Clinical outcome in differentiated thyroid carcinoma and microcarcinoma
| Autor: | Fiammetta Romano, Nunzia Verde, Livia Barba, Marco Milone, Giovanni Lupoli, Gelsy Arianna Lupoli, Maria Vastarella, Roberta Lupoli, Marianna Cacciapuoti, Anna Tortora, Francesco Fonderico, Stefania Masone |
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| Přispěvatelé: | Lupoli, Roberta, Cacciapuoti, Marianna, Tortora, Anna, Barba, Livia, Verde, N, Romano, F, Vastarella, M, Fonderico, F, Masone, S, Milone, Marco, Lupoli, Giovanni, Lupoli, Gelsy |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Iodine Radioisotopes Thyroid carcinoma Lesion Differentiated Thyroid carcinoma Recurrence Risk Factors medicine Humans Thyroid Neoplasms Lymph node Aged business.industry Incidence (epidemiology) Thyroid Thyroidectomy Lymphadenectomy General Medicine Middle Aged Prognosis Tumor Burden Surgery Dissection medicine.anatomical_structure Female Radiotherapy Adjuvant thyroid microcarcinoma Radiology Neoplasm Recurrence Local Radiopharmaceuticals medicine.symptom business Follow-Up Studies |
| Zdroj: | International Journal of Surgery. 12:S148-S151 |
| ISSN: | 1743-9191 |
| Popis: | INTRODUCTION: Due to the frequent use of neck ultrasonography, the incidence of differentiated thyroid microcarcinoma (DTMC), defined as a lesion with greatest dimension ≤1 cm, is increasing worldwide. Although DTMC generally has a lower aggressivity and a better prognosis than differentiated thyroid carcinoma (DTC), some cases of clinically aggressive DTMC were found. The aim of this study is to compare the rate of recurrence in DTMC and DTC, during a 3-year follow-up. METHODS: Patients with differentiated thyroid carcinoma, who underwent total thyroidectomy and postoperative (131)I-RAI ablation, were stratified according to lesion diameter (DTC for diameter > 1 cm or DTMC ≤ 1 cm). After surgery, patients underwent a 3-year follow-up. Recurrent disease was defined on the basis of positive biochemical (Tg > 2 ng/ml under TSH-suppression or after rhTSH-stimulation) and/or imaging (US, WBS, CT, PET/CT) findings. RESULTS: 449 patients have been included in the final analysis. Linfoadenectomy rate and RAI ablative dose were significantly higher in DTC than in DTMC (32.7% vs. 22.4%, p = 0.018 and 112.3 ± 21 vs. 68.3 ± 24.1 mCi, p < 0.001). During the follow-up, 50 carcinoma recurrences occurred, more frequent in DTC than in DTMC (15.6% vs. 7.6%, p = 0.010). After adjustment for gender, age, rate of lymph node dissection and 131I dose of RAI treatment, the difference in the risk of recurrence was no longer significant among DTC and DTMC patients (HR: 1.585, 95% CI 0874-2877, p = 0.130). CONCLUSIONS: The prediction of disease severity cannot be based exclusively on lesion diameter. A more careful therapeutic approach and follow-up should be recommended in DTMC patients. |
| Databáze: | OpenAIRE |
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