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

Abstract

PurposeGenerally, 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 131I therapy, as well as the relevant factors that influence the therapeutic efficacy.MethodsRetrospective 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, χ2 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 BRAFV600E test results were analyzed by χ2 test only.ResultsThe 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 (χ2 = 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.ConclusionsPatients 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.

Correlation of pN Stage and Hypoechogenicity with Tumour Encapsulation and Vascular Invasion in Thyroid Cancer (TC): A Comprehensive Analysis and Clinical Outcomes

“…The presence of vascular invasion and infiltrating capsular lesions in the histopathologic evaluation of malignant tumours has a significant impact on patient prognosis. These features are often associated with the aggressive nature of the tumour and an increased risk of recurrence [ 15 , 16 , 17 , 18 ]. However, our study focused on analysing the correlations between these factors, which may be crucial for the treatment of TC patients.…”

Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

“…Recent studies have shown that several clinicopathologic features may affect ER ( 8 – 10 ). However, those results are not consistent, and there is no clear optimal cutoff value as an indicator to predict ER and support treatment decision-making ( 8 – 10 ).…”

“…Recent studies have shown that several clinicopathologic features may affect ER ( 8 – 10 ). However, those results are not consistent, and there is no clear optimal cutoff value as an indicator to predict ER and support treatment decision-making ( 8 – 10 ). Therefore, in this study, we investigated the potential impact of clinicopathologic features on ER after 131 I ablation in patients with PTC with lymph node metastasis and evaluated the predictive value for ER and the cumulative risk of non-ER.…”

Stimulated Thyroglobulin and Pre-ablation Antithyroglobulin Antibody Product Can Predict the Response to Radioiodine Therapy in TgAb-positive Differentiated Thyroid Cancer Pa-tients: A Retrospective Study

“…Surgery, selective radioiodine therapy (RAIT) after total thyroidectomy (TT) and thyroid stimulating hormone (TSH) sup-pressive therapy are the standard treatments for DTC [1]. As a speci c tumor marker for long-term follow-up after RAIT in DTC, serum thyroglobulin (Tg) can predict DTC persistence, distant metastasis or recurrence [2,3,4]. However, the Tg level can be affected by antithyroglobulin antibody (TgAb), which made Tg measurement becomes unreliable.…”