Ali S Alzahrani1, Noha Mukhtar2,3. 1. Department of Medicine and Department of Molecular Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. aliz@kfshrc.edu.sa. 2. Department of Medicine and Department of Molecular Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. 3. Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Abstract
CONTEXT: The American Thyroid Association (ATA) risk stratification system predicts risk of recurrence of differentiated thyroid cancer (DTC). Although the majority of patients achieve an excellent response, patients with intermediate- or high-risk DTC are at a significant risk of developing incomplete responses. We undertook this work to understand the factors associated with development of biochemically or structurally incomplete response in these two risk subgroups of DTC. PATIENTS AND METHODS: We retrospectively reviewed 287 consecutive patients with intermediate- (213 patients) or high-risk (74 patients) DTC. All patients underwent total thyroidectomy with (223 patients) or without (64 patients) lymph node dissection and 94% of them received at least one dose of I-131ablation/therapy. Univariate and multivariate analysis and Kaplan Meier analysis were used to compare patients who achieved an excellent response with those who continued to have biochemically or structurally incomplete responses. RESULTS: In univariate and multivariate analyses, age (P 0.002, Odds ratio 4.8, 95% CI: 1.8-12.9), tumor size (P 0.027, Odds ratio 1.30, 95% CI: 1.03-1.64) and distant metastases (P < 0.0001, Odds ratio 44.6, 95% CI: 10.7-184.5) were significantly associated with the risk of developing biochemically or structurally incomplete statuses. Patients ≥ 55 years, tumors > 2.5 cm and presence of distant metastasis were associated with higher risk of incomplete response and death from DTC. However, when this analysis was performed on intermediate and high-risk groups separately, only age was consistently associated with risk of biochemically or structurally incomplete response in either and both groups. CONCLUSION: Age is a strong predictor of biochemically and structurally incomplete responses in patients with intermediate and high-risk DTC.
CONTEXT: The American Thyroid Association (ATA) risk stratification system predicts risk of recurrence of differentiated thyroid cancer (DTC). Although the majority of patients achieve an excellent response, patients with intermediate- or high-risk DTC are at a significant risk of developing incomplete responses. We undertook this work to understand the factors associated with development of biochemically or structurally incomplete response in these two risk subgroups of DTC. PATIENTS AND METHODS: We retrospectively reviewed 287 consecutive patients with intermediate- (213 patients) or high-risk (74 patients) DTC. All patients underwent total thyroidectomy with (223 patients) or without (64 patients) lymph node dissection and 94% of them received at least one dose of I-131ablation/therapy. Univariate and multivariate analysis and Kaplan Meier analysis were used to compare patients who achieved an excellent response with those who continued to have biochemically or structurally incomplete responses. RESULTS: In univariate and multivariate analyses, age (P 0.002, Odds ratio 4.8, 95% CI: 1.8-12.9), tumor size (P 0.027, Odds ratio 1.30, 95% CI: 1.03-1.64) and distant metastases (P < 0.0001, Odds ratio 44.6, 95% CI: 10.7-184.5) were significantly associated with the risk of developing biochemically or structurally incomplete statuses. Patients ≥ 55 years, tumors > 2.5 cm and presence of distant metastasis were associated with higher risk of incomplete response and death from DTC. However, when this analysis was performed on intermediate and high-risk groups separately, only age was consistently associated with risk of biochemically or structurally incomplete response in either and both groups. CONCLUSION: Age is a strong predictor of biochemically and structurally incomplete responses in patients with intermediate and high-risk DTC.
Authors: D P Byar; S B Green; P Dor; E D Williams; J Colon; H A van Gilse; M Mayer; R J Sylvester; M van Glabbeke Journal: Eur J Cancer Date: 1979-08 Impact factor: 9.162
Authors: Tae Hyuk Kim; Young Nam Kim; Hye In Kim; So Young Park; Jun-Ho Choe; Jung-Han Kim; Jee Soo Kim; Young Lyun Oh; Soo Yeon Hahn; Jung Hee Shin; Kyunga Kim; Jong Gill Jeong; Sun Wook Kim; Jae Hoon Chung Journal: Oral Oncol Date: 2017-06-10 Impact factor: 5.337