scholarly journals TERT promoter mutations and long-term survival in patients with thyroid cancer

2016 ◽  
Vol 23 (10) ◽  
pp. 813-823 ◽  
Author(s):  
Tae Hyuk Kim ◽  
Young-Eun Kim ◽  
Soomin Ahn ◽  
Ji-Youn Kim ◽  
Chang-Seok Ki ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Survival Rate ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer ◽  
Promoter Mutation ◽  
Papillary Cancer ◽  
Term Survival ◽  
Extrathyroidal Invasion ◽  
Mutational Status ◽  
Promoter Mutations

TERT promoter mutations are emerging prognostic biomarkers in multiple cancers and are found in highly aggressive thyroid cancer. Our aim is to investigate the prognostic value of these mutations for the outcome of thyroid cancer-related mortality in a large cohort of thyroid cancer patients. This was a retrospective study of 409 patients (393 with differentiated thyroid cancer) with a median age of 44 years (range 16–81 years) and median follow-up of 13 years (interquartile range 11–16 years). Analyses of associations between mutational status and various clinicopathological variables were performed. TERT promoter mutations were identified in 32 (9.8%) papillary, 11 (16.7%) follicular and seven (43.8%) poorly differentiated/anaplastic thyroid cancer patients. The presence of TERT promoter mutations was associated with factors such as increased age (P < 0.001), extrathyroidal invasion (P = 0.01), increased stage at diagnosis (P < 0.001) and dedifferentiated histological type (P = 0.001). A TERT promoter mutation was independently associated with poorer overall survival in patients with differentiated thyroid cancer (10-year survival rate, 66.2% vs 98.3% for wild type; adjusted HR, 7.18; 95% CI: 2.77–18.59) and in patients with papillary cancer (74.2% vs 99.3%; 14.20; 3.03–66.68). Concomitant TERT and BRAF mutations worsened the survival rate of patients with papillary cancer (82.6% vs 99.4% for exclusively BRAF mutation alone; 5.62; 1.85–17.09). In conclusion, the presence of TERT promoter mutations is independently associated with increased mortality in patients with differentiated thyroid cancer. The results suggest that inclusion of TERT promoter mutation analysis with conventional clinicopathological evaluation can lead to better prognostication and management for individual patients.

scholarly journals Proposal of a New Prognostic Model for Differentiated Thyroid Cancer with TERT Promoter Mutations

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2943
Author(s):  
Jun Park ◽  
Sungjoo Lee ◽  
Jiyun Park ◽  
Hyunju Park ◽  
Chang-Seok Ki ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Cox Regression ◽  
Term Survival ◽  
Poor Prognostic Factor ◽  
Prognostic System ◽  
Tert Promoter ◽  
Mutational Status ◽  
Tert Promoter Mutations ◽  
Promoter Mutations

The role of telomerase reverse transcriptase (TERT) promoter mutations as an independent poor prognostic factor in differentiated thyroid cancer (DTC) patients is well known, but there is no prognostic system that combines the TERT promoter mutation status with tumor-node-metastasis (TNM) stage to predict cancer-specific survival (CSS). A total of 393 patients with pathologically confirmed DTC after thyroidectomy were enrolled. After incorporating wild-type TERT and mutant TERT with stages I, II, and III/IV of the AJCC TNM system 8th edition (TNM-8), we generated six combinations and calculated 10-year and 15-year CSS and adjusted hazard ratios (HRs) for cancer-related death using Cox regression. Then, a new mortality prediction model termed TNM-8T was derived based on the CSS and HR of each combination in the four groups. Of the 393 patients, there were 27 (6.9%) thyroid cancer-related deaths during a median follow-up of 14 years. Patients with a more advanced stage had a lower survival rate (10-year CSS for TNM-8T stage 1, 2, 3, and 4: 98.7%, 93.5%, 77.3%, and 63.0%, respectively; p < 0.001). TNM-8T showed a better spread of CSS (p < 0.001) than TNM-8 (p = 0.002) in the adjusted survival curves. The C-index for mortality risk predictability was 0.880 (95% CI, 0.665–0.957) in TNM-8T and 0.827 (95% CI, 0.622–0.930) in TNM-8 (p < 0.001). TNM-8T, a new prognostic system that incorporates the TERT mutational status into TNM-8, showed superior predictability to TNM-8 in the long-term survival of DTC patients.

scholarly journals Age, thyroglobulin levels and ATA risk stratification predict 10-year survival rate of differentiated thyroid cancer patients

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0221298 ◽  
Author(s):  
Antony Kelly ◽  
Bertrand Barres ◽  
Fabrice Kwiatkowski ◽  
Marie Batisse-Lignier ◽  
Bernadette Aubert ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Survival Rate ◽  
Risk Stratification ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer

