Clinical Management and Outcomes in Patients with Hyperfunctioning Distant Metastases from Differentiated Thyroid Cancer After Total Thyroidectomy and Radioactive Iodine Therapy

Qiu, Zhong-Ling; Shen, Ce; Luo, Quan-Yong

doi:10.1089/thy.2014.0233

Cited by 24 publications

(30 citation statements)

References 26 publications

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“…The timing of discovery of lung metastases of PTC was divided into lung metastases at presentation and delayed lung metastases. The discovery of lung metastases at presentation was defined as the detection of lung metastasis within 6 months before and after initial thyroidectomy, and the discovery of delayed lung metastases was defined as the detection of lung metastasis ≥6 months after initial thyroidectomy (19). According to the maximal diameter of the lung nodules on chest computed tomography (CT), pulmonary metastatic lesions were classified as lung nodules of >1 cm, 0.5-1 cm, or <0.5 cm.…”

Section: Collection Of Variablesmentioning

confidence: 99%

“…Progressive disease (PD) was evaluated based on the change in metastatic lung nodules compared with baseline using chest CT according to the Response Evaluation Criteria in Solid Tumors (RECIST v1.1) during 131 I treatment and follow-up and similar to our previous studies (19,20). Chest CT examinations were performed with a helical CT scanner on suspended full inspiration with a slice thickness of 3 mm.…”

Section: Evaluation Of Change In Pulmonary Nodules Based On Chest Ct mentioning

confidence: 99%

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Lung Metastases From Papillary Thyroid Cancer With Persistently Negative Thyroglobulin and Elevated Thyroglobulin Antibody Levels During Radioactive Iodine Treatment and Follow-Up: Long-Term Outcomes and Prognostic Indicators

et al. 2020

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Background: The lung is the most frequent site of distant metastasis from differentiated thyroid cancer (DTC). However, lung metastasis from papillary thyroid cancer (PTC) with persistently negative thyroglobulin (Tg) and elevated Tg antibody (TgAb) levels is an extremely rare entity, and the prognosis is therefore elusive. We investigated the clinical characteristics, long-term outcomes, and prognostic factors of lung metastases in PTC patients with persistently negative thyroglobulin (Tg) and elevated Tg antibody (TgAb) levels during radioactive iodine (131 I) treatment and follow-up. Methods: We retrospectively reviewed 10,482 patients with DTC who underwent postoperative 131 I treatment from 2007 to 2017 at Shanghai Sixth's People's Hospital. The relationships between progression-free survival (PFS) and several variables were assessed by univariate and multivariate analyses using the Kaplan-Meier method and a Cox proportional hazards model, respectively. Results: Forty-seven patients with PTC were enrolled in this study (4.48‰ of all patients with DTC). The median age at the initial diagnosis of lung metastasis was 39.6 ± 15.4 years, and the patients comprised 14 male and 33 female patients (male: female ratio = 1.00:2.36). Twenty-five patients had 131 I avidity and 22 had non-131 I avidity. At the end of the 5-years follow-up, 12 patients exhibited progressive disease (PD), and 2 patients had died. At the end of the 10-years follow-up, 21 patients showed PD and five patients had died. The 5-and 10-year PFS rates were 74.47 and 53.32%, respectively; the 5-and 10-years overall survival (OS) rates were 95.74 and 89.36%, respectively. The timing of diagnosis of lung metastases, maximal size of lung metastases, and 131 I avidity were significantly associated with the 5-years PFS rate (P = 0.035, P = 0.030, and P<0.001, respectively). Only 131 I avidity was associated with the 10-years PFS rate (P < 0.001). The multivariate analyses also showed that non-131 I avidity were the independent poor prognostic factors for 10-years PFS at the end of follow-up (P < 0.001). Qiu et al. Lung Metastases From PTC With Elevated TgAb Conclusions: Lung metastases from PTC in patients with persistently negative Tg and elevated TgAb levels had an excellent prognosis and survival rate during 131 I treatment and follow-up. The loss of 131 I avidity remained the strongest independent predictor of a poor prognosis and survival in these patients.

