Differentiated thyroid microcarcinoma − current perspective

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Overall Survival ◽  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Retrospective Analysis ◽  
Differentiated Thyroid Cancer ◽  
Good Prognosis ◽  
Wilcoxon Test ◽  
Nodal Involvement ◽  
Thyroid Microcarcinoma ◽  
Current Perspective

Introduction: Differentiated thyroid cancer (DTC) has a good prognosis and low mortality despite its growing incidence, which is particularly the case of microcarcinomas (T1a – up to 10 mm). Methods: Retrospective analysis of overall survival of patients in the group of thyroid gland surgeries for differentiated forms of microcarcinoma in the period of 2006–2015 up to the present. An overview of contemporary therapeutic methods is included. Results: Thyroid cancer was detected in 144 cases out of the total of 1820 patients with thyreopathy undergoing surgery (8%); DTC microcarcinoma was detected in 65 cases (45.1%) of all carcinomas. The papillary form was diagnosed in 59 cases (51.8% of all papillary cases), and the follicular form was found in 6 cases (37.5% of all follicular cases). Two cases of Hürthle cells cancer were found, both in a stage higher than T1. Overall 10-year survival of carcinomas >T1 was 86%, reaching 90% in the microcarcinoma group (Gehan Wilcoxon test: p=0.10675). Conclusion: Differentiated microcarcinoma shows a very good overall survival. Provided that other criteria are satisfied, particularly unifocal occurrence without spreading through the gland casing and without any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

Radioiodine-131 in differentiated thyroid cancer: a retrospective analysis of an uptake-related ablation strategy

2004 ◽  
Vol 31 (4) ◽  
pp. 499-506 ◽  
Author(s):  
Robbert B. T. Verkooijen ◽  
Marcel P. M. Stokkel ◽  
Jan W. A. Smit ◽  
Ernest K. J. Pauwels
Keyword(s):  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Differentiated Thyroid Cancer

DOES T STAGE AFFECT PROGNOSIS IN PATIENTS WITH STAGE IV B DIFFERENTIATED THYROID CANCER?

2019 ◽  
Vol 25 (9) ◽  
pp. 877-886 ◽  
Author(s):  
Mu Li ◽  
Nitin Trivedi ◽  
Chenyang Dai ◽  
Rui Mao ◽  
Yuning Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Papillary Thyroid ◽  
Follicular Thyroid Cancer ◽  
Cancer Specific Survival ◽  
T Stage

Objective: Differentiated thyroid cancer (DTC), the most common subtype of thyroid cancer, has a relatively good prognosis. The 8th edition of the American Joint Committee on Cancer (AJCC) pathologic tumor-node-metastasis (T [primary tumor size], N [regional lymph nodes], M [distant metastasis]) staging system did not take the T stage into consideration in stage IV B DTC patients. We evaluated the prognostic value of the T stage for advanced DTC survival. Methods: DTC cases that were considered stage IV B in the AJCC 8th edition were extracted from the Surveillance, Epidemiology, and End Results database. T stage (AJCC 6th standard) was categorized into T0–2, T3 and T4. We analyzed overall survival (OS) and cancer specific survival (CSS) in the overall group as well as in pathologic subgroups. We used the Kaplan-Meier method and log-rank test for univariate analysis and the Cox regression model for multivariate analysis. Results: A total of 519 cases were extracted. Patients with earlier T stages showed significantly better OS and CSS in univariate analysis. T stage was an independent prognostic factor for both OS and CSS in multivariate analysis. Subgroup analysis in papillary and follicular thyroid cancer showed that T4 was an independent prognostic factor for both OS and CSS. Conclusion: AJCC 8 stage IV B DTC patients could be further stratified by T stage. Further studies with larger samples and AJCC 8 T stage information are necessary. Abbreviations: AJCC = American Joint Committee on Cancer; CI = confidence interval; CSS = cancer specific survival; DTC = differentiated thyroid cancer; FTC = follicular thyroid cancer; FVPTC = follicular variant of papillary thyroid carcinoma; HR = hazard ratio; OS = overall survival; PTC = papillary thyroid cancer; SEER = surveillance, epidemiology, and end results database

Differentiated thyroid cancer: a retrospective analysis of 832 cases from Greece

1999 ◽  
Vol 50 (5) ◽  
pp. 643-654 ◽  
Author(s):  
Tzavara ◽  
Vlassopoulou ◽  
Alevizaki ◽  
Koukoulis ◽  
Tzanela ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Differentiated Thyroid Cancer

scholarly journals Minimal extrathyroidal extension does not affect survival of well-differentiated thyroid cancer

2017 ◽  
Vol 24 (5) ◽  
pp. 221-226 ◽  
Author(s):  
Zaid Al-Qurayshi ◽  
Mohamed A Shama ◽  
Gregory W Randolph ◽  
Emad Kandil
Keyword(s):  
Overall Survival ◽  
Thyroid Cancer ◽  
Tumor Size ◽  
Differentiated Thyroid Cancer ◽  
Staging System ◽  
Extrathyroidal Extension ◽  
Group 4 ◽  
Group 2 ◽  
Minimal Extrathyroidal Extension ◽  
Group 1

