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Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases

OBJECTIVE: Radioactive iodine (RAI) therapy is effective for differentiated thyroid cancer (DTC) patients with lung metastasis. However, some patients have a poor prognosis despite the RAI accumulation. The utility of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), has been...

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Autores principales: Ohkuwa, Keiko, Sugino, Kiminori, Nagahama, Mitsuji, Kitagawa, Wataru, Matsuzu, Kenichi, Suzuki, Akifumi, Tomoda, Chisato, Hames, Kiyomi, Akaishi, Junko, Masaki, Chie, Ito, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346177/
https://www.ncbi.nlm.nih.gov/pubmed/34223823
http://dx.doi.org/10.1530/EC-21-0215
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author Ohkuwa, Keiko
Sugino, Kiminori
Nagahama, Mitsuji
Kitagawa, Wataru
Matsuzu, Kenichi
Suzuki, Akifumi
Tomoda, Chisato
Hames, Kiyomi
Akaishi, Junko
Masaki, Chie
Ito, Koichi
author_facet Ohkuwa, Keiko
Sugino, Kiminori
Nagahama, Mitsuji
Kitagawa, Wataru
Matsuzu, Kenichi
Suzuki, Akifumi
Tomoda, Chisato
Hames, Kiyomi
Akaishi, Junko
Masaki, Chie
Ito, Koichi
author_sort Ohkuwa, Keiko
collection PubMed
description OBJECTIVE: Radioactive iodine (RAI) therapy is effective for differentiated thyroid cancer (DTC) patients with lung metastasis. However, some patients have a poor prognosis despite the RAI accumulation. The utility of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), has been reported as a prognostic factor for many carcinomas. This study aimed to investigate the risk factors related to DTC patient survival with RAI-avid lung metastasis and to attempt risk stratification. DESIGN AND METHODS: This retrospective study included 123 patients with RAI-accumulating lung metastatic DTC. The cause-specific survival (CSS) rate from the time of detection of lung metastasis was tested using the Kaplan–Meier log-rank test, and the multivariate analysis was calculated using the Cox proportional hazards model. NLR was retrospectively calculated using the blood sample collected before initial RAI treatment. The NLR cutoff value was 2.6 on the ROC curve. RESULTS: Age ≥ 55 years at the time of operative treatment, follicular carcinoma, lung metastasis tumor ≥ 10 mm in diameter, age ≥ 55 years at the time of detection of lung metastasis, age ≥ 55 years at the time of RAI treatment, and NLR ≥ 2.6 at the initial RAI treatment were predictive of decreased CSS. Multivariate analysis identified that the independent prognostic factors were lung metastatic tumor ≥ 10 mm in diameter and NLR ≥ 2.6. Patients in the high-risk group with both factors had significantly lower CSS rates than those in the low- and intermediate-risk groups with one or none of these factors. CONCLUSIONS: The high-risk group patients had significantly poorer survival, and these patients could be considered as future candidates for tyrosine kinase inhibitor therapy.
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spelling pubmed-83461772021-08-10 Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases Ohkuwa, Keiko Sugino, Kiminori Nagahama, Mitsuji Kitagawa, Wataru Matsuzu, Kenichi Suzuki, Akifumi Tomoda, Chisato Hames, Kiyomi Akaishi, Junko Masaki, Chie Ito, Koichi Endocr Connect Research OBJECTIVE: Radioactive iodine (RAI) therapy is effective for differentiated thyroid cancer (DTC) patients with lung metastasis. However, some patients have a poor prognosis despite the RAI accumulation. The utility of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), has been reported as a prognostic factor for many carcinomas. This study aimed to investigate the risk factors related to DTC patient survival with RAI-avid lung metastasis and to attempt risk stratification. DESIGN AND METHODS: This retrospective study included 123 patients with RAI-accumulating lung metastatic DTC. The cause-specific survival (CSS) rate from the time of detection of lung metastasis was tested using the Kaplan–Meier log-rank test, and the multivariate analysis was calculated using the Cox proportional hazards model. NLR was retrospectively calculated using the blood sample collected before initial RAI treatment. The NLR cutoff value was 2.6 on the ROC curve. RESULTS: Age ≥ 55 years at the time of operative treatment, follicular carcinoma, lung metastasis tumor ≥ 10 mm in diameter, age ≥ 55 years at the time of detection of lung metastasis, age ≥ 55 years at the time of RAI treatment, and NLR ≥ 2.6 at the initial RAI treatment were predictive of decreased CSS. Multivariate analysis identified that the independent prognostic factors were lung metastatic tumor ≥ 10 mm in diameter and NLR ≥ 2.6. Patients in the high-risk group with both factors had significantly lower CSS rates than those in the low- and intermediate-risk groups with one or none of these factors. CONCLUSIONS: The high-risk group patients had significantly poorer survival, and these patients could be considered as future candidates for tyrosine kinase inhibitor therapy. Bioscientifica Ltd 2021-07-05 /pmc/articles/PMC8346177/ /pubmed/34223823 http://dx.doi.org/10.1530/EC-21-0215 Text en © The authors https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Research
Ohkuwa, Keiko
Sugino, Kiminori
Nagahama, Mitsuji
Kitagawa, Wataru
Matsuzu, Kenichi
Suzuki, Akifumi
Tomoda, Chisato
Hames, Kiyomi
Akaishi, Junko
Masaki, Chie
Ito, Koichi
Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title_full Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title_fullStr Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title_full_unstemmed Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title_short Risk stratification in differentiated thyroid cancer with RAI-avid lung metastases
title_sort risk stratification in differentiated thyroid cancer with rai-avid lung metastases
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346177/
https://www.ncbi.nlm.nih.gov/pubmed/34223823
http://dx.doi.org/10.1530/EC-21-0215
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