Long-term follow-up of patients with papillary and follicular thyroid cancer : a prospective study on 715 patients
| Autor: | Brassard, M., Borget, I., Edet-Sanson, A., Corrone, C., Mundler, O., Toubeau, M., Bonichon, F., Borson-Chazo, F., Leenhardt, C., Schvartz, C., Dejax, C., Brenot-Rossi, I., Toubert, Me, Torlontano, M., Benhamou, E., Schlumberger, M., Working Group, Thyrdiag |
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| Přispěvatelé: | Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Service de médecine nucléaire [Marseille], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Plateforme de génétique moléculaire des cancers d'Aquitaine, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), FRANCIM, Réseau des registres français du cancer, Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy (IGR), QUANTIF LITIS, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), Equipe 4, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Groupement hospitalier lyon Est (Hospices Civils de Lyon), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de médecine nucléaire [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
MESH: Combined Modality Therapy Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Thyrotropin Carcinoma Papillary Follicular Biochemistry Cohort Studies Iodine Radioisotopes 0302 clinical medicine Endocrinology MESH: Aged 80 and over MESH: Autoantibodies Prospective Studies Prospective cohort study Thyroid cancer MESH: Cohort Studies ComputingMilieux_MISCELLANEOUS MESH: Treatment Outcome Aged 80 and over MESH: Aged MESH: Thyroglobulin MESH: Middle Aged MESH: Hormone Replacement Therapy Thyroid MESH: Iodine Radioisotopes MESH: Follow-Up Studies Middle Aged Combined Modality Therapy MESH: Carcinoma Papillary Follicular MESH: Predictive Value of Tests 3. Good health Treatment Outcome medicine.anatomical_structure MESH: Thyroid Neoplasms MESH: Young Adult 030220 oncology & carcinogenesis Predictive value of tests MESH: Thyrotropin Thyroidectomy Female MESH: Neoplasm Recurrence Local medicine.drug Adult medicine.medical_specialty endocrine system Adolescent Hormone Replacement Therapy Levothyroxine 030209 endocrinology & metabolism [SDV.CAN]Life Sciences [q-bio]/Cancer Thyroglobulin MESH: Thyroidectomy Young Adult 03 medical and health sciences Predictive Value of Tests Internal medicine medicine Humans Thyroid Neoplasms Follicular thyroid cancer Aged Autoantibodies MESH: Adolescent MESH: Humans business.industry MESH: Lymph Node Excision Biochemistry (medical) MESH: Adult MESH: Thyroxine medicine.disease MESH: Male MESH: Prospective Studies Thyroxine Lymph Node Excision Neoplasm Recurrence Local business MESH: Female Follow-Up Studies |
| Zdroj: | Journal of Clinical Endocrinology and Metabolism Journal of Clinical Endocrinology and Metabolism, 2011, 96 (5), pp.1352-1359 14th International Thyroid Congress 14th International Thyroid Congress, Sep 2010, Paris, France. pp.1352-9, ⟨10.1210/jc.2010-2708⟩ Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2011, 96 (5), pp.1352-9. ⟨10.1210/jc.2010-2708⟩ Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2011, 96 (5), pp.1352-1359 Journal of Clinical Endocrinology and Metabolism, 2011, 96 (5), pp.1352-9. ⟨10.1210/jc.2010-2708⟩ |
| ISSN: | 0021-972X 1945-7197 |
| DOI: | 10.1210/jc.2010-2708⟩ |
| Popis: | International audience; PURPOSE: This prospective study evaluated the recurrence rate in 715 patients with differentiated thyroid cancer who had no evidence of persistent disease after total thyroidectomy and lymph node dissection in 94% of them followed up by radioiodine ablation (30-100 mCi) and assessed the predictive value of the initial thyroglobulin (Tg) levels for detecting recurrence, both during levothyroxine (LT4) treatment and after TSH stimulation. PATIENTS AND METHODS: Patients had Tg determinations performed at 3 months on LT4 treatment (Tg1) and at 9-12 months after stimulation by either thyroid hormone withdrawal or recombinant human TSH (Tg2); the Access kit was used (functional sensitivity of 0.11 ng/ml); they had undetectable anti-Tg antibodies. Patients were followed up annually. Predictive values were calculated by comparing Tg levels (Tg1 and Tg2) and the outcome in terms of recurrence. RESULTS: During the median follow-up of 6.2 yr, 32 patients had a recurrence. Assuming a cutoff level for Tg1 at 0.27 ng/ml, Tg1 sensitivity and specificity reached 72 and 86%, respectively, whereas predictive positive and negative values were 20 and 99%, respectively. With a cutoff level for Tg2 at 1.4 ng/ml, sensitivity and specificity reached 78 and 90%, respectively, whereas positive and negative predictive values were 26 and 99%, respectively. CONCLUSION: This large prospective cohort of patients presented a low rate of recurrence. Initial Tg measurements allow to predict long-term recurrence with an excellent specificity. Stimulated Tg determination presented a slightly higher sensitivity than Tg determination on LT4. TSH stimulation may be avoided when Tg measured 3 months after ablation is less than 0.27 ng/ml during LT4 treatment. |
| Databáze: | OpenAIRE |
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