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Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma

PURPOSE: Generally, the prognosis for papillary thyroid cancer (PTC) is favorable. However, the moderate risk involved warrants further evaluation. Hence, we investigated the clinical outcomes in patients with moderate-risk PTC following surgery and the first (131)I therapy, as well as the relevant...

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Autores principales: Li, Yixuan, Rao, Maohua, Zheng, Chenxi, Huang, Jiahui, Fang, Danzhou, Xiong, Yalan, Yuan, Gengbiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613939/
https://www.ncbi.nlm.nih.gov/pubmed/36313750
http://dx.doi.org/10.3389/fendo.2022.1015798
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author Li, Yixuan
Rao, Maohua
Zheng, Chenxi
Huang, Jiahui
Fang, Danzhou
Xiong, Yalan
Yuan, Gengbiao
author_facet Li, Yixuan
Rao, Maohua
Zheng, Chenxi
Huang, Jiahui
Fang, Danzhou
Xiong, Yalan
Yuan, Gengbiao
author_sort Li, Yixuan
collection PubMed
description PURPOSE: Generally, the prognosis for papillary thyroid cancer (PTC) is favorable. However, the moderate risk involved warrants further evaluation. Hence, we investigated the clinical outcomes in patients with moderate-risk PTC following surgery and the first (131)I therapy, as well as the relevant factors that influence the therapeutic efficacy. METHODS: Retrospective analyses of 175 patients with medium-risk PTC who visited the Second Affiliated Hospital of Chongqing Medical University from September 2017 to April 2019 were conducted. In according with the 2015 American Thyroid Association (ATA) guideline treatment response evaluation system, the patients were categorized into the following groups: excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and structurally incomplete response (SIR), of which IDR, BIR, and SIR were collectively referred to as the NER group. To compare the general clinical features between the 2 groups of patients, 2 independent samples t-tests, χ(2) test, and Mann–Whitney U-test were performed, followed by multivariate logistic regression analyses. With reference to the receiver operating characteristic (ROC) curve, the predicted value of ps-Tg to ER was evaluated, and the best cut-off value was determined. The subgroups with BRAF(V600E) test results were analyzed by χ2 test only. RESULTS: The treatment responses of 123 patients were ER, while those of 52 patients were NER. The differences in the maximum tumor diameter (U = 2495.50), the amount of metastatic lymph nodes (U = 2313.50), the size of metastatic lymph node (U = 2113.50), the metastatic lymph node ratio (U = 2111.50), metastatic lymph node location (χ(2) = 9.20), and ps-Tg level (U = 1011.00) were statistically significant. Multivariate regression analysis revealed that ps-Tg (OR = 1.209, 95% CI: 1.120–1.305) was an independent variable affecting ER. The cut-off value of ps-Tg for predicting ER was 6.915 ug/L, while its sensitivity and specificity were 69.2% and 89.4%, respectively. CONCLUSIONS: Patients with smaller tumor size, fewer lymph nodes, lower metastatic lymph node ratio, metastatic lymph nodes in the central region, smaller lymph node size, and ps-Tg <6.915 ug/L demonstrated better therapeutic effects after the initial treatment.
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spelling pubmed-96139392022-10-29 Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma Li, Yixuan Rao, Maohua Zheng, Chenxi Huang, Jiahui Fang, Danzhou Xiong, Yalan Yuan, Gengbiao Front Endocrinol (Lausanne) Endocrinology PURPOSE: Generally, the prognosis for papillary thyroid cancer (PTC) is favorable. However, the moderate risk involved warrants further evaluation. Hence, we investigated the clinical outcomes in patients with moderate-risk PTC following surgery and the first (131)I therapy, as well as the relevant factors that influence the therapeutic efficacy. METHODS: Retrospective analyses of 175 patients with medium-risk PTC who visited the Second Affiliated Hospital of Chongqing Medical University from September 2017 to April 2019 were conducted. In according with the 2015 American Thyroid Association (ATA) guideline treatment response evaluation system, the patients were categorized into the following groups: excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and structurally incomplete response (SIR), of which IDR, BIR, and SIR were collectively referred to as the NER group. To compare the general clinical features between the 2 groups of patients, 2 independent samples t-tests, χ(2) test, and Mann–Whitney U-test were performed, followed by multivariate logistic regression analyses. With reference to the receiver operating characteristic (ROC) curve, the predicted value of ps-Tg to ER was evaluated, and the best cut-off value was determined. The subgroups with BRAF(V600E) test results were analyzed by χ2 test only. RESULTS: The treatment responses of 123 patients were ER, while those of 52 patients were NER. The differences in the maximum tumor diameter (U = 2495.50), the amount of metastatic lymph nodes (U = 2313.50), the size of metastatic lymph node (U = 2113.50), the metastatic lymph node ratio (U = 2111.50), metastatic lymph node location (χ(2) = 9.20), and ps-Tg level (U = 1011.00) were statistically significant. Multivariate regression analysis revealed that ps-Tg (OR = 1.209, 95% CI: 1.120–1.305) was an independent variable affecting ER. The cut-off value of ps-Tg for predicting ER was 6.915 ug/L, while its sensitivity and specificity were 69.2% and 89.4%, respectively. CONCLUSIONS: Patients with smaller tumor size, fewer lymph nodes, lower metastatic lymph node ratio, metastatic lymph nodes in the central region, smaller lymph node size, and ps-Tg <6.915 ug/L demonstrated better therapeutic effects after the initial treatment. Frontiers Media S.A. 2022-10-14 /pmc/articles/PMC9613939/ /pubmed/36313750 http://dx.doi.org/10.3389/fendo.2022.1015798 Text en Copyright © 2022 Li, Rao, Zheng, Huang, Fang, Xiong and Yuan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Li, Yixuan
Rao, Maohua
Zheng, Chenxi
Huang, Jiahui
Fang, Danzhou
Xiong, Yalan
Yuan, Gengbiao
Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title_full Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title_fullStr Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title_full_unstemmed Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title_short Analysis of factors influencing the clinical outcome after surgery and (131)I therapy in patients with moderate-risk thyroid papillary carcinoma
title_sort analysis of factors influencing the clinical outcome after surgery and (131)i therapy in patients with moderate-risk thyroid papillary carcinoma
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613939/
https://www.ncbi.nlm.nih.gov/pubmed/36313750
http://dx.doi.org/10.3389/fendo.2022.1015798
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