Prognostic factors determining survival in differentiated thyroid cancer

Gülçelik, Mehmet Ali; Gülçelik, Neşe Ersöz; Kuru, Bekir; Camlibel, Mithat; Ağuş, Haluk

doi:10.1002/jso.20845

Cited by 40 publications

(23 citation statements)

References 33 publications

(37 reference statements)

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“…Numerous studies have described the importance of Tg and TSH values for optimal accuracy of 18F-FDG-PET/CT [31][32][33][34][35][36]. Our results agree with previous studies.…”

Section: Discussionsupporting

confidence: 95%

The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

et al. 2015

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Little is known about the role in ongoing risk stratification of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed early after radioactive iodine (RAI) ablation in differentiated thyroid carcinoma (DTC). The aim of the study is to investigate whether 18F-FDG PET/CT performed early after RAI ablation is useful to detect disease and to influence therapy and ongoing risk stratification. Patients with high/intermediate risk of recurrent DTC were included. 18F-FDG PET/CT scan was performed within 6 months after RAI ablation. We confirmed results with other imaging techniques, pathology reports, or follow-up. We classified the patient response as excellent, acceptable, or incomplete. Modified Hicks criteria were used to evaluate clinical impact. We included 81 patients with high/intermediate risk of recurrent DTC. Forty-one (50.6%) had positive uptake in 18F-FDG PET/CT, with negative (131)I whole-body scan ((131)I WBS). Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT were 92.5, 90.2, and 91.4%, respectively. 18F-FDG PET/CT results had an impact on therapy in 38.3% of patients. One year after initial therapy, 45.7% showed excellent response, 8.6% acceptable response, and 45.7% incomplete response. A statistically significant relationship was found between negative 18F-FDG PET/CT and excellent response (80 vs. 12.2%, p < 0.001; OR 52.8). 18F-FDG PET/CT scan performed early in surveillance of patients with high/intermediate-risk thyroid carcinoma provides important additional information not available with conventional follow-up methods and had a high impact on therapy. A negative 18F-FDG PET/CT predicts an excellent response to therapy in the new ongoing risk stratification.

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“…Numerous studies have described the importance of Tg and TSH values for optimal accuracy of 18F-FDG-PET/CT [31][32][33][34][35][36]. Our results agree with previous studies.…”

Section: Discussionsupporting

confidence: 95%

The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

et al. 2015

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“…On the other hand, the AMES (5) prognostic scoring system and various versions of the TNM (3, 4) system do not include histology as an independent risk factor. In various other studies, histology in some does (13,14), and in others does not (15) come out as an independent prognostic factor for survival in DTC. DeGroot et al (16) report that FTC patients have a considerably poorer prognosis than PTC patients; however, they do not report what happens when differences in disease stage at the time of presentation are compensated for.…”

Section: Discussionmentioning

confidence: 94%

Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases

Verburg¹,

Mäder²,

Luster³

et al. 2009

European Journal of Endocrinology

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Objective: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) show considerable differences in disease stage at initial presentation. The aim of this study was to investigate whether there are differences in tumour-specific survival if initial staging is accounted for. Design: Retrospective chart review study. Patients: The study sample comprised 875 PTC and 350 FTC patients (856 females, 369 males, mean age 47.8 years) treated in our hospital from 1978 to 2002. All patients received total thyroidectomy with subsequent I-131 ablation except for those patients with an isolated papillary microcarcinoma. Methods: Kaplan-Meier analyses and Cox-regression analyses were performed to assess the influence of histology on thyroid cancer-specific survival. Results: FTC patients were on average older, more likely to be male, presented with a larger tumour and more frequently had multifocal carcinoma and distant metastases than PTC patients, whereas they presented less frequently with extrathyroidal invasion or lymph node metastases. Twenty-year tumour-specific survival in PTC was 90.6% and in FTC 73.7% (P!0.001). In multivariate analysis the presence of distant metastases (P!0.001), age (P!0.001), tumour size (PZ0.001) and the presence of extrathyroidal invasion (PZ0.007), but not histology (PZ0.26), were independent determinant variables for tumour-specific survival. Conclusion: There is no difference in tumour-specific survival between PTC and FTC when accounting for the presence of metastases, age, tumour size and the presence of extrathyroidal invasion.

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“…By contrast, distant metastases, mainly to the lungs and bones, are more frequent at disease presentation (~20%) (4). Although former studies have indicated that FTCs, particularly the invasive form, have a poorer prognosis than PTCs (74,75), a recent study that evaluated more than 1,000 patients did not find differences in tumor-specific survival between PTC and FTC, after controlling for age, primary tumor size, extrathyroidal invasion or distant metastasis at diagnosis (76).…”

Section: Follicular Thyroid Carcinomamentioning

confidence: 84%

Signaling pathways in follicular cell-derived thyroid carcinomas

Romitti

Ceolin

Siqueira

et al. 2012

International Journal of Oncology

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Abstract. Thyroid carcinoma is the most common malignant endocrine neoplasia. Differentiated thyroid carcinomas (DTCs) represent more than 90% of all thyroid carcinomas and comprise the papillary and follicular thyroid carcinoma subtypes. Anaplastic thyroid carcinomas correspond to less than 1% of all thyroid tumors and can arise de novo or by dedifferentiation of a differentiated tumor. The etiology of DTCs is not fully understood. Several genetic events have been implicated in thyroid tumorigenesis. Point mutations in the BRAF or RAS genes or rearranged in transformation (RET)/papillary thyroid carcinoma (PTC) gene rearrangements are observed in approximately 70% of papillary cancer cases. Follicular carcinomas commonly harbor RAS mutations and paired box gene 8 (PAX8)-peroxisome proliferator-activated receptor γ (PPARγ) rearrangements. Anaplastic carcinomas may have a wide set of genetic alterations, that include gene effectors in the mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3K) and/or β-catenin signaling pathways. These distinct genetic alterations constitutively activate the MAPK, PI3K and β-catenin signaling pathways, which have been implicated in thyroid cancer development and progression. In this context, the evaluation of specific genes, as well as the knowledge of their effects on thyroid carcinogenesis may provide important information on disease presentation, prognosis and therapy, through the development of specific tyrosine kinase targets. In this review, we aimed to present an updated and comprehensive review of the recent advances in the understanding of the genetic basis of follicular cell-derived thyroid carcinomas, as well as the molecular mechanisms involved in tumor development and progression.

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Prognostic factors determining survival in differentiated thyroid cancer

Abstract: In DTC patients, in addition to traditional risk factors, prognostic factors, such as vascular invasion and capsular invasion, need to be evaluated; not only for achieving an adequate therapeutic approach, but also for avoiding overtreatment of low-risk patients.

Cited by 40 publications

References 33 publications

The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases

Signaling pathways in follicular cell-derived thyroid carcinomas

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