scholarly journals Late-onset distant metastases confer poor prognosis in patients with well-differentiated thyroid cancer

Gland Surgery ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 1857-1866
Author(s):  
Chan Kwon Jung ◽  
Sohee Lee ◽  
Ja Seong Bae ◽  
Dong-Jun Lim
Keyword(s):  
Thyroid Cancer ◽  
Poor Prognosis ◽  
Differentiated Thyroid Cancer ◽  
Late Onset ◽  
Distant Metastases ◽  
Well Differentiated

scholarly journals Regional Variation across Canadian Centers in Radioiodine Administration for Thyroid Remnant Ablation in Well-Differentiated Thyroid Cancer Diagnosed in 2000–2010

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
I. Rachinsky ◽  
M. Rajaraman ◽  
W. D. Leslie ◽  
A. Zahedi ◽  
C. Jefford ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Distant Metastases ◽  
Tnm Staging ◽  
Remnant Ablation ◽  
Thyroid Hormone Withdrawal ◽  
Care Patterns ◽  
Major Variation ◽  
Well Differentiated ◽  
Over Time

Background. Use of radioactive iodine (RAI) ablation has been reported to vary significantly between studies. We explored variation in RAI ablation care patterns between seven thyroid cancer treatment centers in Canada.Methods. The Canadian Collaborative Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe and analyze patterns of care for thyroid cancer. We analyzed data from seven participating centers on RAI ablation in patients diagnosed with well-differentiated (papillary and follicular) thyroid cancer between 2000 and 2010. We compared RAI ablation protocols including indications (based on TNM staging), preparation protocols, and administered dose. We excluded patients with known distant metastases at time of RAI ablation.Results. We included 3072 patients. There were no significant differences in TNM stage over time. RAI use increased in earlier years and then declined. The fraction of patients receiving RAI varied significantly between centers, ranging between 20–85% for T1, 44–100% for T2, 58–100% for T3, and 59–100% for T4. There were significant differences in the RAI doses between centers. Finally, there was major variation in the use of thyroid hormone withdrawal or rhTSH for preparation of RAI ablation.Conclusion. Our study identified significant variation in use of RAI for ablation in patients with well-differentiated thyroid cancer both between Canadian centers and over time.

scholarly journals CLINICAL CASES OF THE EFFICACY OF THERAPY MULTIKINASE INHIBITORS OF METASTATIC RADIOID-REFRACTORY DIFFERENTIATED THYROID CANCER

2018 ◽  
Vol 12 (2) ◽  
pp. 81-88
Author(s):  
Andrey P. Polyakov ◽  
Alexander V. Mordovskiy ◽  
Petr A. Nikiforovich ◽  
Mikhail V. Ratushnyy ◽  
Irina V. Rebrikova ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Therapy Resistance ◽  
Multikinase Inhibitor ◽  
Drug Of Choice ◽  
Targeted Drug ◽  
Well Differentiated ◽  
Life Therapy

Well differentiated thyroid cancer (WDTC) is referred to non-aggressive tumors with a relatively favorable course. However, in 10% of cases, distant metastases are recorded in this pathology, of them 5–15% of cases develop refractoriness to I131 therapy. Resistance to radioactive iodine therapy in patients with WDTC significantly worsens the overall and disease-free survival. In 2014, the targeted drug Sorafenib was registered in our country, as the first drug of choice for the treatment of patients with metastatic radio-refractory WDTC. The article presents his own experience in the therapy of radiorefractory thyroid cancer with a multikinase inhibitor – Sorafenib. This drug is effective for the treatment of this cohort of patients and also helps to maintain a satisfactory quality of life. Therapy with a multikinase inhibitor statistically significantly increases the time to progression and the median time without progression. In this way, patients have been monitored for a process that would not have been possible to achieve without the use of a targeted drug with multikinase inhibition.

scholarly journals Long-Term Outcomes and Prognoses of Elderly Patients (≥65-Years-Old) With Distant Metastases From Well-Differentiated Thyroid Cancer During Radioiodine Therapy and Follow-Up

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhong-Ling Qiu ◽  
Chen-Tian Shen ◽  
Zhen-Kui Sun ◽  
Hong-Jun Song ◽  
Chuang Xi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Differentiated Thyroid Cancer ◽  
Distant Metastases ◽  
Extrathyroidal Extension ◽  
Long Term Outcomes ◽  
Well Differentiated

