Purpose This study conducted a propensity score matching (PSM) analysis to investigate whether radioactive iodine therapy (RAIT) is effective in reducing the recurrence of intermediate-risk papillary thyroid cancer (PTC) with low thyroglobulin (Tg) levels. Methods In total, 1487 intermediate-risk PTC patients with unstimulated Tg ≤ 1 ng/mL or stimulated Tg ≤ 10 ng/mL after total thyroidectomy were enrolled retrospectively. The clinicopathological characteristics were compared between the non-RAIT and RAIT groups before and after PSM (1:4 matching). The impact of RAIT on biochemical recurrence and structural recurrence was evaluated. Results Overall, 1349 (90.7%) patients underwent RAIT, and 138 (9.3%) did not. After a median follow-up time of 51 months, 30 patients presented with recurrence, including 11 structural and 19 biochemical recurrences. After PSM, compared to the RAIT group, the non-RAIT group had a higher rate of structural recurrence (5/138 vs. 5/552, P = 0.046) and biochemical recurrence (6/138 vs. 4/552, P = 0.005). Multivariate analysis showed that not receiving RAIT was an independent risk factor for structural recurrence (HR: 10.572, 95% CI: 2.439-45.843, P = 0.002) and biochemical recurrence (HR: 16.568, 95% CI: 3.670-74.803, P < 0.001). Kaplan-Meier analysis showed that non-RAIT group had more unfavorable RFS (structural and biochemical, all P < 0.05). Conclusions RAIT could decrease the recurrence risk of intermediate-risk PTC in patients with unstimulated Tg ≤ 1 ng/mL or stimulated Tg ≤ 10 ng/mL. Further prospective randomized studies are needed to confirm these findings.
The incidence of colorectal cancer (CRC) is increasing in China. Here, we aimed to evaluate the latest demographic trends and KRAS/BRAF mutations status of Chinese CRC. Five thousand five hundred and forty-six CRC patients diagnosed from 2010 to 2017 were involved. KRAS exon 2 and BRAF V600E mutations were detected by Sanger sequencing and high-resolution melting analysis or allelic-specific probe method. Gene mutation profiles and clinicopathologic characteristics of 5495 patients were analyzed. The joinpoint regression model was used to predict the demographic data in 2018. We found KRAS exon 2 and BRAF V600E mutation rates were 37.7 and 2.8% in CRC patients. Tumors with KRAS exon 2 mutations were more likely to be present in female and patients aged older than 75 years, right colon and have well-differentiated histology. Tumors with BRAF V600E mutations were more likely to be present in the female, right colon and have poorly differentiated histology. From 2010 to 2017, the percentage of colon cancer and tubular adenocarcinoma in CRC increased substantially (from 39.3 to 51.8%, from 78.6 to 93.4%, respectively). The percentage of right colon cancer increased from 18.3 to 20.5%, which predictively may keep at 22.6% in 2018. The rise trends for patients with moderate differentiation tumor or KRAS exon 2 mutated tumor were apparent (from 50.3 to 78.6%, from 32.8 to 39.7%, respectively). In conclusion, in recent 8 years, there is a shift to the colon, especially right colon in the incidence of Chinese CRC. Moreover tubular adenocarcinoma is becoming the primary histology type.most common cancer and the fifth leading cause of cancer death. 2,3 In Guangzhou, a more developed coast area in South China, CRC incidence has reached 34/100,000, according to
PurposeThis study investigated the relationship between BRAFV600E mutation of the primary tumor and radioiodine avidity in lung metastases (LMs) and then further evaluated the impact of BRAFV600E mutation and radioiodine avidity status on the prognosis of papillary thyroid cancer (PTC) with LMs.MethodsNinety-four PTC patients with LMs after total thyroidectomy and cervical lymph node dissection between January 2012 and September 2021 were retrospectively included. All patients received BRAFV600E mutation examination of primary tumors and radioactive iodine (RAI) therapy. The therapeutic response was evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) assessments (version 1.1). For patients with target lesions, the response was divided into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD); for patients without target lesions, the response was divided into CR, non-CR/non-PD, and PD. In therapeutic response, PR and SD were classified as non-CR/non-PD for analysis. The chi-square test and logistic regression were used to analyze the impact factor on PD and mortality. Progression-free survival (PFS) and overall survival (OS) curves were constructed by the Kaplan–Meier method.ResultsIt was found that 21.2% (7/33) of patients with positive BRAFV600E mutation and 62.3% (38/61) of patients with negative BRAFV600E mutation had radioiodine-avid LMs (χ2 = 14.484, p = 0.000). Patients with positive BRAFV600E mutation are more likely to lose radioiodine avidity; the odds ratios (ORs) were 5.323 (95% CI: 1.953–14.514, p = 0.001). Finally, 25 patients had PD, and six patients died; loss of radioiodine avidity was the independent predictor for PD, and the ORs were 10.207 (95% CI: 2.629–39.643, p = 0.001); BRAFV600E mutation status was not correlated with PD (p = 0.602), whether in the radioiodine avidity group (p = 1.000) or the non-radioiodine avidity group (p = 0.867). Similarly, BRAFV600E mutation status was not correlated with mortality; only loss of radioiodine avidity was the unfavorable factor associated with mortality in univariate analyses (p = 0.030).ConclusionPatients with LMs of PTC were more likely to lose radioiodine avidity when their primary tumor had positive BRAFV600E mutation; however, only radioiodine avidity and not BRAFV600E mutation status affected the clinical outcome of patients with lung metastatic PTC.
Purpose This study assesses the diagnostic performance of 131I SPECT/CT and treatment efficacy of initial postoperative radioiodine (RAI) compared with reoperation on residual lymph node metastasis (LNM). Methods Patients with iodine-avid LNM detected on postoperative 131I SPECT/CT and who underwent re-operative dissection within 12 months were included. LNMs (numbers and locations) detected via both methods were compared. The ongoing risk stratification was used to evaluate the therapeutic response to RAI and reoperation. Results Fifty-three patients with 95 iodine-avid LNMs detected by 131I SPECT/CT were enrolled in this study. A total of 51 (96.2%) patients had 212 LNMs confirmed by reoperation (p=0.004). The sensitivity and specificity of 131I SPECT/CT in detecting LNM were 44.8% (95/212) and 91.6% (87/95), respectively. The location frequency of residual LNMs found by 131I SPECT/CT was similar to that of reoperation (p=0.057). Excluding 2 false-positive patients, the remaining 51 patients were in structural incomplete response (SIR) after a single RAI treatment. Sixteen patients were evaluated on a second RAI treatment after reoperation. The SIR, biochemical incomplete response (BIR), indeterminate response (IR) and excellent response (ER) were 4 (23.5%), 4 (23.5%),5 (29.4%) and 3 (17.6%), respectively (p=0.000). Conclusion 131I SPECT/CT has high specificity but relatively low sensitivity in finding all residual LNMs. Reoperation is more effective than RAI therapy, however, less than 20% of patients achieved ER. The success rate must be balanced with the risk of reoperation for residual LNMs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.