Cargando…
Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital
BACKGROUND: The management of papillary thyroid carcinoma (PTC) in high-risk patients is well-standardized. However, this is not the case for low-risk patients. Filipinos show a high incidence of recurrence of thyroid cancer. Thus, the identification of risk factors for recurrence in this population...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Endocrine Society
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803546/ https://www.ncbi.nlm.nih.gov/pubmed/26676333 http://dx.doi.org/10.3803/EnM.2016.31.1.113 |
_version_ | 1782422882579644416 |
---|---|
author | Jauculan, Maria Cristina Magracia Buenaluz-Sedurante, Myrna Jimeno, Cecilia Alegado |
author_facet | Jauculan, Maria Cristina Magracia Buenaluz-Sedurante, Myrna Jimeno, Cecilia Alegado |
author_sort | Jauculan, Maria Cristina Magracia |
collection | PubMed |
description | BACKGROUND: The management of papillary thyroid carcinoma (PTC) in high-risk patients is well-standardized. However, this is not the case for low-risk patients. Filipinos show a high incidence of recurrence of thyroid cancer. Thus, the identification of risk factors for recurrence in this population could potentially identify individuals for whom radioactive iodine (RAI) therapy might be beneficial. METHODS: We reviewed the medical records of adult Filipinos with low-risk PTC who underwent near-total or total thyroidectomy at the University of the Philippines-Philippine General Hospital. Multivariate logistic regression analysis was used to determine risk factors for recurrence. RESULTS: Recurrence was documented in 51/145 of patients (35.17%) included in this study. Possible risk factors such as age, sex, family history, smoking history, tumor size, multifocality, prophylactic lymph node dissection, initial thyroglobulin (Tg) level, initial anti-thyroglobulin (anti-Tg) antibody concentration, suppression of thyroid stimulating hormone production, and RAI therapy were analyzed. Multivariate analysis revealed that a tumor diameter 2 to 4 cm (odds ratio [OR], 9.17; 95% confidence interval [CI], 1.62 to 51.88; P=0.012), a tumor diameter >4 cm (OR, 16.46; 95% CI, 1.14 to 237.31; P=0.04), and a family history of PTC (OR, 67.27; 95% CI, 2.03 to 2228.96; P=0.018) were significant predictors of recurrence. In addition, RAI therapy (OR, 0.026; 95% CI, 0.01 to 0.023; P≤0.005), an initial Tg level ≤2 ng/mL (OR, 0.049; 95% CI, 0.01 to 0.23; P≤0.005), and an anti-Tg antibody level ≤50 U/mL (OR, 0.087; 95% CI, 0.011 to 0.67; P=0.019) were significant protective factors. CONCLUSION: A tumor diameter ≥2 cm and a family history of PTC are significant predictors of recurrence. RAI therapy and low initial titers of Tg and anti-Tg antibody are significant protective factors against disease recurrence among low-risk PTC patients. |
format | Online Article Text |
id | pubmed-4803546 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-48035462016-03-27 Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital Jauculan, Maria Cristina Magracia Buenaluz-Sedurante, Myrna Jimeno, Cecilia Alegado Endocrinol Metab (Seoul) Original Article BACKGROUND: The management of papillary thyroid carcinoma (PTC) in high-risk patients is well-standardized. However, this is not the case for low-risk patients. Filipinos show a high incidence of recurrence of thyroid cancer. Thus, the identification of risk factors for recurrence in this population could potentially identify individuals for whom radioactive iodine (RAI) therapy might be beneficial. METHODS: We reviewed the medical records of adult Filipinos with low-risk PTC who underwent near-total or total thyroidectomy at the University of the Philippines-Philippine General Hospital. Multivariate logistic regression analysis was used to determine risk factors for recurrence. RESULTS: Recurrence was documented in 51/145 of patients (35.17%) included in this study. Possible risk factors such as age, sex, family history, smoking history, tumor size, multifocality, prophylactic lymph node dissection, initial thyroglobulin (Tg) level, initial anti-thyroglobulin (anti-Tg) antibody concentration, suppression of thyroid stimulating hormone production, and RAI therapy were analyzed. Multivariate analysis revealed that a tumor diameter 2 to 4 cm (odds ratio [OR], 9.17; 95% confidence interval [CI], 1.62 to 51.88; P=0.012), a tumor diameter >4 cm (OR, 16.46; 95% CI, 1.14 to 237.31; P=0.04), and a family history of PTC (OR, 67.27; 95% CI, 2.03 to 2228.96; P=0.018) were significant predictors of recurrence. In addition, RAI therapy (OR, 0.026; 95% CI, 0.01 to 0.023; P≤0.005), an initial Tg level ≤2 ng/mL (OR, 0.049; 95% CI, 0.01 to 0.23; P≤0.005), and an anti-Tg antibody level ≤50 U/mL (OR, 0.087; 95% CI, 0.011 to 0.67; P=0.019) were significant protective factors. CONCLUSION: A tumor diameter ≥2 cm and a family history of PTC are significant predictors of recurrence. RAI therapy and low initial titers of Tg and anti-Tg antibody are significant protective factors against disease recurrence among low-risk PTC patients. Korean Endocrine Society 2016-03 2016-03-16 /pmc/articles/PMC4803546/ /pubmed/26676333 http://dx.doi.org/10.3803/EnM.2016.31.1.113 Text en Copyright © 2016 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Jauculan, Maria Cristina Magracia Buenaluz-Sedurante, Myrna Jimeno, Cecilia Alegado Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title | Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title_full | Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title_fullStr | Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title_full_unstemmed | Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title_short | Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital |
title_sort | risk factors associated with disease recurrence among patients with low-risk papillary thyroid cancer treated at the university of the philippines-philippine general hospital |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803546/ https://www.ncbi.nlm.nih.gov/pubmed/26676333 http://dx.doi.org/10.3803/EnM.2016.31.1.113 |
work_keys_str_mv | AT jauculanmariacristinamagracia riskfactorsassociatedwithdiseaserecurrenceamongpatientswithlowriskpapillarythyroidcancertreatedattheuniversityofthephilippinesphilippinegeneralhospital AT buenaluzsedurantemyrna riskfactorsassociatedwithdiseaserecurrenceamongpatientswithlowriskpapillarythyroidcancertreatedattheuniversityofthephilippinesphilippinegeneralhospital AT jimenoceciliaalegado riskfactorsassociatedwithdiseaserecurrenceamongpatientswithlowriskpapillarythyroidcancertreatedattheuniversityofthephilippinesphilippinegeneralhospital |