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Recombinant human TSH versus thyroid hormone withdrawal in adjuvant therapy with radioactive iodine of patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central compartment (cN1b).
Arch Endocrinol Metab. 2017 Mar-Apr; 61(2):167-172.AE

Abstract

Objective

To compare the short- and long-term outcomes of adjuvant therapy with radioactive iodine (RAI) preceded by the administration of recombinant human TSH (rhTSH) versus thyroid hormone withdrawal (THW) in patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central neck compartment (cN1b).

Subjects and methods

The sample consisted of 178 cN1b patients at intermediate risk who underwent total thyroidectomy with apparently complete tumor resection [including postoperative ultrasonography (US) without anomalies] and who received adjuvant therapy with RAI (30-100 mCi) preceded by the administration of rhTSH (n = 91) or THW (n = 87).

Results

One year after RAI, the rates of excellent response to therapy, i.e., nonstimulated thyroglobulin (Tg) ≤ 0.2 ng/mL with negative antithyroglobulin antibodies and negative neck US, and of structural disease were similar for the two preparations (84% and 4.5%, respectively, in both groups). During follow-up (median 66 months), the rate of structural or biochemical (nonstimulated Tg > 1 ng/mL, with increment) recurrence was also similar in the two groups (4.5%). In the last assessment, the percentage of patients without evidence of disease, i.e., nonstimulated Tg < 1 ng/mL and no evidence of structural disease, was similar for the two preparations [92.3% in the rhTSH group and 97.7% in the THW group (p = 0.17)].

Conclusion

Preparation with rhTSH was equally effective (short- and long-term) as THW for adjuvant RAI therapy of cN1b patients at intermediate risk and with apparently complete tumor resection.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28226001

Citation

Rosario, Pedro Weslley, et al. "Recombinant Human TSH Versus Thyroid Hormone Withdrawal in Adjuvant Therapy With Radioactive Iodine of Patients With Papillary Thyroid Carcinoma and Clinically Apparent Lymph Node Metastases Not Limited to the Central Compartment (cN1b)." Archives of Endocrinology and Metabolism, vol. 61, no. 2, 2017, pp. 167-172.
Rosario PW, Mourão GF, Calsolari MR. Recombinant human TSH versus thyroid hormone withdrawal in adjuvant therapy with radioactive iodine of patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central compartment (cN1b). Arch Endocrinol Metab. 2017;61(2):167-172.
Rosario, P. W., Mourão, G. F., & Calsolari, M. R. (2017). Recombinant human TSH versus thyroid hormone withdrawal in adjuvant therapy with radioactive iodine of patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central compartment (cN1b). Archives of Endocrinology and Metabolism, 61(2), 167-172. https://doi.org/10.1590/2359-3997000000247
Rosario PW, Mourão GF, Calsolari MR. Recombinant Human TSH Versus Thyroid Hormone Withdrawal in Adjuvant Therapy With Radioactive Iodine of Patients With Papillary Thyroid Carcinoma and Clinically Apparent Lymph Node Metastases Not Limited to the Central Compartment (cN1b). Arch Endocrinol Metab. 2017 Mar-Apr;61(2):167-172. PubMed PMID: 28226001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recombinant human TSH versus thyroid hormone withdrawal in adjuvant therapy with radioactive iodine of patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central compartment (cN1b). AU - Rosario,Pedro Weslley, AU - Mourão,Gabriela Franco, AU - Calsolari,Maria Regina, Y1 - 2017/02/13/ PY - 2016/10/03/received PY - 2016/11/25/accepted PY - 2017/2/23/pubmed PY - 2017/9/7/medline PY - 2017/2/23/entrez SP - 167 EP - 172 JF - Archives of endocrinology and metabolism JO - Arch Endocrinol Metab VL - 61 IS - 2 N2 - Objective: To compare the short- and long-term outcomes of adjuvant therapy with radioactive iodine (RAI) preceded by the administration of recombinant human TSH (rhTSH) versus thyroid hormone withdrawal (THW) in patients with papillary thyroid carcinoma and clinically apparent lymph node metastases not limited to the central neck compartment (cN1b). Subjects and methods: The sample consisted of 178 cN1b patients at intermediate risk who underwent total thyroidectomy with apparently complete tumor resection [including postoperative ultrasonography (US) without anomalies] and who received adjuvant therapy with RAI (30-100 mCi) preceded by the administration of rhTSH (n = 91) or THW (n = 87). Results: One year after RAI, the rates of excellent response to therapy, i.e., nonstimulated thyroglobulin (Tg) ≤ 0.2 ng/mL with negative antithyroglobulin antibodies and negative neck US, and of structural disease were similar for the two preparations (84% and 4.5%, respectively, in both groups). During follow-up (median 66 months), the rate of structural or biochemical (nonstimulated Tg > 1 ng/mL, with increment) recurrence was also similar in the two groups (4.5%). In the last assessment, the percentage of patients without evidence of disease, i.e., nonstimulated Tg < 1 ng/mL and no evidence of structural disease, was similar for the two preparations [92.3% in the rhTSH group and 97.7% in the THW group (p = 0.17)]. Conclusion: Preparation with rhTSH was equally effective (short- and long-term) as THW for adjuvant RAI therapy of cN1b patients at intermediate risk and with apparently complete tumor resection. SN - 2359-4292 UR - https://www.unboundmedicine.com/medline/citation/28226001/Recombinant_human_TSH_versus_thyroid_hormone_withdrawal_in_adjuvant_therapy_with_radioactive_iodine_of_patients_with_papillary_thyroid_carcinoma_and_clinically_apparent_lymph_node_metastases_not_limited_to_the_central_compartment__cN1b__ L2 - https://core.ac.uk/reader/190765684?utm_source=linkout DB - PRIME DP - Unbound Medicine ER -