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Radioactive iodine (RAI) therapy for distantly metastatic differentiated thyroid cancer (DTC) in juvenile versus adult patients.
Endocr J. 2015; 62(12):1067-75.EJ

Abstract

In general, juvenile differentiated thyroid carcinoma (DTC) demonstrate indolent characteristics and favorable prognosis are observed in comparison with many other carcinomas. However, recurrence is frequent, necessitating additional treatment, including radioactive iodine (RAI) therapy. In this report, the probability of recurrence, prognostic factors, treatment, and outcomes in both juvenile- and adult-onset DTC were analyzed and compared. At our institution, a total of 1552 DTC patients underwent thyroidectomy and/or lymph node dissection. The patients included 23 in their teens, 118 in their twenties, and 1412 in their thirties or older. The risk factors for distant metastases for DTC were male gender, follicular carcinoma, size of the PTC primary tumor, cervical lymph node metastases from PTC, and the presence of more than two distant metastatic foci. Patients with the highest risk underwent RAI ablation in line with institutional guidelines. Although the overall outcome in our juvenile patients was excellent, during follow-up, 4 (17.4%) of the 23 patients developed recurrent disease: 91.3% achieved complete remission, 4.35% partial remission, and 4.35% stable disease, with no disease-related deaths. Among the 118 patients in their twenties to thirties, 1 (0.8%) experienced progressive disease and disease-related death. A younger age at diagnosis and less radical primary surgery without subsequent RAI ablation are factors strongly predictive of distant metastases in patients with juvenile-onset DTC. To reduce the rate of relapse and improve surveillance for recurrent disease, total thyroidectomy followed by RAI appears to be the most beneficial initial treatment for patients with high- and intermediate-risk juvenile DTC.

Authors+Show Affiliations

Department of Surgery, Kanaji Thyroid Hospital, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26424174

Citation

Kammori, Makoto, et al. "Radioactive Iodine (RAI) Therapy for Distantly Metastatic Differentiated Thyroid Cancer (DTC) in Juvenile Versus Adult Patients." Endocrine Journal, vol. 62, no. 12, 2015, pp. 1067-75.
Kammori M, Fukumori T, Sugishita Y, et al. Radioactive iodine (RAI) therapy for distantly metastatic differentiated thyroid cancer (DTC) in juvenile versus adult patients. Endocr J. 2015;62(12):1067-75.
Kammori, M., Fukumori, T., Sugishita, Y., Hoshi, M., Shimizu, K., & Yamada, T. (2015). Radioactive iodine (RAI) therapy for distantly metastatic differentiated thyroid cancer (DTC) in juvenile versus adult patients. Endocrine Journal, 62(12), 1067-75. https://doi.org/10.1507/endocrj.EJ15-0451
Kammori M, et al. Radioactive Iodine (RAI) Therapy for Distantly Metastatic Differentiated Thyroid Cancer (DTC) in Juvenile Versus Adult Patients. Endocr J. 2015;62(12):1067-75. PubMed PMID: 26424174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radioactive iodine (RAI) therapy for distantly metastatic differentiated thyroid cancer (DTC) in juvenile versus adult patients. AU - Kammori,Makoto, AU - Fukumori,Tatsuya, AU - Sugishita,Yoshiyuki, AU - Hoshi,Masae, AU - Shimizu,Kazuo, AU - Yamada,Tetsu, Y1 - 2015/10/01/ PY - 2015/10/2/entrez PY - 2015/10/2/pubmed PY - 2016/10/8/medline SP - 1067 EP - 75 JF - Endocrine journal JO - Endocr J VL - 62 IS - 12 N2 - In general, juvenile differentiated thyroid carcinoma (DTC) demonstrate indolent characteristics and favorable prognosis are observed in comparison with many other carcinomas. However, recurrence is frequent, necessitating additional treatment, including radioactive iodine (RAI) therapy. In this report, the probability of recurrence, prognostic factors, treatment, and outcomes in both juvenile- and adult-onset DTC were analyzed and compared. At our institution, a total of 1552 DTC patients underwent thyroidectomy and/or lymph node dissection. The patients included 23 in their teens, 118 in their twenties, and 1412 in their thirties or older. The risk factors for distant metastases for DTC were male gender, follicular carcinoma, size of the PTC primary tumor, cervical lymph node metastases from PTC, and the presence of more than two distant metastatic foci. Patients with the highest risk underwent RAI ablation in line with institutional guidelines. Although the overall outcome in our juvenile patients was excellent, during follow-up, 4 (17.4%) of the 23 patients developed recurrent disease: 91.3% achieved complete remission, 4.35% partial remission, and 4.35% stable disease, with no disease-related deaths. Among the 118 patients in their twenties to thirties, 1 (0.8%) experienced progressive disease and disease-related death. A younger age at diagnosis and less radical primary surgery without subsequent RAI ablation are factors strongly predictive of distant metastases in patients with juvenile-onset DTC. To reduce the rate of relapse and improve surveillance for recurrent disease, total thyroidectomy followed by RAI appears to be the most beneficial initial treatment for patients with high- and intermediate-risk juvenile DTC. SN - 1348-4540 UR - https://www.unboundmedicine.com/medline/citation/26424174/Radioactive_iodine__RAI__therapy_for_distantly_metastatic_differentiated_thyroid_cancer__DTC__in_juvenile_versus_adult_patients_ L2 - https://dx.doi.org/10.1507/endocrj.EJ15-0451 DB - PRIME DP - Unbound Medicine ER -