Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer

Hakala, T.; Sand, Juhani; Jukkola, Arja; Huhtala, Heini; Metso, Saara; Kellokumpu-Lehtinen, Pirkko-Liisa

doi:10.1007/s10147-015-0904-6

Cited by 17 publications

(32 citation statements)

References 27 publications

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“…Hakala et al . 9 even reported that for young patients (<40 years), the risk of secondary malignancies would dramatically increase. More importantly, the use of 131 I for remnant ablation to reduce the risk of recurrence following thyroidectomy in low risk DTC patients remained controversial 10 11 .…”

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confidence: 99%

Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status

Liu

Meng

Jia

et al. 2016

Sci Rep

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131I treatment is an important management method for patients with differentiated thyroid cancer (DTC). Unsuccessful 131I ablation drastically affects the prognosis of the patients. This study aimed to analyze potential predictive factors influencing the achievement of a disease-free status following the first 131I therapy. This retrospective review included 315 DTC patients, and multiple factors were analyzed. Tumor size, pathological tumor stage, lymph node (LN) metastasis, distant metastasis, American Thyroid Association recommended risks, pre-ablation thyroglobulin (Tg), and thyroid stimulating hormone (TSH) displayed significant differences between unsuccessful and successful group. Cutoff values of Tg and TSH to predict a successful outcome were 3.525 ng/mL and 99.700 uIU/ml by receiver operating characteristic curves analysis. Binary logistic regression analysis showed that tumor stage T3 or T4, LN metastasis to N1b station, intermediate and high risks, pre-ablation Tg ≥ 3.525 ng/ml and TSH <99.700 μIU/mL were significantly associated with unsuccessful outcomes. Logistic regression equation for achieving a disease-free status could be rendered as: y (successful treatment) = −0.270–0.503 X1 (LN metastasis) −0.236 X2 (Tg) + 0.015 X3 (TSH). This study demonstrated LN metastasis, pre-ablation Tg and TSH were the most powerful predictors for achieving a disease-free status by the first 131I therapy.

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mentioning

confidence: 99%

Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status

Liu

Meng

Jia

et al. 2016

Sci Rep

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“…Given the higher risk of complications, such procedures should be limited to very experienced surgeons [18][19][20][21][22]. However, as there are no proven benefits concerning long-term outcome [21,[23][24][25] and most thyroid procedures in Switzerland are not performed by subspecialised surgeons, prophylactic lymph node dissection cannot be recommended as a standard procedure in patients with small a PTC without macroscopic evidence of lymph node metastases.…”

Section: No Vascular Invasionmentioning

confidence: 99%

“…An increased incidence of second cancer has been reported after radioiodine treatment for thyroid cancer, but data were conflicting and a causal relationship may be difficult to establish [23][24][25]. An increased risk of second malignancies is definitely proved when cumulative exposures exceed 37 GBq (1000 mCi).…”

Section: Nuclear Medicine Perspectivementioning

confidence: 99%

Multidisciplinary approach for risk-oriented treatment of low-risk papillary thyroid cancer in Switzerland

et al. 2019

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“…The expanding use of RNT has raised concern regarding potential carcinogenic and leukemogenic effects (Hakala et al 2016;Martinez et al 2017). Research on second primary cancer after RNT has been developing especially on 131 I therapy for hyperthyroidism and differentiated thyroid cancer.…”

Section: Second Primary Cancer In Radionuclide Therapymentioning

confidence: 99%

Radiation protection in therapy with radiopharmaceuticals

Hosono

2018

International Journal of Radiation Biology

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Purpose: Radionuclide therapy (RNT) involves the selective delivery of radiation, emitted from radionuclides to tumors or target organs. The techniques of RNT are increasingly being used for the treatment of various tumors. The purpose of this article is to report on the current state of RNT, to clarify the issues of radiation protection associated with RNT, and to show future prospects. Results and conclusions: Medical exposure of patients has unique features; application of dose limits is not undertaken, and justification and optimization do apply but in a different way from in other exposures. The expanding use of RNT has raised concern regarding potential carcinogenic and leukemogenic effects and research on second primary cancer after RNT have been developing. RNT combined with imaging and dosimetry and featuring a theranostic approach is undergoing a significant expansion, and such dosimetry-based treatment planning leads to individualization, or personalization, which is likely to improve the effectiveness and safety of patient management in RNT.

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Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer

Abstract: The overall incidence of SPMs was not higher in patients than in controls. The incidence of SPMs in thyroid carcinoma patients was higher in patients <40 years old and patients diagnosed since 1996. The incidence of sarcomas and lymphomas was higher in patients than in controls.

Cited by 17 publications

References 27 publications

Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status

Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status

Multidisciplinary approach for risk-oriented treatment of low-risk papillary thyroid cancer in Switzerland

Radiation protection in therapy with radiopharmaceuticals

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