Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study

Yuan, Liyi; Wang, Jing; Pan, Liqin; Feng, Huijuan; Chen, Pan; Luo, Jiaxin; Xie, Jiahao; Xiong, Xiaoli; Wu, Jing; Ouyang, Wei

doi:10.1007/s12149-022-01799-5

Cited by 5 publications

(14 citation statements)

References 20 publications

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“…Different from a previous report [9], pre-therapy Tg values and age were identified as independent predictors of outcome in addition to empiric RAI treatment. Both age and pre-therapy Tg values have been previously recognized as strong predictors of outcome in patients with DTC [10,26].…”

Section: Discussioncontrasting

confidence: 97%

“…After subsequent treatment, the rate of subsequent structural events was higher in no-ET patients compared to ET. Our data are in agreement with previous studies [ 8 , 9 , 21 ] where the potential benefit of empiric treatment in terms of outcome were observed in particular in patients with distant metastases on post-therapy WBS scan. In our population, the patients with distant metastases at initial diagnosis have been excluded.…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, Tramontin et al [ 20 ] confirmed no significant differences during a long-term follow-up between treated and untreated patients. Likewise, Yuan et al [ 9 ] evaluated the outcome of 80 DTC patients with elevated Tg levels after surgery and RAI treatment and negative diagnostic WBS. Among these 80 patients, 52 underwent ET and 28 did not; the authors found that ET was associated with an improved outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, differently from previous reports [ 9 ], in order to account for differences between the two populations and reduce potential bias related to different risk profiles, a propensity score analysis was applied. Therefore, a final cohort of119 ET and 119 no-ET patients with balanced clinical variables was obtained.…”

Section: Discussionmentioning

confidence: 99%

“…A beneficial effect of 131 I therapy in patients with DTC and elevated Tg values has been observed in patients with distant metastases on post-therapy WBS scans [ 8 ]. More recently, the improved prognosis of patients with detectable serum Tg levels but negative diagnostic WBS has been proven in patients who underwent empiric RAI treatment compared to those who did not [ 9 ]. The aim of this study was to assess the prognostic impact of empiric RAI therapy in a propensity-score-matched cohort of DTC patients, treated with surgery and RAI administration and who had detectable Tg serum levels during follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Empirical Radioiodine Therapy in Patients with Differentiated Thyroid Cancer and Elevated Serum Thyroglobulin without Evidence of Structural Disease: A Propensity Score Analysis

Piscopo,

Zampella,

Volpe

et al. 2023

Cancers

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We assessed the outcome of administration of empiric radioactive iodine (RAI) therapy to patients with differentiated thyroid cancer (DTC), in a propensity-score-matched cohort of patients with biochemical incomplete response (BIR) and without evidence of structural disease. We retrospectively evaluated 820 DTC patients without distant metastases, who underwent total thyroidectomy followed by RAI therapy, with available BIR at 12 months and follow-up evaluations. The patients were categorized according to the administration of empiric therapy (ET). To account for differences between patients with (n = 119) and without (n = 701) ET, a propensity-score-matched cohort of 119 ET and 119 no-ET patients was created. The need for additional therapy and the occurrence of structural disease were considered as end-points. During a median follow-up of 53 months (range 3–285), 57 events occurred (24% cumulative event rate). The rate of events was significantly higher in the no-ET compared to the ET patients (30% vs. 18% p < 0.001). The multivariate Cox analysis identified age (p < 0.01), pre-therapy Tg (p < 0.05) and empiric RAI therapy (p < 0.01) as predictors of outcome. The Kaplan–Meier analysis found that progression-free survival was lower in no-ET patients compared to the ET group (p < 0.01). In patients with DTC treated with surgery and RAI, and with biochemical incomplete response at the 12-month evaluation, their prognosis seemed to be affected by Tg values and the empiric treatment. The identification of candidates for this approach may improve prognosis.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Empirical Radioiodine Therapy in Patients with Differentiated Thyroid Cancer and Elevated Serum Thyroglobulin without Evidence of Structural Disease: A Propensity Score Analysis

Piscopo,

Zampella,

Volpe

et al. 2023

Cancers

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Efficacy of Empirical 131I Radioiodine Therapy in Well-Differentiated Thyroid Carcinoma Patients With Thyroglobulin-Elevated Negative Iodine Scintigraphy Syndrome

Kim,

Hong,

et al. 2024

Clin Nucl Med

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Objectives This study aimed to perform a systematic review and meta-analysis on the efficacy of empirical high-dose radioiodine therapy in treating differentiated thyroid cancer patients with thyroglobulin (Tg)-elevated negative iodine scintigraphy (TENIS) syndrome. Methods We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis. Results We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51–0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52–0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09–0.87), which suggests a lower risk of disease progression. Conclusions Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.

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Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part II. Follow-up Surveillance after Initial Treatment 2024

Kim,

Bang,

Kang

et al. 2024

Int J Thyroidol

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Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study

Cited by 5 publications

References 20 publications

Efficacy of Empirical Radioiodine Therapy in Patients with Differentiated Thyroid Cancer and Elevated Serum Thyroglobulin without Evidence of Structural Disease: A Propensity Score Analysis

Efficacy of Empirical Radioiodine Therapy in Patients with Differentiated Thyroid Cancer and Elevated Serum Thyroglobulin without Evidence of Structural Disease: A Propensity Score Analysis

Efficacy of Empirical 131I Radioiodine Therapy in Well-Differentiated Thyroid Carcinoma Patients With Thyroglobulin-Elevated Negative Iodine Scintigraphy Syndrome

Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part II. Follow-up Surveillance after Initial Treatment 2024

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