Persistent and recurrent disease in patients with papillary thyroid carcinoma with clinically apparent (cN1), but not extensive, lymph node involvement and without other factors for poor prognosis

Autor: Pedro Weslley Rosario, Mariana Souza Furtado, Maria Regina Calsolari
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
Time Factors
preoperative ultrasonography
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
persistent or recurrent disease
lcsh:Medicine
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Gastroenterology
Papillary thyroid cancer
Iodine Radioisotopes
Risk Factors
Young adult
Child
Lymph node
Thyroid cancer
Middle Aged
Prognosis
Treatment Outcome
medicine.anatomical_structure
Thyroid Cancer
Papillary
Lymphatic Metastasis
Thyroidectomy
Female
lymph node metastases
Adult
medicine.medical_specialty
Adolescent
Thyroid carcinoma
Young Adult
Internal medicine
medicine
Carcinoma
Humans
Thyroid Neoplasms
Aged
lcsh:RC648-665
business.industry
lcsh:R
medicine.disease
Carcinoma
Papillary
Surgery
Radiation therapy
Radiotherapy
Adjuvant
Lymph Nodes
Neoplasm Recurrence
Local
business
Zdroj: Archives of Endocrinology and Metabolism, Volume: 59, Issue: 4, Pages: 285-291, Published: AUG 2015
Archives of Endocrinology and Metabolism, Vol 59, Iss 4, Pp 285-291
Archives of Endocrinology and Metabolism v.59 n.4 2015
Arquivos de Endocrinologia e Metabolismo
Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)
instacron:SBEM
Popis: Objective Lymph node metastases (LNM) are frequent in patients with papillary thyroid cancer (PTC). The risk of persistent disease (PD) and tumor recurrence (TR) is increased when factors for poor prognosis other than LNM exist, when LNM are numerous, large, detected by preoperative ultrasonography (US), or exhibit extranodal extension. This study evaluated the risk of PD and TR in patients with LNM not exhibiting these characteristics.Subjects and methods Eighty-six patients with 5 or fewer LNM detected during intraoperative inspection, but not by preoperative US, who had no other factors for poor prognosis [tumors > 4 cm, extensive extrathyroid invasion, vascular invasion, aggressive histological subtype, distant metastases, incomplete tumor resection], were studied. All patients underwent total thyroidectomy followed by radioiodine ablation. PD was defined as metastases on initial post-therapy whole-body scans (RxWBS) or detected by imaging methods up to 12 months after ablation. TR was defined as structural disease diagnosed more than one year after ablation in patients without PD.Results PD was diagnosed in 3/86 patients (3.5%). TR was observed in 2/83 patients (2.5%) after 62 months of follow-up. There was no case of death due to the disease. A correlation was observed between pre-ablation Tg and PD or TR [1/48 (2%) with Tg ≤ 2 ng/mL versus 2/22 (9%) with Tg > 2 ≤ 10 ng/mL versus 2/7 (28.5%) with Tg ≥ 10 ng/ml)]. It is noteworthy that 38 patients had up to 3 positive LN and pre-ablation Tg ≤ 2 ng/ml, and none of them had PD or TR.Conclusions The frequency of PD and TR was low in patients with PTC with 5 or fewer LNM and without other factors for poor prognosis. Low postoperative stimulated Tg was predictive of the absence of PD and TR in these patients.
Databáze: OpenAIRE
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