ObjectiveThe objective of this study was to investigate the clinicopathological characteristics, long-term outcomes, and prognostic factors of elderly patients with distant metastases at initial diagnosis from well-differentiated thyroid cancer (WDTC) during radioactive iodine (131I) treatment and follow-up.MethodsA retrospective review of medical records identified 183 elderly patients with DTC who underwent 131I treatment at our institution between 2006 and 2019.ResultsIn total, 57 elderly WDTC patients with distant metastases were enrolled in this study. After 131I treatment, 32 (56.14%) patients had 131I avidity and 25 (43.86%) had non-131I avidity; 35 (61.40%) cases were classified as radioiodine refractory (RR)-WDTC and 22 (38.60%) as non-RR-WDTC. At the end of follow-up, 25 (43.86%) patients had died and 32 (56.14%) were alive. The 5- and 10-year overall survival (OS) rates were 71.50% and 30.49%, respectively, while the 5- and 10-year disease-specific survival (DSS) rates were 76.89% and 48.71%, respectively. Multivariate analyses showed that gross extrathyroidal extension and RR-DTC were independent prognostic factors for poor OS (P=0.04 and P=0.03, respectively), while gross extrathyroidal extension, extrapulmonary distant metastases, and RR-WDTC were independent prognostic factors for poor DSS at the end of follow-up (P=0.02, P=0.03, and P=0.02, respectively).ConclusionsWDTC with distant metastases at initial diagnosis accounted for 31.15% of all elderly patients with DTC. Gross extrathyroidal extension and RR-DTC were the major factors associated with poor OS; gross extrathyroidal extension, extrapulmonary distant metastases, and RR-DTC were independent prognostic factors for poor DSS in elderly DTC patients with distant metastases.

scholarly journals A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima: Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis

2021 ◽  
Vol 18 (7) ◽  
pp. 3444
Author(s):  
Valentina Drozd ◽  
Vladimir Saenko ◽  
Daniel I. Branovan ◽  
Kate Brown ◽  
Shunichi Yamashita ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Children And Adolescents ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Distant Metastases ◽  
Lifestyle Changes ◽  
Radiation Doses ◽  
Related Factors ◽  
Fukushima Accident ◽  
Tumor Stages

The incidence of differentiated thyroid cancer (DTC) is steadily increasing globally. Epidemiologists usually explain this global upsurge as the result of new diagnostic modalities, screening and overdiagnosis as well as results of lifestyle changes including obesity and comorbidity. However, there is evidence that there is a real increase of DTC incidence worldwide in all age groups. Here, we review studies on pediatric DTC after nuclear accidents in Belarus after Chernobyl and Japan after Fukushima as compared to cohorts without radiation exposure of those two countries. According to the Chernobyl data, radiation-induced DTC may be characterized by a lag time of 4–5 years until detection, a higher incidence in boys, in children of youngest age, extrathyroidal extension and distant metastases. Radiation doses to the thyroid were considerably lower by appr. two orders of magnitude in children and adolescents exposed to Fukushima as compared to Chernobyl. In DTC patients detected after Fukushima by population-based screening, most of those characteristics were not reported, which can be taken as proof against the hypothesis, that radiation is the (main) cause of those tumors. However, roughly 80% of the Fukushima cases presented with tumor stages higher than microcarcinomas pT1a and 80% with lymph node metastases pN1. Mortality rates in pediatric DTC patients are generally very low, even at higher tumor stages. However, those cases considered to be clinically relevant should be followed-up carefully after treatment because of the risk of recurrencies which is expected to be not negligible. Considering that thyroid doses from the Fukushima accident were quite small, it makes sense to assess the role of other environmental and lifestyle-related factors in thyroid carcinogenesis. Well-designed studies with assessment of radiation doses from medical procedures and exposure to confounders/modifiers from the environment as e.g., nitrate are required to quantify their combined effect on thyroid cancer risk.

Quality of Life with Well-Differentiated Thyroid Cancer: Treatment Toxicities and Their Reduction

Thyroid ◽  
2004 ◽  
Vol 14 (2) ◽  
pp. 133-140 ◽  
Author(s):  
April Mendoza ◽  
Brian Shaffer ◽  
Daniel Karakla ◽  
M. Elizabeth Mason ◽  
David Elkins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Cancer Treatment ◽  
Differentiated Thyroid Cancer ◽  
Well Differentiated
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