Risk Stratification of Neck Lesions Detected Sonographically During the Follow-Up of Differentiated Thyroid Cancer

Autor: Fabiana Trulli, Livia Lamartina, Cosimo Durante, Antonella Verrienti, Marianna Maranghi, Sebastiano Filetti, Stefania Lupo, Giuseppe Costante, Marco Biffoni, Laura Giacomelli, Giorgio Grani, Marialuisa Sponziello, Katia Plasmati
Rok vydání: 2016
Předmět:
Male
recurrent disease
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Clinical Biochemistry
persistent disease
thyroid bed
risk stratification
Biochemistry
0302 clinical medicine
Endocrinology
lymph nodes
Risk Factors
Thyroid Nodule
neck ultrasound
Thyroid cancer
Ultrasonography
Thyroid
Middle Aged
Treatment Outcome
medicine.anatomical_structure
Thyroid Cancer
Papillary
030220 oncology & carcinogenesis
Predictive value of tests
Disease Progression
Thyroidectomy
differentiated thyroid cancer
neck ultrasound
lymph nodes
thyroid bed
risk stratification
persistent disease
recurrent disease
Neck Dissection
Female
Risk Adjustment
Radiology
Adult
medicine.medical_specialty
Adolescent
Biopsy
Fine-Needle
differentiated thyroid cancer
030209 endocrinology & metabolism
Context (language use)
Young Adult
03 medical and health sciences
Predictive Value of Tests
Internal medicine
Carcinoma
medicine
Humans
Thyroid Neoplasms
Aged
Monitoring
Physiologic
Retrospective Studies
business.industry
Biochemistry (medical)
Neck dissection
Retrospective cohort study
medicine.disease
Carcinoma
Papillary
business
Neck
Zdroj: The Journal of Clinical Endocrinology & Metabolism. 101:3036-3044
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2016-1440
Popis: Context:The European Thyroid Association (ETA) has classified posttreatment cervical ultrasound findings in thyroid cancer patients based on their association with disease persistence/recurrence.Objective:The objective of the study was to assess this classification's ability to predict the growth and persistence of such lesions during active posttreatment surveillance of patients with differentiated thyroid cancer (DTC).Design:This was a retrospective, observational study.Setting:The study was conducted at a thyroid cancer center in a large Italian teaching hospital.Patients:Center referrals (2005–2014) were reviewed and patients selected with pathologically-confirmed DTC; total thyroidectomy, with or without neck dissection and/or radioiodine remnant ablation; abnormal findings on two or more consecutive posttreatment neck sonograms; and subsequent follow-up consisting of active surveillance. Baseline ultrasound abnormalities (thyroid bed masses, lymph nodes) were classified according to the ETA system. Patients were divided into group S (those with one or more lesions classified as suspicious) and group I (indeterminate lesions only). We recorded baseline and follow-up clinical data through June 30, 2015.Main Outcomes:The main outcomes were patients with growth (>3 mm, largest diameter) of one or more lesions during follow-up and patients with one or more persistent lesions at the final visit.Results:The cohort included 58 of the 637 DTC cases screened (9%). A total of 113 lesions were followed up (18 thyroid bed masses, 95 lymph nodes). During surveillance (median 3.7 y), group I had significantly lower rates than group S of lesion growth (8% vs 36%, P = .01) and persistence (64% vs 97%, P = .014). The median time to scan normalization was 2.9 years.Conclusions:The ETA's evidence-based classification of sonographically detected neck abnormalities can help identify papillary thyroid cancer patients eligible for more relaxed follow-up.
Databáze: OpenAIRE
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