Differentiated thyroid cancer (DTC) with minimal extrathyroidal extension (MEE) is classified as stage III regardless of the tumor size. In this study, we aim to examine the effect of MEE on the overall survival and management of this population. A retrospective cohort study was performed, which utilized the National Cancer Database (NCDB), 2004–2012. The study population included patients, aged ≥ 45 years, who underwent surgery for DTC (pT3N0M0) with MEE compared to that in patients with pT2N0M0. A total of 9556 patients were included. These were divided into four groups, 4410 patients with pT2N0M0 (Group 1: T ≤ 4 cm without MEE), 3274 with pT3N0M0 (Group 2: T ≤ 4 cm with MEE), 447 with pT3N0M0 (Group 3: T > 4 cm with MEE) and 1430 patients with pT3N0M0 without MEE (Group 4: T > 4 cm without MEE). Median follow-up time was 46.7 months (interquartile range: 27.8–72.1). Patients in Group 2 (T ≤ 4 cm with MEE) had no significant worse survival compared to patients in Group 1 (T ≤ 4 cm without MEE) (P = 0.85), whereas Groups 3 and 4 (T > 4 cm), both had significantly lower survival (P < 0.001) with no difference between the two groups. Total thyroidectomy was associated with improved overall survival compared to that in lobectomy in Group 4 (T > 4 cm without MEE). Radioiodine utilization was associated with improved survival only with tumors larger than 4 cm with or without MEE. In DTC patients aged older than 45 years of age with tumor size less than 4 cm, MEE has no survival significance. Tumor size is an independent prognostic marker regardless of MEE status. Our data support re-evaluation of the current staging system.

Only a Rapid Complete Biochemical Remission After 131I-Therapy is Associated with an Unimpaired Life Expectancy in Differentiated Thyroid Cancer

2017 ◽  
Vol 49 (11) ◽  
pp. 860-868
Author(s):  
Frederik Verburg ◽  
Uwe Mäder ◽  
Inge Grelle ◽  
Luca Giovanella ◽  
Christoph Reiners ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Life Expectancy ◽  
Differentiated Thyroid Cancer ◽  
Survival Rates ◽  
Relative Survival ◽  
Good Prognosis ◽  
Response To Therapy ◽  
131I Therapy ◽  
Group Life ◽  
Biochemical Remission

AbstractThe objective of the work was to investigate the relationship between thyroglobulin doubling time (TgDT) as a marker of speed of response to 131I-therapy and the differentiated thyroid cancer (DTC) recurrence rate, DTC specific mortality rate, and relative survival rate in a DTC population followed over a long period of time after 131I-therapy. From our database, data of 1354 patients were reviewed. TgDT could be calculated in 174 patients, however, 376 patients did not have sufficient Tg values available for TgDT calculation and 804 patients reached biochemical remission before a sufficient number of Tg measurements for TgDT calculation was acquired. Main outcome measures were recurrence-free, DTC specific, and relative survival rates. In patients<45 years, TgDT in multivariate analysis was identified as the solitary significant determinant of DTC specific and relative survival. In patients≥45 years of age at diagnosis, TgDT is an independent, but not the only determinant of recurrence free, DTC specific, and relative survival. Importantly, in this age group life expectancy is normal in patients reaching rapid biochemical remission (i. e., before TgDT can be calculated); it was reduced in patients with a negative TgDT, which normally is deemed a marker of response to therapy. Only DTC patients with a rapid biochemical remission have a very good prognosis with a normal life expectancy. If no rapid biochemical remission occurs, both biochemically progressive disease and a slower biochemical remission of disease are associated with a reduced prognosis, especially in older DTC patients.

scholarly journals Controversies in the Management and Followup of Differentiated Thyroid Cancer: Beyond the Guidelines

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Hala Ahmadieh ◽  
Sami T. Azar
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Cancer Staging ◽  
Good Prognosis ◽  
Conservative Approach ◽  
Cancer Management ◽  
Node Metastases ◽  
Genetic And Environmental Factors ◽  
Well Differentiated ◽  
Differentiated Thyroid Cancers

Thyroid cancer is among the most common endocrine malignancies. Genetic and environmental factors play an important role in the pathogenesis of differentiated thyroid cancer. Both have good prognosis but with frequent recurrences. Cancer staging is an essential prognostic part of cancer management. There are multiple controversies in the management and followup of differentiated thyroid cancer. Debate still exists with regard to the optimal surgical approach but trends toward a more conservative approach, such as lobectomy, are being more favored, especially in papillary thyroid cancer, of tumor sizes less than 4 cm, in the absence of other high-risk suggestive features. Survival of patients with well-differentiated thyroid cancer was adversely affected by lymph node metastases. Prophylactic central LN dissection did improve accuracy in staging and decrease postop TG level, but it had no effect on small-sized tumors. Conservative approach was more applied with regard to the need and dose of radioiodine given postoperatively. There have been several advancements in the management of radioiodine resistant advanced differentiated thyroid cancers. Appropriate followup is required based on risk stratification of patients postoperatively. Many studies are still ongoing in order to reach the optimal management and followup of differentiated thyroid cancer.

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