and neck ultrasound, and estimated the potential additional impact of diagnostic whole-body scan (WBS) in patients with differentiated thyroid cancer (DTC) treated with surgery and radioactive iodine (RAI) therapy. We retrospectively evaluated 606 DTC patients treated with surgery and RAI. Response to 131I therapy at 12 months was assessed by serum Tg measurement, neck ultrasound, and diagnostic WBS. According to American Thyroid Association (ATA) guidelines, patients were classified as having a low, intermediate or high risk of recurrence and at 12 months as having an excellent response (ER) or no-ER. Follow-up was then performed every 6–12 months with serum Tg determination and imaging procedures. With a median follow-up of 105 months (range 10–384), 42 (7%) events requiring further treatments occurred. Twenty-five patients had additional RAI therapy, 11 with structural disease in the thyroid bed, eight in both thyroid bed and neck lymph nodes, four had lung metastases and two had bone metastases. The other 17 patients had additional surgery for nodal disease followed by RAI therapy. The ATA intermediate and high risk of recurrence, post-operative and pre-RAI therapy Tg ≥ 10 ng/mL, and the absence of ER at 12 months were independent predictors of events. Diagnostic WBS at 12 months permitted the identification of only five recurrences among the 219 ER patients according to serum Tg levels and ultrasound. In DTC patients, the response to therapy at 12 months after RAI therapy could rely on serum Tg measurement and neck ultrasound, while diagnostic WBS was not routinely indicated in patients considered in ER.

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