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Clinical outcome of low-risk differentiated thyroid cancer patients after radioiodine remnant ablation and recombinant human thyroid-stimulating hormone preparation.
Clin Oncol (R Coll Radiol) 2012; 24(3):162-8CO

Abstract

AIM

Recombinant human thyroid-stimulating hormone (rhTSH) has been approved in Europe as a preparation tool for radioiodine ablation of post-surgical thyroid remnants in patients with low-risk differentiated thyroid cancer (DTC). Published studies report that, both thyroid hormone withdrawal and rhTSH preparation result in similar rates of successful remnant ablation, but few studies have determined the effectiveness of rhTSH preparation on disease recurrence. We sought to determine the clinical outcome, considering both ablation success and disease recurrence, of low-risk DTC patients who underwent (131)I ablation.

MATERIALS AND METHODS

This retrospective study describes the clinical outcome of 100 patients treated with (131)I remnant ablation after preparation with rhTSH. After ablation, patients were classified as in complete remission, as having no evidence of persistent disease, or as having clinical recurrence on the basis of a subsequent diagnostic whole body scan with (131)I, stimulated thyroglobulin and cross-sectional imaging studies.

RESULTS

Overall assessment of ablation success was verified and obtained in 75% of patients (75/100). Considering only patients who underwent a diagnostic whole body scan and stimulated thyroglobulin without interfering anti-thyroglobulin antibody, complete ablation was obtained in 96% of patients (75/78). After a follow-up of about 4 years, 78 patients are in complete remission: 75 with initial ablation success and three who achieved a complete remission during subsequent follow-up. Among the remaining 22 patients, 21 have no clinical evidence of disease (NCED), indicating the inability to verify the complete remission or to detect residual disease, as in patients with positive thyroglobulin antibody, whereas one has persistent disease demonstrated only by stimulated thyroglobulin. No recurrences were observed. Of four patients initially classified as having persistent disease, one obtained a complete remission and two are now considered NCED.

CONCLUSION

Our data confirm the favourable outcome, with low rates of recurrence and persistent disease, of patients with low-risk DTC who underwent (131)I ablation after rhTSH. Moreover, our results compare favourably with those reported in the literature in patients prepared with rhTSH, but also in patients prepared with hormone withdrawal.

Authors+Show Affiliations

Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto-IRCCS, Via Gattamelata 64, Padua, Italy. federica.vianello@ioveneto.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21411300

Citation

Vianello, F, et al. "Clinical Outcome of Low-risk Differentiated Thyroid Cancer Patients After Radioiodine Remnant Ablation and Recombinant Human Thyroid-stimulating Hormone Preparation." Clinical Oncology (Royal College of Radiologists (Great Britain)), vol. 24, no. 3, 2012, pp. 162-8.
Vianello F, Mazzarotto R, Mian C, et al. Clinical outcome of low-risk differentiated thyroid cancer patients after radioiodine remnant ablation and recombinant human thyroid-stimulating hormone preparation. Clin Oncol (R Coll Radiol). 2012;24(3):162-8.
Vianello, F., Mazzarotto, R., Mian, C., Lora, O., Saladini, G., Servodio, O., ... Sotti, G. (2012). Clinical outcome of low-risk differentiated thyroid cancer patients after radioiodine remnant ablation and recombinant human thyroid-stimulating hormone preparation. Clinical Oncology (Royal College of Radiologists (Great Britain)), 24(3), pp. 162-8. doi:10.1016/j.clon.2011.02.011.
Vianello F, et al. Clinical Outcome of Low-risk Differentiated Thyroid Cancer Patients After Radioiodine Remnant Ablation and Recombinant Human Thyroid-stimulating Hormone Preparation. Clin Oncol (R Coll Radiol). 2012;24(3):162-8. PubMed PMID: 21411300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical outcome of low-risk differentiated thyroid cancer patients after radioiodine remnant ablation and recombinant human thyroid-stimulating hormone preparation. AU - Vianello,F, AU - Mazzarotto,R, AU - Mian,C, AU - Lora,O, AU - Saladini,G, AU - Servodio,O, AU - Basso,M, AU - Pennelli,G, AU - Pelizzo,M R, AU - Sotti,G, Y1 - 2011/03/15/ PY - 2010/11/30/received PY - 2010/12/27/revised PY - 2011/02/17/accepted PY - 2011/3/18/entrez PY - 2011/3/18/pubmed PY - 2012/7/11/medline SP - 162 EP - 8 JF - Clinical oncology (Royal College of Radiologists (Great Britain)) JO - Clin Oncol (R Coll Radiol) VL - 24 IS - 3 N2 - AIM: Recombinant human thyroid-stimulating hormone (rhTSH) has been approved in Europe as a preparation tool for radioiodine ablation of post-surgical thyroid remnants in patients with low-risk differentiated thyroid cancer (DTC). Published studies report that, both thyroid hormone withdrawal and rhTSH preparation result in similar rates of successful remnant ablation, but few studies have determined the effectiveness of rhTSH preparation on disease recurrence. We sought to determine the clinical outcome, considering both ablation success and disease recurrence, of low-risk DTC patients who underwent (131)I ablation. MATERIALS AND METHODS: This retrospective study describes the clinical outcome of 100 patients treated with (131)I remnant ablation after preparation with rhTSH. After ablation, patients were classified as in complete remission, as having no evidence of persistent disease, or as having clinical recurrence on the basis of a subsequent diagnostic whole body scan with (131)I, stimulated thyroglobulin and cross-sectional imaging studies. RESULTS: Overall assessment of ablation success was verified and obtained in 75% of patients (75/100). Considering only patients who underwent a diagnostic whole body scan and stimulated thyroglobulin without interfering anti-thyroglobulin antibody, complete ablation was obtained in 96% of patients (75/78). After a follow-up of about 4 years, 78 patients are in complete remission: 75 with initial ablation success and three who achieved a complete remission during subsequent follow-up. Among the remaining 22 patients, 21 have no clinical evidence of disease (NCED), indicating the inability to verify the complete remission or to detect residual disease, as in patients with positive thyroglobulin antibody, whereas one has persistent disease demonstrated only by stimulated thyroglobulin. No recurrences were observed. Of four patients initially classified as having persistent disease, one obtained a complete remission and two are now considered NCED. CONCLUSION: Our data confirm the favourable outcome, with low rates of recurrence and persistent disease, of patients with low-risk DTC who underwent (131)I ablation after rhTSH. Moreover, our results compare favourably with those reported in the literature in patients prepared with rhTSH, but also in patients prepared with hormone withdrawal. SN - 1433-2981 UR - https://www.unboundmedicine.com/medline/citation/21411300/Clinical_outcome_of_low_risk_differentiated_thyroid_cancer_patients_after_radioiodine_remnant_ablation_and_recombinant_human_thyroid_stimulating_hormone_preparation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0936-6555(11)00596-6 DB - PRIME DP - Unbound Medicine ER -