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Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity ¹³¹I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up.
J Clin Endocrinol Metab 2013; 98(7):2693-700JC

Abstract

BACKGROUND

No long-term follow-up data are available for differentiated thyroid carcinoma (DTC) patients prepared with either exogenous or endogenous TSH and treated with low-activity (1.1 GBq [30 mCi]) radioiodine (¹³¹I).

AIM

The aim of this study was to evaluate the 10-year follow-up of DTC patients who underwent remnant ablation with 1.1 GBq ¹³¹I after l-T4 withdrawal, recombinant human TSH (rhTSH) administration, or both.

PATIENTS

A total of 159 DTC patients treated with total thyroidectomy and 1.1 GBq (30 mCi) of ¹³¹I for remnant ablation and stimulated with rhTSH and/or endogenous TSH were separated into ablated (n = 115) and not ablated (n = 44) patients and prospectively followed-up for at least 10 years. In addition, we evaluated several features that could correlate with the final status of patients.

RESULTS

During the follow-up, 4 of 115 (3.5%) ablated patients showed a recurrence and 1 was successfully cured. Among not ablated patients, 16 of 44 (36.4%) had a persistent disease. At the end of the 10-year follow-up, 140 of 159 (88.1%) patients were disease-free, whereas 19 of 159 (11.9%) remained affected. No correlation was found with the type of TSH stimulation, and no other clinical and pathological features showed any correlation with the final status. However, low levels of stimulated serum thyroglobulin (<5.4 ng/mL) at first control after remnant ablation identified a subgroup of not ablated patients who became spontaneously cured.

CONCLUSIONS

Long-term outcomes are similar in DTC patients treated with 1.1 GBq (30 mCi) ¹³¹I and prepared either with rhTSH or endogenous TSH. It is of interest that serum thyroglobulin at first control after ablation can have a prognostic role.

Authors+Show Affiliations

Unit of Endocrinology, Department of Clinical and Experimental Medicine, World Health Organization Collaborating Center for the Study and Treatment of Thyroid Diseases and Other Endocrine and Metabolic Disorders, University of Pisa, 56100 Pisa, Italy.No 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23626005

Citation

Molinaro, Eleonora, et al. "Patients With Differentiated Thyroid Cancer Who Underwent Radioiodine Thyroid Remnant Ablation With Low-activity ¹³¹I After Either Recombinant Human TSH or Thyroid Hormone Therapy Withdrawal Showed the Same Outcome After a 10-year Follow-up." The Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 7, 2013, pp. 2693-700.
Molinaro E, Giani C, Agate L, et al. Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity ¹³¹I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up. J Clin Endocrinol Metab. 2013;98(7):2693-700.
Molinaro, E., Giani, C., Agate, L., Biagini, A., Pieruzzi, L., Bianchi, F., ... Elisei, R. (2013). Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity ¹³¹I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up. The Journal of Clinical Endocrinology and Metabolism, 98(7), pp. 2693-700. doi:10.1210/jc.2012-4137.
Molinaro E, et al. Patients With Differentiated Thyroid Cancer Who Underwent Radioiodine Thyroid Remnant Ablation With Low-activity ¹³¹I After Either Recombinant Human TSH or Thyroid Hormone Therapy Withdrawal Showed the Same Outcome After a 10-year Follow-up. J Clin Endocrinol Metab. 2013;98(7):2693-700. PubMed PMID: 23626005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity ¹³¹I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up. AU - Molinaro,Eleonora, AU - Giani,Carlotta, AU - Agate,Laura, AU - Biagini,Agnese, AU - Pieruzzi,Letizia, AU - Bianchi,Francesca, AU - Brozzi,Federica, AU - Ceccarelli,Claudia, AU - Viola,David, AU - Piaggi,Paolo, AU - Vitti,Paolo, AU - Pacini,Furio, AU - Elisei,Rossella, Y1 - 2013/04/26/ PY - 2013/4/30/entrez PY - 2013/4/30/pubmed PY - 2013/10/1/medline SP - 2693 EP - 700 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 98 IS - 7 N2 - BACKGROUND: No long-term follow-up data are available for differentiated thyroid carcinoma (DTC) patients prepared with either exogenous or endogenous TSH and treated with low-activity (1.1 GBq [30 mCi]) radioiodine (¹³¹I). AIM: The aim of this study was to evaluate the 10-year follow-up of DTC patients who underwent remnant ablation with 1.1 GBq ¹³¹I after l-T4 withdrawal, recombinant human TSH (rhTSH) administration, or both. PATIENTS: A total of 159 DTC patients treated with total thyroidectomy and 1.1 GBq (30 mCi) of ¹³¹I for remnant ablation and stimulated with rhTSH and/or endogenous TSH were separated into ablated (n = 115) and not ablated (n = 44) patients and prospectively followed-up for at least 10 years. In addition, we evaluated several features that could correlate with the final status of patients. RESULTS: During the follow-up, 4 of 115 (3.5%) ablated patients showed a recurrence and 1 was successfully cured. Among not ablated patients, 16 of 44 (36.4%) had a persistent disease. At the end of the 10-year follow-up, 140 of 159 (88.1%) patients were disease-free, whereas 19 of 159 (11.9%) remained affected. No correlation was found with the type of TSH stimulation, and no other clinical and pathological features showed any correlation with the final status. However, low levels of stimulated serum thyroglobulin (<5.4 ng/mL) at first control after remnant ablation identified a subgroup of not ablated patients who became spontaneously cured. CONCLUSIONS: Long-term outcomes are similar in DTC patients treated with 1.1 GBq (30 mCi) ¹³¹I and prepared either with rhTSH or endogenous TSH. It is of interest that serum thyroglobulin at first control after ablation can have a prognostic role. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/23626005/Patients_with_differentiated_thyroid_cancer_who_underwent_radioiodine_thyroid_remnant_ablation_with_low_activity_¹³¹I_after_either_recombinant_human_TSH_or_thyroid_hormone_therapy_withdrawal_showed_the_same_outcome_after_a_10_year_follow_up_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-4137 DB - PRIME DP - Unbound Medicine ER -