BRAFV600E status and Stimulated Thyroglobulin at ablation time increase prognostic value of American Thyroid Association (ATA) classification systems for persistent disease in Differentiated Thyroid Carcinoma (DTC)

2017 ◽  
Author(s):  
Andrea Repaci ◽  
Valentina Vicennati ◽  
Alexandro Paccapelo ◽  
Nicola Salituro ◽  
Ottavio Cavicchi ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Prognostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Classification Systems ◽  
American Thyroid Association ◽  
Time Increase ◽  
Persistent Disease ◽  
Ablation Time

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.

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.

Prognostic value of the eighth edition AJCC TNM classification for differentiated thyroid carcinoma

Oral Oncology ◽  
2017 ◽  
Vol 71 ◽  
pp. 81-86 ◽  
Author(s):  
Tae Hyuk Kim ◽  
Young Nam Kim ◽  
Hye In Kim ◽  
So Young Park ◽  
Jun-Ho Choe ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Prognostic Value ◽  
Tnm Classification ◽  
Differentiated Thyroid Carcinoma ◽  
Eighth Edition

Prognostic Value of Age and Distant Metastasis in Differentiated Thyroid Carcinoma Undergoing Salvage Surgery

2020 ◽  
Vol 40 (2) ◽  
pp. 1127-1133
Author(s):  
HIDENORI SUZUKI ◽  
DAISUKE NISHIKAWA ◽  
SHINTARO BEPPU ◽  
HOSHINO TERADA ◽  
MICHI SAWABE ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Distant Metastasis ◽  
Prognostic Value ◽  
Salvage Surgery ◽  
Differentiated Thyroid Carcinoma

scholarly journals Risk stratification of 282 differentiated thyroid cancers found incidentally in 1369 total thyroidectomies according to the 2015 ATA guidelines; implications for management and treatment

2018 ◽  
Vol 100 (5) ◽  
pp. 357-365 ◽  
Author(s):  
I Christakis ◽  
S Dimas ◽  
ID Kafetzis ◽  
N Roukounakis
Keyword(s):  
Thyroid Carcinoma ◽  
Preoperative Diagnosis ◽  
Radioactive Iodine ◽  
Risk Group ◽  
Differentiated Thyroid Carcinoma ◽  
Stage I ◽  
American Thyroid Association ◽  
Intermediate Risk ◽  
Incidental Group ◽  
Iodine Treatment

Introduction The purpose of this study was to evaluate the incidence of incidental differentiated thyroid carcinoma in thyroid operations for a benign preoperative diagnosis, to identify the risk factors involved and to risk stratify the cancer patients according to the 2015 American Thyroid Association (ATA) guidelines. Materials and methods The study was a retrospective review of all thyroidectomy operations performed in a single institution (January 2004 to January 2009). We excluded patients with a preoperative diagnosis of thyroid malignancy. Results Incidental differentiated thyroid carcinoma was diagnosed in 282/1369 patients (21%). The incidental group had a significantly higher number of males (19% vs 14%, P = 0.033) and a higher number of patients with histopathological evidence of thyroiditis (35% vs 25%, P = 0.004). There was a higher number of lymph nodes present in the incidental group but numbers did not reach statistical significance (17% vs 13%, P = 0.079). There were 270 cases in the ATA low-risk group (96%) and 12 cases in the ATA intermediate-risk group (4%). Patients with an ATA intermediate risk had a statistically higher number of capsule invasion, extrathyroidal extension and angioinvasion (P < 0.001, P < 0.001 and P < 0.001, respectively). Overall, 22% of patients with an incidental differentiated thyroid carcinoma should be considered for radioactive iodine 131I treatment. 29 of the 191 patients in American Joint Committee on Cancer stage I should be considered for radioactive iodine treatment (15%). Conclusions Males and patients with thyroiditis are at a higher risk for an incidental differentiated thyroid carcinoma. One of every five of patients diagnosed with cancer will need radioactive iodine treatment, even some patients with stage I disease.

Sign in / Sign up

Export Citation Format

Share Document