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Persistent and recurrent disease in patients with papillary thyroid carcinoma with clinically apparent (cN1), but not extensive, lymph node involvement and without other factors for poor prognosis.
Arch Endocrinol Metab. 2015 Aug; 59(4):285-91.AE

Abstract

OBJECTIVE

Lymph node metastases (LNM) are frequent in patients with papillary thyroid cancer (PTC). The risk of persistent disease (PD) and tumor recurrence (TR) is increased when factors for poor prognosis other than LNM exist, when LNM are numerous, large, detected by preoperative ultrasonography (US), or exhibit extranodal extension. This study evaluated the risk of PD and TR in patients with LNM not exhibiting these characteristics.

SUBJECTS AND METHODS

Eighty-six patients with 5 or fewer LNM detected during intraoperative inspection, but not by preoperative US, who had no other factors for poor prognosis [tumors > 4 cm, extensive extrathyroid invasion, vascular invasion, aggressive histological subtype, distant metastases, incomplete tumor resection], were studied. All patients underwent total thyroidectomy followed by radioiodine ablation. PD was defined as metastases on initial post-therapy whole-body scans (RxWBS) or detected by imaging methods up to 12 months after ablation. TR was defined as structural disease diagnosed more than one year after ablation in patients without PD.

RESULTS

PD was diagnosed in 3/86 patients (3.5%). TR was observed in 2/83 patients (2.5%) after 62 months of follow-up. There was no case of death due to the disease. A correlation was observed between pre-ablation Tg and PD or TR [1/48 (2%) with Tg ≤ 2 ng/mL versus 2/22 (9%) with Tg > 2 ≤ 10 ng/mL versus 2/7 (28.5%) with Tg ≥ 10 ng/ml)]. It is noteworthy that 38 patients had up to 3 positive LN and pre-ablation Tg ≤ 2 ng/ml, and none of them had PD or TR.

CONCLUSIONS

The frequency of PD and TR was low in patients with PTC with 5 or fewer LNM and without other factors for poor prognosis. Low postoperative stimulated Tg was predictive of the absence of PD and TR in these patients.

Authors+Show Affiliations

Santa Casa de Belo Horizonte, Belo Horizonte, MG, BR.Santa Casa de Belo Horizonte, Belo Horizonte, MG, BR.Santa Casa de Belo Horizonte, Belo Horizonte, MG, BR.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26331314

Citation

Furtado, Mariana de Souza, et al. "Persistent and Recurrent Disease in Patients With Papillary Thyroid Carcinoma With Clinically Apparent (cN1), but Not Extensive, Lymph Node Involvement and Without Other Factors for Poor Prognosis." Archives of Endocrinology and Metabolism, vol. 59, no. 4, 2015, pp. 285-91.
Furtado Mde S, Rosario PW, Calsolari MR. Persistent and recurrent disease in patients with papillary thyroid carcinoma with clinically apparent (cN1), but not extensive, lymph node involvement and without other factors for poor prognosis. Arch Endocrinol Metab. 2015;59(4):285-91.
Furtado, M. d. e. . S., Rosario, P. W., & Calsolari, M. R. (2015). Persistent and recurrent disease in patients with papillary thyroid carcinoma with clinically apparent (cN1), but not extensive, lymph node involvement and without other factors for poor prognosis. Archives of Endocrinology and Metabolism, 59(4), 285-91. https://doi.org/10.1590/2359-3997000000081
Furtado Mde S, Rosario PW, Calsolari MR. Persistent and Recurrent Disease in Patients With Papillary Thyroid Carcinoma With Clinically Apparent (cN1), but Not Extensive, Lymph Node Involvement and Without Other Factors for Poor Prognosis. Arch Endocrinol Metab. 2015;59(4):285-91. PubMed PMID: 26331314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent and recurrent disease in patients with papillary thyroid carcinoma with clinically apparent (cN1), but not extensive, lymph node involvement and without other factors for poor prognosis. AU - Furtado,Mariana de Souza, AU - Rosario,Pedro Weslley, AU - Calsolari,Maria Regina, PY - 2015/04/06/received PY - 2015/05/11/accepted PY - 2015/9/3/entrez PY - 2015/9/4/pubmed PY - 2017/8/2/medline SP - 285 EP - 91 JF - Archives of endocrinology and metabolism JO - Arch Endocrinol Metab VL - 59 IS - 4 N2 - OBJECTIVE: Lymph node metastases (LNM) are frequent in patients with papillary thyroid cancer (PTC). The risk of persistent disease (PD) and tumor recurrence (TR) is increased when factors for poor prognosis other than LNM exist, when LNM are numerous, large, detected by preoperative ultrasonography (US), or exhibit extranodal extension. This study evaluated the risk of PD and TR in patients with LNM not exhibiting these characteristics. SUBJECTS AND METHODS: Eighty-six patients with 5 or fewer LNM detected during intraoperative inspection, but not by preoperative US, who had no other factors for poor prognosis [tumors > 4 cm, extensive extrathyroid invasion, vascular invasion, aggressive histological subtype, distant metastases, incomplete tumor resection], were studied. All patients underwent total thyroidectomy followed by radioiodine ablation. PD was defined as metastases on initial post-therapy whole-body scans (RxWBS) or detected by imaging methods up to 12 months after ablation. TR was defined as structural disease diagnosed more than one year after ablation in patients without PD. RESULTS: PD was diagnosed in 3/86 patients (3.5%). TR was observed in 2/83 patients (2.5%) after 62 months of follow-up. There was no case of death due to the disease. A correlation was observed between pre-ablation Tg and PD or TR [1/48 (2%) with Tg ≤ 2 ng/mL versus 2/22 (9%) with Tg > 2 ≤ 10 ng/mL versus 2/7 (28.5%) with Tg ≥ 10 ng/ml)]. It is noteworthy that 38 patients had up to 3 positive LN and pre-ablation Tg ≤ 2 ng/ml, and none of them had PD or TR. CONCLUSIONS: The frequency of PD and TR was low in patients with PTC with 5 or fewer LNM and without other factors for poor prognosis. Low postoperative stimulated Tg was predictive of the absence of PD and TR in these patients. SN - 2359-4292 UR - https://www.unboundmedicine.com/medline/citation/26331314/Persistent_and_recurrent_disease_in_patients_with_papillary_thyroid_carcinoma_with_clinically_apparent__cN1__but_not_extensive_lymph_node_involvement_and_without_other_factors_for_poor_prognosis_ L2 - https://medlineplus.gov/thyroidcancer.html DB - PRIME DP - Unbound Medicine ER -