Pre-Ablation Thyroglobulin and Thyroglobulin to Thyroid-Stimulating Hormone Ratio may be Associated with Pulmonary Metastases in Children with Differentiated Thyroid Cancer

Livhits, Masha J.; Pasternak, Jesse D.; Xiong, Maggie; Li, Ning; Gosnell, Jessica E.; Yeh, Michael W.; Chiu, Harvey K.

doi:10.4158/ep161360.or

Cited by 17 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given the small number of FTC cases, comparisons with PTC could not be made but it was noted that the latency period from FTC diagnosis to DM diagnosis was longer in the FTC patients, which underscores the importance of long-term follow-up of children with FTC, especially in the presence of angioinvasive tumors. The present study was not designed to compare the clinical characteristics of patients with stage II DTC (DM+) with those of stage I (DM-) disease, but similar to prior studies (7,14,21,23,25,28,34,64), patients with DM had larger tumors and a very high rate of lymph node metastases to the lateral neck. The vast majority (86.5%) of evaluable patients were considered to be ATA high risk at diagnosis.…”

Section: Braf Mutation 13%mentioning

confidence: 91%

Distant Metastases From Childhood Differentiated Thyroid Carcinoma: Clinical Course and Mutational Landscape

Nies

Vassilopoulou‐Sellin

Bassett

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

Context Distant metastases (DM) from childhood differentiated thyroid carcinoma (DTC) are uncommon and published studies are limited. Objective This work aimed to describe the outcomes of patients with DM from childhood DTC and to evaluate the molecular landscape of these tumors. Methods A retrospective study was conducted at a tertiary cancer center including patients with pediatric DTC (diagnosed at age ≤ 18 years from 1946 to 2019) and DM. Results We identified 148 patients; 144 (97%) had papillary thyroid carcinoma (PTC) and 104 (70%) were female. Median age at DTC diagnosis was 13.4 years (interquartile range [IQR], 9.9-15.9 years). Evaluable individuals received a median of 2 (IQR, 1-3) radioactive iodine (RAI) treatments at a median cumulative administered activity of 238.0 mCi (IQR, 147.5-351.0 mCi). The oncogenic driver was determined in 64 of 69 PTC samples: RET fusion (38/64; 59%), NTRK1/3 fusions (18/64; 28%), and the BRAF V600E mutation (8/64; 13%). At last evaluation, 93% had persistent disease. The median overall and disease-specific survival after DTC diagnosis were 50.7 and 52.8 years, respectively. Eight (5%) PTC patients died of disease after a median of 30.7 years (IQR, 20.6-37.6 years). Conclusion Childhood DTC with DM persists in most patients despite multiple courses of RAI, but disease-specific death is uncommon, typically occurring decades after diagnosis. Fusion genes are highly prevalent in PTC, and all identified molecular alterations have appropriate targeted therapies. Future studies should focus on expanding genotype-phenotype correlations, determining how to integrate molecularly targeted therapy into treatment paradigms, and relying less on repeated courses of RAI to achieve cure in patients with DM from childhood DTC.

show abstract

Section: Braf Mutation 13%mentioning

confidence: 91%

Distant Metastases From Childhood Differentiated Thyroid Carcinoma: Clinical Course and Mutational Landscape

Nies

Vassilopoulou‐Sellin

Bassett

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

show abstract

“…In adults, the pre-ablation stimulated thyroglobulin (sTg) had high predictive value in identifying the risk of disease persistence/recurrence after initial treatment and overall survival [3,8,11] regardless the DTC stage. Instead, the role of sTg in DTC pediatric patients remains to be fully established [12][13][14][15]. At the same time, the usefulness of ATA risk classification in children with DTC has been evaluated in few studies [16][17][18][19][20][21], and also the 1-year response to initial therapy categories presented in the 2015 adults' guideline (i.e., excellent response, biochemical incomplete response, structural incomplete response and indeterminate response) [3] has been tested few cases of pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in children and adolescents with differentiated thyroid carcinoma treated with total thyroidectomy and RAI: a real-life multicentric study

Cistaro

Quartuccio

Garganese

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose This multicentric study aimed to investigate the main prognostic factors associated with treatment response at 1 year after radioactive iodine therapy (RAIT) and the last disease status in pediatric patients affected by differentiated thyroid carcinoma (DTC). Materials and methods In the period 1990–2020, all consecutive patients ≤ 18 years from six different centers were retrospectively included. Patients were classified as low, intermediate, and high risk for persistence/recurrence. The response to RAIT was evaluated and scored 1 year later according to 2015 ATA guidelines. Moreover, at the last follow-up, the disease status was evaluated and dichotomized as no evidence of disease (NED) or persistent disease. Results Two hundred and eighty-five patients (197 female, 88 male; mean age 14.4 years) were recruited. All, except nine, underwent near-total thyroidectomy followed by RAIT. One-year after first RAIT, 146/276 (53%) patients had excellent response, 37/276 (14%) indeterminate response, and 91/276 (33%) incomplete response. One-year after RAIT, children with excellent response had significantly lower stimulated thyroglobulin (sTg) compared to not excellent group (median sTg 4.4 ng/ml vs 52.5 ng/ml, p < 0.001). ROC curve showed sTg higher than 27.2 ng/ml as the most accurate to predict 1-year treatment response. After a median follow-up of 133 months, NED was present in 241 cases (87%) while persistent disease in 35 (13%). At multivariate analysis, sTg and 1-year treatment response categories were both significantly associated with the last disease status (p value 0.023 and < 0.001). Conclusions In pediatric DTC, sTg is significantly associated with 1-year treatment response and final outcome. However, 1-year response is the principal prognostic factor able to predict pediatric DTCs outcome.

show abstract

“…In our practice, we obtain diagnostic WBSs prior to RAI in most patients under 18 years of age. If the postoperative sTg and anti-Tg levels are normal, and the WBS does not show any lung disease, it is our practice to defer chest CT. Data about the use of Tg, sTg, and anti-Tg as biomarkers continues to evolve in the population of children and young adults, though cutoffs in the literature have been variable (3,4). Similar to the authors' description of a CT-negative, WBS-positive patient, it has been our experience that chest CT can be negative in the setting of positive nuclear imaging.…”

Section: Commentarymentioning

confidence: 72%

Understanding of Pulmonary Metastases in Pediatric Patients with Differentiated Thyroid Cancer Is Evolving

Meister

Orloff

2021

Clinical Thyroidology

View full text Add to dashboard Cite

BackgroundLung metastases present more commonly and with better survival rates in children and young adults than in older adults with differentiated thyroid cancer (DTC). However, given the fairly low incidence of pediatric thyroid cancer, there is a paucity of literature about the clinical considerations among children and young adults with lung metastases. This retrospective study was performed to illustrate clinical considerations of lung metastases among children and young adults including associated factors, clinical presentation, and responses to therapy (1).

show abstract

Pre-Ablation Thyroglobulin and Thyroglobulin to Thyroid-Stimulating Hormone Ratio may be Associated with Pulmonary Metastases in Children with Differentiated Thyroid Cancer

Cited by 17 publications

References 26 publications

Distant Metastases From Childhood Differentiated Thyroid Carcinoma: Clinical Course and Mutational Landscape

Distant Metastases From Childhood Differentiated Thyroid Carcinoma: Clinical Course and Mutational Landscape

Prognostic factors in children and adolescents with differentiated thyroid carcinoma treated with total thyroidectomy and RAI: a real-life multicentric study

Understanding of Pulmonary Metastases in Pediatric Patients with Differentiated Thyroid Cancer Is Evolving

Contact Info

Product

Resources

About