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Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine

SIMPLE SUMMARY: The main aim of this retrospective study was to investigate the dynamic evolution and prognostic role of patients affected by DTC and IR after initial therapy. From January 2010 to December 2017, 2176 patients who received radioiodine (RAI) for DTC after total or near total thyroidec...

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Autores principales: Albano, Domenico, Bellini, Pietro, Dondi, Francesco, Calabrò, Anna, Casella, Claudio, Taboni, Stefano, Lombardi, Davide, Treglia, Giorgio, Bertagna, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954717/
https://www.ncbi.nlm.nih.gov/pubmed/36831612
http://dx.doi.org/10.3390/cancers15041270
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author Albano, Domenico
Bellini, Pietro
Dondi, Francesco
Calabrò, Anna
Casella, Claudio
Taboni, Stefano
Lombardi, Davide
Treglia, Giorgio
Bertagna, Francesco
author_facet Albano, Domenico
Bellini, Pietro
Dondi, Francesco
Calabrò, Anna
Casella, Claudio
Taboni, Stefano
Lombardi, Davide
Treglia, Giorgio
Bertagna, Francesco
author_sort Albano, Domenico
collection PubMed
description SIMPLE SUMMARY: The main aim of this retrospective study was to investigate the dynamic evolution and prognostic role of patients affected by DTC and IR after initial therapy. From January 2010 to December 2017, 2176 patients who received radioiodine (RAI) for DTC after total or near total thyroidectomy were included. Among them, 288 had IR one year after therapy (187 TgAb+, 76 Tg+, 25 imaging+). IRTg+ patients had a higher probability of evolving into an incomplete response. Only stimulated Tg after one year and nodal disease at diagnosis may predict the final status of the disease. Progression-free survival was significantly shorter in IRTg+ than IRTgAb+ and IRimaging+ groups and in patients with sTg > 3.3 ng/mL. ABSTRACT: The clinical outcome of patients affected by Differentiated Thyroid Carcinoma (DTC) and an indeterminate response (IR) after initial therapy is not yet clear. IR includes three different sub-groups of patients: (1) IRTg+ group: Detectable thyroglobulin (Tg), regardless of antithyroglobulin antibodies (TgAb) presence or imaging studies; (2) IRTgAb+ group: Positive TgAb, regardless of Tg levels and nonspecific imaging findings; (3) IRImaging+ group: Nonspecific findings on neck ultrasonography or faint uptake in the thyroid bed on the whole-body scan, negative TgAb, and undetectable Tg. The main aim of this retrospective study was to investigate the dynamic evolution and prognostic role of these patients. From January 2010 to December 2017, 2176 patients who received radioiodine for DTC after total thyroidectomy were included. Two-hundred-eighty-eight patients had IR one year after therapy (187 TgAb+, 76 Tg+, 25 imaging+). After two years, 110 patients (38%) were reclassified as an excellent response and 5 (2%) as an incomplete response; after five years, 221 (77%) achieved an excellent response and 11 (4%) showed an incomplete response. One-year stimulated Tg and nodal disease at diagnosis may predict the final status of the disease. Progression-free survival was significantly shorter in IRTg+ than in IRTgAb+ and IRimaging+ groups. Considering Tg+ patients, a threshold of 3.3 ng/mL is best to predict prognosis.
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spelling pubmed-99547172023-02-25 Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine Albano, Domenico Bellini, Pietro Dondi, Francesco Calabrò, Anna Casella, Claudio Taboni, Stefano Lombardi, Davide Treglia, Giorgio Bertagna, Francesco Cancers (Basel) Article SIMPLE SUMMARY: The main aim of this retrospective study was to investigate the dynamic evolution and prognostic role of patients affected by DTC and IR after initial therapy. From January 2010 to December 2017, 2176 patients who received radioiodine (RAI) for DTC after total or near total thyroidectomy were included. Among them, 288 had IR one year after therapy (187 TgAb+, 76 Tg+, 25 imaging+). IRTg+ patients had a higher probability of evolving into an incomplete response. Only stimulated Tg after one year and nodal disease at diagnosis may predict the final status of the disease. Progression-free survival was significantly shorter in IRTg+ than IRTgAb+ and IRimaging+ groups and in patients with sTg > 3.3 ng/mL. ABSTRACT: The clinical outcome of patients affected by Differentiated Thyroid Carcinoma (DTC) and an indeterminate response (IR) after initial therapy is not yet clear. IR includes three different sub-groups of patients: (1) IRTg+ group: Detectable thyroglobulin (Tg), regardless of antithyroglobulin antibodies (TgAb) presence or imaging studies; (2) IRTgAb+ group: Positive TgAb, regardless of Tg levels and nonspecific imaging findings; (3) IRImaging+ group: Nonspecific findings on neck ultrasonography or faint uptake in the thyroid bed on the whole-body scan, negative TgAb, and undetectable Tg. The main aim of this retrospective study was to investigate the dynamic evolution and prognostic role of these patients. From January 2010 to December 2017, 2176 patients who received radioiodine for DTC after total thyroidectomy were included. Two-hundred-eighty-eight patients had IR one year after therapy (187 TgAb+, 76 Tg+, 25 imaging+). After two years, 110 patients (38%) were reclassified as an excellent response and 5 (2%) as an incomplete response; after five years, 221 (77%) achieved an excellent response and 11 (4%) showed an incomplete response. One-year stimulated Tg and nodal disease at diagnosis may predict the final status of the disease. Progression-free survival was significantly shorter in IRTg+ than in IRTgAb+ and IRimaging+ groups. Considering Tg+ patients, a threshold of 3.3 ng/mL is best to predict prognosis. MDPI 2023-02-16 /pmc/articles/PMC9954717/ /pubmed/36831612 http://dx.doi.org/10.3390/cancers15041270 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Albano, Domenico
Bellini, Pietro
Dondi, Francesco
Calabrò, Anna
Casella, Claudio
Taboni, Stefano
Lombardi, Davide
Treglia, Giorgio
Bertagna, Francesco
Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title_full Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title_fullStr Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title_full_unstemmed Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title_short Temporal Evolution and Prognostic Role of Indeterminate Response Sub-Groups in Patients with Differentiated Thyroid Cancer after Initial Therapy with Radioiodine
title_sort temporal evolution and prognostic role of indeterminate response sub-groups in patients with differentiated thyroid cancer after initial therapy with radioiodine
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954717/
https://www.ncbi.nlm.nih.gov/pubmed/36831612
http://dx.doi.org/10.3390/cancers15041270
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