The Frequency of Differentiated Thyroid Cancer Recurrence in 2302 Patients With Excellent Response to Primary Therapy.

Autor:	Pałyga I; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland., Rumian M; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland., Kosel A; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland., Albrzykowski M; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland., Krawczyk P; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland., Kalwat A; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland., Gąsior-Perczak D; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland., Walczyk A; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland., Kuchareczko A; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland., Kopczyński J; Department of Pathology, Holycross Cancer Centre, Kielce 25-734, Poland., Chrapek M; Department of Mathematics, Faculty of Natural Sciences, Jan Kochanowski University, Kielce 25-406, Poland., Góźdź S; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Department of Clinical Oncology, Holycross Cancer Centre, Kielce 25-734, Poland., Kowalska A; Collegium Medicum, Jan Kochanowski University, Kielce 25-317, Poland.; Endocrinology Clinic, Holycross Cancer Centre, Kielce 25-734, Poland.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Jan 18; Vol. 109 (2), pp. e569-e578.
DOI:	10.1210/clinem/dgad571
Abstrakt:	Context: Discrepant data on the recurrence rate of differentiated thyroid cancer (DTC) are reported. Objective: To evaluate the frequency and risk factors of true recurrence in DTC patients with excellent responses (ExR) to initial therapy. Methods: A retrospective analysis of the 2302 consecutive DTC patients with ExR to primary therapy, treated during 24 years at single center. The percentage of recurrence and cumulative recurrence rate (CRR) were analyzed. Risk factors for recurrence for patients with papillary thyroid cancer (PTC) were investigated and methods for establishing a diagnosis of recurrence were evaluated. Results: Of DTC patients, 32 (1.4%) experienced recurrence. PTC patients with recurrence were more likely to have younger age (P = .0182), larger tumor size (P = .0013), lymph node metastases (P = .0013), incomplete resection (P = .0446), higher ATA risk (P = .0002), and had more frequently been treated with 131I (P = .0203). CRRs at 5, 10, 15, 20, and 24 years after surgery were 1.2%, 1.9%, 2.5%, 2.9%, and 2.9%, respectively. The CRRs according to histological type were highest for poorly differentiated thyroid cancer (PDTC), lower for oncocytic (OTC) and follicular thyroid cancer (FTC), and lowest for PTC. Most recurrences occurred within the first 5 years of observation. The most effective method for detecting local recurrence was ultrasonography with fine needle aspiration cytology, and for distant metastases, 18F-FDG PET. Conclusion: True recurrence is rare in DTC patients. PTC patients with ExR to primary therapy and N0/Nx can be dismissed from oncological follow-up. Despite ExR to primary therapy, DTC patients with N1, and PDTC, OTC, FTC should remain under oncological follow-up. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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