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Section: Collection Of Variablesmentioning

confidence: 99%

Section: Evaluation Of Change In Pulmonary Nodules Based On Chest Ct mentioning

confidence: 99%

Lung Metastases From Papillary Thyroid Cancer With Persistently Negative Thyroglobulin and Elevated Thyroglobulin Antibody Levels During Radioactive Iodine Treatment and Follow-Up: Long-Term Outcomes and Prognostic Indicators

et al. 2020

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“…The major sites of hyperfunctioning metastases are pulmonary and bone (Haq et al 2007, Nishihara et al 2010, Biyi et al 2016, and the rare metastases site of the liver was also reported (Takano et al 2006, Kunawudhi et al 2016. According to the study of Qiu, 0.71% DTC patients present with hyperfunctioning metastases, and the 10-year survival rate of patients with hyperfunctioning metastases was 65.79%, patients younger than 45 years at occurrence of distant metastases, those with only lung metastases, and patients with PTC had better prognoses (Qiu et al 2015).…”

Section: Hyperfunctioning Metastases Of Dtcmentioning

confidence: 99%

“…Hyperfunctioning lung metastases are found to be more sensitive to 131 I therapy than those of bone, in which radiation therapy is an excellent alternative used to relieve symptoms (Qiu et al 2015). In addition, since a small number of patients are accompanied by liver metastasis, which is less 131 I-avid, preliminary debulking of a large liver metastasis by percutaneous interstitial laser photocoagulation treatment followed by 131 I therapy could achieve effective management (Guglielmi et al 1999).…”

Section: Treatmentmentioning

confidence: 99%

Thyrotoxicosis with concomitant thyroid cancer

Cheng

Jin

et al. 2019

Endocrine-Related Cancer

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Thyrotoxicosis with concomitant thyroid cancer is rare and poorly recognized, which may result in delayed diagnosis, inappropriate treatment and even poor prognosis. To provide a comprehensive guidance for clinicians, the etiology, pathogenesis, diagnosis and treatment of this challenging setting were systematically reviewed. According to literatures available, the etiologies of thyrotoxicosis with concomitant thyroid cancer were categorized into Graves’ disease with concurrent differentiated thyroid cancer (DTC) or medullary thyroid cancer, Marine–Lenhart Syndrome with coexisting DTC, Plummer’s disease with concomitant DTC, amiodarone-induced thyrotoxicosis with concomitant DTC, central hyperthyroidism with coexisting DTC, hyperfunctioning metastases of DTC and others. The underlying causal mechanisms linking thyrotoxicosis and thyroid cancer were elucidated. Medical history, biochemical assessments, radioiodine uptake, anatomic and metabolic imaging and ultrasonography-guided fine-needle aspiration combined with pathological examinations were found to be critical for precise diagnosis. Surgery remains a mainstay in both tumor elimination and control of thyrotoxicosis, while anti-thyroid drugs, beta-blockers, 131I, glucocorticoids, plasmapheresis, somatostatin analogs, dopamine agonists, radiation therapy, chemotherapy and tyrosine kinase inhibitors should also be appropriately utilized as needed.

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“…Radioactive iodine 131 is one of the main postoperative treatment modes for metastatic PTC. It is often poor in patients with distant metastasis, and the 10-year survival rate can even drop to about 10% [13]. Therefore, early diagnosis of PTC and finding excellent tumor metastasis markers have been one of the hotspots of PTC research [14].…”

Section: Stress Response In Patients With Papillary Thyroid Carcinomamentioning

confidence: 99%

Progress in Research on 5-HTTLPR under Stress and Thyroid Papillary Carcinoma

Luo¹,

Guo²,

Chen³

et al. 2019

JBBS

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The central nervous system plays an important role in regulating thyroid hormone homeostasis. 5-HT is one of the important neurotransmitters involved in energy balance regulation. 5-HT transporters affect 5-HT function by regulating SERT protein expression and transcriptional activity. Based on the biological correlation between thyroid hormone and thyroid tumors, 5-HTTLPR is associated with thyroid tumors under stress. Animal models of thyroid disease have shown that some of the transmitters in the brain's monoaminergic nervous system have changed, and when the monoamine transporter gene expression is altered, it is found that this disorder is more pronounced. This article discusses whether thyroid papillary carcinoma patients are associated with 5-HTTLPR and whether the mechanism of thyroid papillary carcinoma "gene x environment" has an effect. Briefly describe the role of 5-HTTLPR in the development of patients with papillary thyroid carcinoma, and provide a basis for clinical diagnosis and treatment of papillary thyroid cancer.

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Clinical Management and Outcomes in Patients with Hyperfunctioning Distant Metastases from Differentiated Thyroid Cancer After Total Thyroidectomy and Radioactive Iodine Therapy

Cited by 24 publications

References 26 publications

Lung Metastases From Papillary Thyroid Cancer With Persistently Negative Thyroglobulin and Elevated Thyroglobulin Antibody Levels During Radioactive Iodine Treatment and Follow-Up: Long-Term Outcomes and Prognostic Indicators

Lung Metastases From Papillary Thyroid Cancer With Persistently Negative Thyroglobulin and Elevated Thyroglobulin Antibody Levels During Radioactive Iodine Treatment and Follow-Up: Long-Term Outcomes and Prognostic Indicators

Thyrotoxicosis with concomitant thyroid cancer

Progress in Research on 5-HTTLPR under Stress and Thyroid Papillary Carcinoma

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