scholarly journals Cumulative doses of radioiodine in the treatment of differentiated thyroid carcinoma: knowing when to stop

2010 ◽  
Vol 54 (9) ◽  
pp. 807-812 ◽  
Author(s):  
Raul Martins-Filho ◽  
Laura S. Ward ◽  
Barbara J. Amorim ◽  
Allan O. Santos ◽  
Mariana C. L. de Lima ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Progressive Disease ◽  
Treatment Strategies ◽  
Differentiated Thyroid Carcinoma ◽  
Tumor Node Metastasis ◽  
Node Metastasis ◽  
The Impact

OBJECTIVE: Evaluate the efficacy of cumulative doses (CDs) of 131I-iodide therapy (RIT) in differentiated thyroid cancer (DTC). SUBJECTS AND METHODS: The probability of progressive disease according to CDs was evaluated in patients < 45 years old and > 45 years old and correlated to tumor-node-metastasis (TNM), thyroglobulin values, histological types and variants, age, and zduration of the disease. RESULTS: At the end of a follow-up period of 69 ± 56 months, 85 out of 150 DTC patients submitted to fixed doses RIT had no evidence of disease, 47 had stable disease and 18 had progressive disease. Higher CDs were used in the more aggressive variants (p < 0.0001), higher TNM stages (p < 0.0001), and follicular carcinomas (p = 0.0034). Probability of disease progression was higher with CDs > 600 mCi in patients > 45 years old and with CDs > 800 mCi in patients < 45 years. CONCLUSION: Although some patients may still respond to high CDs, the impact of further RIT should be carefully evaluated and other treatment strategies may be warranted.

scholarly journals Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

2013 ◽  
Vol 5 (2) ◽  
pp. 45-49
Author(s):  
Ian C Bennett ◽  
Magdalena Biggar ◽  
Clement Wong ◽  
Michael Law
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes ◽  
Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

scholarly journals Impact of BRAF V600E and TERT Promoter Mutations on Response to Therapy in Papillary Thyroid Cancer

Endocrinology ◽  
2019 ◽  
Vol 160 (10) ◽  
pp. 2328-2338 ◽  
Author(s):  
Tomasz Trybek ◽  
Agnieszka Walczyk ◽  
Danuta Gąsior-Perczak ◽  
Iwona Pałyga ◽  
Estera Mikina ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Response To Therapy ◽  
Braf V600e ◽  
Papillary Thyroid ◽  
Tumor Node Metastasis ◽  
Node Metastasis ◽  
Tert Promoter ◽  
Tert Promoter Mutations ◽  
Promoter Mutations

Abstract In this study, we examined the relationship between coexisting BRAF V600E and TERT promoter mutations in papillary thyroid cancer (PTC) and response to therapy. PTC cases (n = 568) with known BRAF and TERT status, diagnosed from 2000 to 2012 and actively monitored at one institution, were reviewed retrospectively. Associations between BRAF V600E and TERT promoter mutations and clinicopathological features, Tumor-Node-Metastasis stage, initial risk, response to therapy, follow-up, and final disease outcome were assessed according to American Thyroid Association 2015 criteria and the American Joint Committee on Cancer/Tumor-Node-Metastasis (8th edition) staging system. Median follow-up was 120 months. TERT promoter mutations (any type) were detected in 13.5% (77/568) of PTC cases with known BRAF status. The C228T and C250T TERT hotspot mutations were found in 54 (9.5%) and 23 (4%) patients, respectively, and 22 other TERT promoter alterations were identified. Coexisting BRAF V600E and TERT hotspot promoter mutations were detected in 9.5% (54/568) of patients, and significantly associated with older patient age (P = 0.001), gross extrathyroidal extension (P = 0.003), tumor stage pT3-4 (P = 0.005), stage II to IV (P = 0.019), intermediate or high initial risk (P = 0.003), worse than excellent response to primary therapy (P = 0.045), recurrence (P = 0.015), and final outcome of no remission (P = 0.014). We conclude that coexisting BRAF V600E and TERT mutations in patients with PTC are associated with poor initial prognostic factors and clinical course and may be useful for predicting a worse response to therapy, recurrence, and poorer outcome than in patients without the above mutations.

scholarly journals Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Renata Midori Hirosawa ◽  
Monica Marivo ◽  
Juliana de Moura Leite Luengo ◽  
Jose Vicente Tagliarini ◽  
Emanuel Cellice Castilho ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Clinical Laboratory ◽  
Malignant Neoplasm ◽  
Differentiated Thyroid Carcinoma ◽  
Cancer Type ◽  
Primary Malignancy ◽  
The Moment

Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P=0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P<0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I.

Prevalence of iodine- and thyroglobulin negative findings in differentiated thyroid cancer

2001 ◽  
Vol 40 (05) ◽  
pp. 143-147 ◽  
Author(s):  
S. Klutmann ◽  
L. Jenicke ◽  
M. Geiss-Tönshoff ◽  
J. Mester ◽  
M. Clausen ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Progressive Disease ◽  
Recurrent Disease ◽  
University Hospital ◽  
Follicular Thyroid Cancer ◽  
Negative Findings ◽  
Additional Imaging ◽  
Iodine Scan

Summary Aim: The prevalence of iodine- and thyroglobulin-nega-tive findings was evaluated in all patients with differentiated thyroid cancer (DTC) treated from 1961 until 1998 at the Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf. Methods: A total of 490 patients with papillary thyroid cancer (PCA) and 242 patients with follicular thyroid cancer (FCA) were analyzed retrospectively. Patients were divided into four groups: 1: no recurrence, 2: recurrent disease, 3: primary metas-tatic/progressive disease and 4: inconclusive follow-up. Results of iodine scan, serum-TG, and additional imaging modalities as well as histology were compared in all patients. Results: 21/490 (4,3%) of patients with PCA and 16/242 (6,6%) with FCA suffered from recurrent disease. 62/490 (12,7%) of patients with PCA and 59/242 (24,4%) with FCA had primary metastatic/progressive disease. 12/21 patients with PCA and 12/16 with FCA showing up with recurrent disease had a negative iodinescan. 11/21 of patients with PCA and 4/16 with FCA and tumor recurrence had negative serum-TG levels. 14/62 patients with PCA and 14/59 with FCA presenting with primary metastatic/ progressive disease had negative iodinescan. 14/62 patients with PCA and 6/59 with FCA had negative serum-TG. Conclusion: The prevalence of iodine-negative recurrent"/metastatic disease is in accordance to the literature, whereas the prevalence of TG-negative recurrent/metastatic was noted higher than reported previously. Thus, the commonly used follow-up scheme of DTC is confirmed. However, iodine scan should be regularly performed in patients with high risk of recurrence.

scholarly journals Therapeutic Outcomes of Recurrent Well-Differentiated Thyroid Carcinomas

2019 ◽  
Vol 104 (7-8) ◽  
pp. 304-313
Author(s):  
Chih-Yiu Tsai ◽  
Shu-Fu Lin ◽  
Szu-Tah Chen ◽  
Chuen Hsueh ◽  
Yann Sheng Lin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Well Differentiated ◽  
Disease Specific

Objective The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed. Summary of Background Data Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques. Methods The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients. Results The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse. Conclusions These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.

Sign in / Sign up

Export Citation Format

Share Document