Impact of age at the diagnosis of radioiodine resistance in differentiated thyroid cancer patients

2019 ◽  
Author(s):  
Clotilde Saie ◽  
Johanna Wassermann ◽  
Elise Mathy ◽  
Sophie Tezenas ◽  
Nathalie Chereau ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer

scholarly journals Is prophylactic central neck dissection necessary for cN0 differentiated thyroid cancer patients at initial treatment? A meta-analysis of the literature

2017 ◽  
Vol 37 (1) ◽  
pp. 1-8
Author(s):  
J. Liang ◽  
Z. Li ◽  
F. Fang ◽  
T. Yu ◽  
C. Leone
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer ◽  
Web Of Science ◽  
Meta Analysis ◽  
Central Neck Dissection ◽  
Cochrane Library ◽  
Central Neck ◽  
Sono Stati ◽  
Prophylactic Central Neck Dissection

Le metastasi ai linfonodi del compartimento centrale del collo sono comuni nei pazienti affetti da carcinoma differenziato della tiroide (DTC). La gestione dei pazienti con stadiazione preoperatoria cN0 è ancora dibattuta. L’obiettivo di questo lavoro è stato quello di analizzare le differenze in merito a ricorrenza e complicanze chirurgiche tra tiroidectomia (TT) isolata e TT associata a svuotamento linfonodale profilattico del compartimento centrale del collo (pCND) come trattamenti iniziali di pazienti con DTC cN0, e di valutare l’importanza clinica del pCND per questi pazienti. I database PubMed, Ovid, Cochrane Library e Web of Science sono stati analizzati scrupolosamente, e sono stati identificati ventitré articoli per un totale di 6823 pazienti. La qualità di evidenza è stata valutata tramite lo score di Jadad e tramite la Newcastle-Ottawa Quality assessment scale. I risultati hanno mostrato che i pazienti sottoposti a TT e pCND, se paragonati ai pazienti sottoposti a TT isolata, hanno avuto un tasso significativamente più alto di lesioni transitorie del nervo laringeo inferiore (p = 0,023), di ipocalcemia transitoria (p < 0,01) e di ipocalcemia permanente (p < 0,01). Inoltre è stato rilevato un trend in diminuzione per quel che riguarda il tasso di ricorrenza nei pazienti sottoposti a TT e pCND (p < 0,01). La tiroidectomia totale associata allo svuotamento del compartimento centrale del collo come trattamento iniziale per quei pazienti con cN0 potrebbe ridurre il rischio di ricorrenza di malattia, ma aumenta l’incidenza di alcune complicanze. Si rendono necessari ulteriori studi di maggior qualità metodologica.

Lowest effective 131I activity for thyroid remnant ablation of differentiated thyroid cancer patients

2015 ◽  
Vol 54 (03) ◽  
pp. 137-143 ◽  
Author(s):  
A.-S. Moldovan ◽  
M. Ruhlmann ◽  
R. Görges ◽  
A. Bockisch ◽  
S. Rosenbaum-Krumme ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer ◽  
Absorbed Dose ◽  
Thyroid Remnant ◽  
Remnant Ablation ◽  
Dose Threshold ◽  
131I Activity ◽  
Pet Ct ◽  
Absorbed Radiation Dose

SummaryAim: A theoretical dosimetry-based model was applied to estimate the lowest effective radioiodine activity for thyroid remnant ablation of low-risk differentiated thyroid cancer patients. Patients, methods: The model is based on the distribution of the absorbed (radiation) dose per administered radioiodine activity and the absorbed dose threshold of 300 Gy for thyroid remnants, the level believed to destroy most thyroid remnants. For this purpose, 124I PET/CT images of 49 thyroid-ectomised patients were retrospectively analysed to measure the distribution of the (average) absorbed doses to thyroid remnant per administered 131I activity. The fraction of thyroid remnants that received at least 300 Gy was determined for standard activities between 0.37 and 5.55 GBq. The lower activity was considered to be equally effective to that obtained with higher activity if the (absolute) fraction difference was below 5%. Results: A total of 62 thyroid remnants were included. The medians and ranges (in parentheses) for the absorbed dose per unit 131I activity were 359 Gy/GBq (34 to 1825 Gy/ GBq). The fractions of thyroid remnants receiving more than 300 Gy at different therapy activities (within parentheses) were 60% (1.11 GBq), 76% (1.85 GBq), 79% (2.22 GBq), and 81–82% for activities between 2.59 and 3.70 GBq. The therapy activity of 1.11 GBq is considerably less effective than that of 1.85 or 2.22 GBq; therapy activities were equally effective in the range between 2.22 to 3.70 GBq. Conclusion: On the basis of the model and the patients' data included, the lowest effective therapy activity appears to be approximately 2.2 GBq to ablate thyroid remnants. The results of this study may help to guide the design of prospective clinical studies.

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