Age, thyroglobulin levels and ATA risk stratification predict 10-year survival rate of differentiated thyroid cancer patients

Autor: Kelly, Antony, Barres, Bertrand, Kwiatkowski, Fabrice, Batisse-Lignier, Marie, Aubert, Bernadette, Valla, Clémence, Somda, Frédéric, Cachin, Florent, Tauveron, Igor, Maqdasy, Salwan
Přispěvatelé: Bodescot, Myriam, Service de médecine nucléaire [Clermont-Ferrand], Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER-UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Département de recherche clinique [Clermont-Ferrand], Service d'endocrinologie, diabétologie et maladies métaboliques [Clermont-Ferrand], CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Faculté de Médecine - Clermont-Auvergne (FM - UCA), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Cancer Treatment
Thyroid Gland
Biochemistry
Lung and Intrathoracic Tumors
Iodine Radioisotopes
Thymic Tumors
Medicine and Health Sciences
Postoperative Period
Endocrine Tumors
Thyroid
[SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism
Age Factors
Middle Aged
[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism
Prognosis
Survival Rate
Treatment Outcome
Oncology
Preoperative Period
Thyroidectomy
Medicine
Female
Anatomy
Research Article
Adult
Endocrine System Procedures
Science
Endocrine System
Surgical and Invasive Medical Procedures
[SDV.CAN]Life Sciences [q-bio]/Cancer
Thyroglobulin
Carcinomas
Risk Assessment
Lymphatic System
[SDV.CAN] Life Sciences [q-bio]/Cancer
Diagnostic Medicine
Humans
Thyroid Neoplasms
Retrospective Studies
Biology and Life Sciences
Proteins
Cancers and Neoplasms
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Radiotherapy
Adjuvant
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Thyroid Carcinomas
Lymph Nodes
Follow-Up Studies
Zdroj: PLoS ONE, Vol 14, Iss 8, p e0221298 (2019)
PLoS ONE
PLoS ONE, 2019, 14 (8), pp.e0221298. ⟨10.1371/journal.pone.0221298⟩
PLoS ONE, Public Library of Science, 2019, 14 (8), pp.e0221298. ⟨10.1371/journal.pone.0221298⟩
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0221298⟩
Popis: IntroductionDifferentiated thyroid cancer (DTC) is the most common of endocrine cancers. Many studies have focused on recurrence-free survival of DTC patients, however, few studies have addressed overall survival rates. Given its very good prognosis, estimating overall or long-term survival in patients with DTC seems rational. So far, neither the impact of pre- and post-ablation thyroglobulin, nor that of initial American Thyroid Association (ATA) risk stratification on long-term disease-specific survival, have been sufficiently studied.ObjectiveThe aim of this study was to determine the factors that influence long-term disease-specific survival and thyroglobulin levels in patients with DTC who have been previously treated with thyroidectomy and radioactive iodine (RAI) remnant ablation.Patients and methodsThis observational retrospective study included 1093 patients who were treated for DTC between 1995 and 2010 and are still monitored in our tertiary center. Only patients who needed RAI ablation after thyroidectomy were included in this study. Patients who were treated with RAI following rhTSH stimulation, patients who presented positive anti-thyroglobulin antibodies, and patients who had micro-cancers were excluded. Pre-ablation stimulated thyroglobulin (Pre-ablation sTg) was measured after thyroid hormone withdrawal (THW), just before RAI.ResultsAccording to ATA standards, 29 patients (2.7%) were classified as high-risk patients. Initial ATA high-recurrence risk rating (HR 21.9; 95% CI: 8.5-56.3), age>55 years (HR 23.8; 95%-CI: 7.5-75.3) and pre-ablation sTg≥30 μg/l (HR 8.4; 95% CI: 4.6-15.3) significantly impacted ten-year survival. Moreover, age over 45 years, ATA moderate-risk and follicular DTC were also significant. Ten-year survival was lower in ATA high-risk patients (51% vs 95% and 93% for the low and intermediate risk; pConclusionInitial ATA high-risk classification, age over 55 years old and pre-ablation sTg ≥30 μg/l are the main negative factors that influence the ten-year survival in DTC. We suggest three categories of overall survival rates. Patients older than 55 years with pre-ablation sTg ≥30 μg/l have the worst survival rate.
Databáze: OpenAIRE
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