Outcomes of 756 patients with differentiated thyroid cancer and excellent response to treatment: An evidence‐based paradigm for long‐term surveillance strategies

Seejore, Khyatisha; Mulla, Omar; Gerrard, G.; Gill, Vanessa; Al-Qaissi, Ahmed; Moor, James; Murray, Robert

doi:10.1111/cen.14549

Cited by 6 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, only a few studies have assessed the prognostic role of the ATA risk criteria integrated with the response to initial therapy [ 28 , 29 , 30 ]. Seejore et al evaluated a large cohort of 756 DTC patients who achieved an excellent response to treatment at the first evaluation after initial therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Only 15 patients (2.0%) developed radiological disease recurrence after a median follow-up of 11.2 years. They further analyzed the outcomes according to postoperative ATA risk stratification and showed that patients with an excellent response after initial therapy and classified as having a high-risk disease according to the ATA guidelines had an almost threefold higher recurrence rate (2/34 (5.9%) vs. 13/722 (1.8%)) than those with ATA low- or intermediate-risk disease [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, we demonstrated that the ATA risk criteria are independently associated with the long-term follow-up in all patients dynamically risk-stratified in the multivariate analysis. Moreover, in these studies [ 28 , 29 ], only selected subgroups of patients were evaluated (excellent response or biochemical incomplete response), while, in our study, we assessed all subgroups of response to initial therapy in a series of PTC patients followed at the same institution. Finally, we evaluated, for the first time, the prognostic value of two different stratification systems alone and in combination using an ROC curve analysis.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Dynamic Risk Stratification Integrated with ATA Risk System for Predicting Long-Term Outcome in Papillary Thyroid Cancer

Valerio,

Dalmiglio,

Maino

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: In recent years, there has been a renewed interest in thyroid cancer management paradigms that use individualized risk assessments as the basis for treatment and follow-up recommendations. In this study, we assumed that the long-term follow-up of differentiated thyroid cancer patients might be better tailored by integrating the response to initial therapy with the America Thyroid Association (ATA) risk classes. Methods: This retrospective study included low- and intermediate-risk papillary thyroid cancer (PTC) patients followed up for a median time of 8 years and classified according to the response to initial therapy assessed 6–12 months after initial treatment. Results: After a median follow-up of 8 years, in the initial excellent response subgroup of PTC patients (n = 522), the rate of recurrent disease was significantly higher in intermediate-risk patients than in low-risk PTC patients (6.9% versus 1.2%, p = 0.0005). Similarly, in the initial biochemical incomplete response subgroup (n = 82), the rate of excellent response was significantly higher in low-risk PTC patients (58.0%) than in intermediate-risk PTC patients (33.3%) (p = 0.007). Finally, in the initial structural incomplete response subgroup (n = 66), the rate of excellent response was higher in low-risk patients (80.0%) than in intermediate-risk patients (46.4%) (p = 0.08). Moreover, all patients with initial indeterminate response had an excellent response at the last follow-up visit. ATA risk classes were independently associated with long-term outcome in each subgroup of patients classified dynamically after initial therapy and the overall prognostic performance, defined via ROC curve analysis, of response to initial therapy integrated with the ATA risk system (AUC: 0.89; 95% CI: 0.86–0.92) was significantly higher compared to the ATA risk stratification (AUC 0.69; 95% CI: 0.65–0.74, p < 0.001) or the dynamic risk stratification (DRS) systems alone (AUC: 0.86 95% CI: 0.82–0.90, p = 0.007). Conclusions: This study of a large cohort of PTC patients showed that the initial ATA risk criteria may be useful for improving the risk-adapted management of PTC patients based on the response to initial therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dynamic Risk Stratification Integrated with ATA Risk System for Predicting Long-Term Outcome in Papillary Thyroid Cancer

Valerio,

Dalmiglio,

Maino

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…On the other hand, Ito et al [28] found that patients with BRAFV600E were equally distributed amongst both high-and low-risk cases. So far, no single marker can predict clinical outcome or structural recurrence [29], and thorough disease surveillance is required for BIR patients [25,30].…”

