Outcomes of Patients with Differentiated Thyroid Cancer Risk-Stratified According to the American Thyroid Association and Latin American Thyroid Society Risk of Recurrence Classification Systems

Thyroid ◽  
2013 ◽  
Vol 23 (11) ◽  
pp. 1401-1407 ◽  
Author(s):  
Fabián Pitoia ◽  
Fernanda Bueno ◽  
Carolina Urciuoli ◽  
Erika Abelleira ◽  
Graciela Cross ◽  
...  
2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Andrea Repaci ◽  
Valentina Vicennati ◽  
Alexandro Paccapelo ◽  
Ottavio Cavicchi ◽  
Nicola Salituro ◽  
...  

Background. Stimulated thyroglobulin levels measured at the time of remnant ablation (A-hTg) and BRAFV600E mutation had shown prognostic value in predicting persistent disease in differentiated thyroid cancer (DTC). The aim of this study was to evaluate the prognostic role of A-hTg combined with the BRAFV600E status in association with the revised American Thyroid Association (ATA) risk stratification. Material and Methods. 620 patients treated for a DTC were included in this study with a median follow-up duration of 6.1 years. All patients underwent total thyroidectomy followed by radioiodine ablation. Patients with positive anti-thyroglobulin antibodies were excluded. The predictive value of A-hTg was calculated by receiver operating characteristic curve (ROC curve) analysis. The Cox proportional hazard regression model, including the BRAF status, A-hTg, and ATA classification system, was assessed to evaluate the existing persistent disease risk. Results. Taken together, the BRAF status and A-hTg levels improve the ATA risk classification in all categories. In particular, in the low-risk ATA classification, only the combination of BRAFV600E+A-hTg>8.9ng/ml was associated with persistent disease (P=0.001, HR 60.2, CI 95% 5.28-687). In the intermediate-risk ATA classification, BRAFWT+A-hTg>8.9ng/ml was associated with persistent disease (P=0.029, HR 2.71, CI 95% 1.106-6.670) and BRAFV600E+A-hTg>8.9ng/ml was also associated with persistent disease (P<0.001, HR 5.001, CI 95% 2.318-10.790). In the high-risk ATA classification, both BRAFV600E+A-hTg<8.9ng/ml and BRAFV600E+A-hTg>8.9 ng/ml were associated with persistent disease (P=0.042, HR 5.963, CI 95% 1.069-33.255 and P=0.002, HR 11.564, CI 95% 2.543-52.576, respectively). Conclusions. The BRAF status and stimulated thyroglobulin levels at ablation time improve the ATA risk stratification of differentiated thyroid cancer; therefore, even A-hTg could be included in risk classification factors.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Melanie Paquet ◽  
Dominique Baron-Dubourdieu ◽  
Pascal Guénel ◽  
Thérèse Truong

Abstract Background Aetiology of differentiated thyroid cancer is poorly understood. Among the risk factors strongly suspected to be involved in thyroid carcinogenesis are dietary factors. Recent evidence suggests polyphenols (i.e., natural bioactive compounds found in plant species), and their anticancer properties, may deserve closer epidemiological attention. Therefore, we examined the association between polyphenol intake levels and thyroid cancer risk in New Caledonia – a Pacific archipelago with some of the highest recorded thyroid cancer incidence rates in the world. Methods Food frequency questionnaire information from a population-based case-control study was used. Daily lignan and flavonoid intakes, expressed as aglycone equivalents, were estimated using Phenol-Explorer and relevant USDA databases. Unconditional logistic regression analyses were performed on data from 324 histologically confirmed cases of papillary or follicular carcinoma, diagnosed from 1993 to 1999, and 402 controls. Polyphenol intakes were analysed as both continuous and categorical variables (quartiles). Results Estimated median flavonoid and lignan intakes were 351.0 and 2.6 mg, respectively. When adjusting for sex, age, ethnic community, province of residence, BMI, smoking status, alcohol consumption and energy intake, no association with differentiated thyroid cancer risk was observed for flavonoids (OR = 1.06, 95% CI: 0.66, 1.70; comparing extreme quartiles), but a negative association was demonstrated for lignans (ORQ4vs.Q1=0.60, 95% CI: 0.37, 0.96; comparing extreme quartiles). Conclusions Our findings suggest that lignans may exert a protective effect on differentiated thyroid cancer. However, large-scale cohort studies and further analytical data on lignans are required to confirm this association. Key messages Lignans may play a role in thyroid carcinogenesis.


2014 ◽  
Vol 99 (10) ◽  
pp. E2084-E2092 ◽  
Author(s):  
Gisella Figlioli ◽  
Aleksandra Köhler ◽  
Bowang Chen ◽  
Rossella Elisei ◽  
Cristina Romei ◽  
...  

Author(s):  
Li Zhang ◽  
Jia Liu ◽  
Peisong Wang ◽  
Shuai Xue ◽  
Jie Li ◽  
...  

Gross strap muscle invasion (gSMI) in patients with differentiated thyroid cancer (DTC) was defined as high-risk recurrent group in the 2015 American Thyroid Association guidelines. However, controversy persists because several studies suggested gSMI had little effect on disease outcome. Herein, a systematic review and meta-analysis was conducted to investigate impact of gSMI on outcome of DTC. Methods: A systematic search of electronic databases (PubMed, EMBASE, Cochrane Library, and MEDLINE) for studies published until February 2020 was performed. Case-control studies and randomized controlled trials that studied the impact of gSMI on outcome of DTC were included. Results: Six studies (all retrospective studies) involving 13639 patients met final inclusion criteria. Compared with no extrathyroidal extension (ETE), patients with gSMI were associated with increased risk of recurrence (P=0.0004,OR, 1.46; 95% CI: 1.18 to 1.80) and lymph node metastasis (LNM) (P&lt;0.00001,OR 4.19;95% CI. 2.53 to 6.96). For mortality (P=0.34,OR 1.47;95% CI:0.67 to 3.25), ten-year disease-specific survival (P=0.80, OR 0.91;95% CI:0.44 to 1.88) and distant metastasis (DM) (P=0.21, OR 2.94;95% CI. 0.54 to 15.93), there was no significant difference between gSMI and no ETE group. In contrast with maximal ETE, patients with gSMI were associated with decreased risk of recurrence (P&lt;0.0001,OR, 0.58; 95% CI: 0.44 to 0.76) , mortality (P=0.0003,OR 0.20;95% CI:0.08 to 0.48), LNM (P=0.0003,OR 0.64;95% CI. 0.50 to 0.81) and DM (P=0.0009,OR 0.28;95% CI. 0.13 to 0.59). Conclusions: DTC patients with gSMI had a higher risk of recurrence and LNM than those without ETE. However, in contrast with maximal ETE, a much better prognosis was observed in DTC patients with only gSMI. The findings of our meta-analysis provide supportive evidence for the validity of the T category changes in the 8th edition American Joint Committee on Cancer system. The actual impact of gSMI should be re-evaluated and revised in the recurrent risk stratification system in the future.


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