Can the follow‐up of patients with papillary thyroid carcinoma of low and intermediate risk and excellent response to initial therapy be simplified using second‐generation thyroglobulin assays?

Rosário, Pedro Weslley; Mourão, Gabriela Franco; Calsolari, Maria Regina

doi:10.1111/cen.13053

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…Several studies have shown that undetectable post-operative Tg levels correspond with a low incidence of recurrence, while elevated Tg levels are associated with recurrence (12–15). Rosario and colleagues demonstrated that Tg levels often detected recurrent PTC, even prior to structurally detectable disease on ultrasound (16). One study evaluating the risk of recurrent PTC demonstrated an increase in Tg more than 2 fold was seen in 80% of patients with recurrence and only 13% of patients without recurrent PTC (17).…”

Section: Discussionmentioning

confidence: 99%

Back so soon? Is early recurrence of papillary thyroid cancer really just persistent disease?

Bates

Lamas

Randle

et al. 2018

Surgery

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Background Papillary thyroid carcinoma (PTC) has excellent survival, yet recurrence remains a challenge. We sought to determine the proportion of re-operations performed for persistent, rather than truly recurrent disease. Methods We conducted a retrospective review of a prospectively maintained database. Patients with PTC that had re-operation for disease from 2000–2016 were included. We defined recurrence as disease that developed after a patient had an undetectable thyroglobulin and negative ultrasound within one year of surgery. Results A total of 69 patients underwent 92 re-operations. On initial pathology: mean tumor size was 2.6cm; 50.7% were multifocal; and 42% had extra-thyroidal extension. Half (46%) of the patients underwent a central/lateral neck dissection at initial surgery and 76.8% were treated with post-operative radioactive iodine. The median time to first re-operation was 21 months (range, 1–292), and 41.8% occurred within 1 year. Only three operations met criteria for true “recurrence”, while 71 operations were categorized as persistence. Conclusion Many re-operations for PTC are for management of persistent disease. Over half of the patients required re-operation within the first two years, which strongly suggests that improvements in the pre-operative assessment and adequacy of initial surgery need to be made to improve the care of patients with thyroid cancer.

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Section: Discussionmentioning

confidence: 99%

Back so soon? Is early recurrence of papillary thyroid cancer really just persistent disease?

Bates

Lamas

Randle

et al. 2018

Surgery

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“…The introduction of highly sensitive Tg (hsTg), whose functional sensitivity is about 0.1 or 0.2 ng/mL, allows for the simplification of the follow-up protocol, avoiding the need for stimulated Tg (stTg). In fact, hsTg proved its equivalence in revealing distant metastases compared with stTg, even in patients without RRA [ 32 , 33 , 34 , 35 ].…”

Section: Radioiodine Treatment Goalsmentioning

confidence: 99%

Strategies for Radioiodine Treatment: What’s New

Sparano

Moog

Hadoux

et al. 2022

Cancers

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Radioiodine treatment (RAI) represents the most widespread and effective therapy for differentiated thyroid cancer (DTC). RAI goals encompass ablative (destruction of thyroid remnants, to enhance thyroglobulin predictive value), adjuvant (destruction of microscopic disease to reduce recurrences), and therapeutic (in case of macroscopic iodine avid lesions) purposes, but its use has evolved over time. Randomized trial results have enabled the refinement of RAI indications, moving from a standardized practice to a tailored approach. In most cases, low-risk patients may safely avoid RAI, but where necessary, a simplified protocol, based on lower iodine activities and human recombinant TSH preparation, proved to be just as effective, reducing overtreatment or useless impairment of quality of life. In pediatric DTC, RAI treatments may allow tumor healing even at the advanced stages. Finally, new challenges have arisen with the advancement in redifferentiation protocols, through which RAI still represents a leading therapy, even in former iodine refractory cases. RAI therapy is usually well-tolerated at low activities rates, but some concerns exist concerning higher cumulative doses and long-term outcomes. Despite these achievements, several issues still need to be addressed in terms of RAI indications and protocols, heading toward the RAI strategy of the future.

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“…On the other hand, radioisotopes (RI) have emerged as power radio-therapeutic agents and have been widely utilized in clinical practices. Radionuclide such as isotope [ 89 Sr] has been employed for metastatic bone cancers 5 and isotope [ 131 I] is used as radio-therapeutic medicine for thyroid cancers 6 . More importantly, radiolabeled biomolecules have become more useful as tumor-targeting drugs for specific radiations.…”

Section: Introductionmentioning

confidence: 99%

A One-Pot Three-Component Double-Click Method for Synthesis of [67Cu]-Labeled Biomolecular Radiotherapeutics

Fujiki

Yano

Ito

et al. 2017

Sci Rep

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A one-pot three-component double-click process for preparing tumor-targeting agents for cancer radiotherapy is described here. By utilizing DOTA (or NOTA) containing tetrazines and the TCO-substituted aldehyde, the two click reactions, the tetrazine ligation (an inverse electron-demand Diels-Alder cycloaddition) and the RIKEN click (a rapid 6π-azaelectrocyclization), could simultaneously proceed under mild conditions to afford covalent attachment of the metal chelator DOTA or NOTA to biomolecules such as to albumin and anti-IGSF4 antibody without altering their activities. Subsequently, radiolabeling of DOTA- or NOTA-attached albumin and anti-IGSF4 antibody (an anti-tumor-targeting antibody) with [67Cu], a β−-emitting radionuclide, could be achieved in a highly efficient manner via a simple chelation with DOTA proving to be a more superior chelator than NOTA. Our work provides a new and operationally simple method for introducing the [67Cu] isotope even in large quantities to biomolecules, thereby representing an important process for preparations of clinically relevant tumor-targeting agents for radiotherapy.

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Can the follow‐up of patients with papillary thyroid carcinoma of low and intermediate risk and excellent response to initial therapy be simplified using second‐generation thyroglobulin assays?

Cited by 12 publications

References 26 publications

Back so soon? Is early recurrence of papillary thyroid cancer really just persistent disease?

Back so soon? Is early recurrence of papillary thyroid cancer really just persistent disease?

Strategies for Radioiodine Treatment: What’s New

A One-Pot Three-Component Double-Click Method for Synthesis of [67Cu]-Labeled Biomolecular Radiotherapeutics

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