Section: Developing Structural Recurrencementioning

confidence: 99%

Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes

Steinschneider

Pitaro

Koren

et al. 2021

Cancers

View full text Add to dashboard Cite

Although most patients with differentiated thyroid cancer (DTC) and biochemical incomplete response (BIR) follow a good clinical outcome, progression to structural disease may occur in 8–17% of patients. We aimed to identify factors that could predict the long-term outcomes of BIR patients. To this end, we conducted a retrospective review study of 1049 charts from our Differential Thyroid Cancer registry of patients who were initially treated with total thyroidectomy between 1962 and 2019. BIR was defined as suppressed thyroglobulin (Tg) > 1 ng/mL, stimulated Tg > 10 ng/mL or rising anti-Tg antibodies, who did not have structural evidence of disease, and who were assessed 12–24 months after initial treatment. We found 83 patients (7.9%) matching the definition of BIR. During a mean follow-up of 12 ± 6.6 years, 49 (59%) patients remained in a state of BIR or reverted to no evidence of disease, while 34 (41%) progressed to structural disease. At the last follow-up, three cases (3.6%) were recorded as disease-related death. The American Thyroid Association (ATA) Initial Risk Stratification system and/or AJCC/TNM (8th ed.) staging system at diagnosis predicted the shift from BIR to structural disease, irrespective of their postoperative Tg levels. We conclude that albeit 41% of BIR patients may shift to structural disease, and most have a rather indolent disease. Specific new individual data enable the Response to Therapy reclassification to become a dynamic system to allow for the better management of BIR patients in the long term.

show abstract

“…The American Thyroid Association (ATA) guidelines (version 2015) state that 131 I ablation should be performed selectively for DTC patients according to different recurrence risk stratifications and is not necessary for all patients. Patients with intermediate-risk DTC should be monitored more closely in terms of therapeutic effects because of the higher probability of disease persistence and recurrence after the initial 131 I ablation [9][10][11]. Until recently, there were still controversies about whether patients with intermediate-risk DTC could benefit from initial 131 I ablation and if 131 I ablation should even be used as a routine clinical treatment due to the lack of authoritative and systematic evidence-based recommendations.…”

Section: Introductionmentioning

confidence: 99%

Impact factors of benefiting from initial 131I ablation in patients with intermediate-risk differentiated thyroid carcinoma: a study based on a re-evaluation of therapeutic response

Ren,

Hu,

et al. 2023

Nuclear Medicine Communications

View full text Add to dashboard Cite

Objective This study was carried out to confirm whether patients with intermediate-risk differentiated thyroid cancer (DTC) could benefit from initial 131I ablation and to identify the factors that impacted the benefit. Methods We retrospectively assessed a cohort of 548 patients with intermediate-risk DTC who were classified into structural incomplete response (SIR), biochemical incomplete response (BIR), indeterminate response (IDR), and excellent response (ER) groups according to the ATA guidelines (version 2015). A downgrade in the classification, such as from initial SIR to final BIR, IDR, or ER, from BIR to IDR or ER, and from initial IDR to final ER, was defined as benefiting from initial 131I ablation (benefit group). Non-downgraded classification meant non-benefit. Results 64.78% of patients benefited from the initial 131I ablation in the final re-evaluation. Gender (OR = 0.038, P = 0.002), interval time (OR = 0.038, P = 0.002) and serum ps-Tg (OR = 0.961, P = 0.001) were independent prognostic factors for benefiting from initial 131I ablation, with the cutoff value were 5 months and 19.08 ng/ml. Conclusion Patients with intermediate-risk DTC could benefit from initial 131I ablation. Female patients with intermediate-risk DTC whose interval time <5 months and ps-Tg <19.08 ng/ml were more likely to benefit. Early 131I ablation for such patients is beneficial for achieving a complete therapeutic response.

show abstract

Outcomes of 756 patients with differentiated thyroid cancer and excellent response to treatment: An evidence‐based paradigm for long‐term surveillance strategies

Cited by 6 publications

References 20 publications

Dynamic Risk Stratification Integrated with ATA Risk System for Predicting Long-Term Outcome in Papillary Thyroid Cancer

Dynamic Risk Stratification Integrated with ATA Risk System for Predicting Long-Term Outcome in Papillary Thyroid Cancer

Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes

Impact factors of benefiting from initial 131I ablation in patients with intermediate-risk differentiated thyroid carcinoma: a study based on a re-evaluation of therapeutic response

Contact Info

Product

Resources

About