Recent Pregnancy Is Not Associated with High-Risk Pathological Features of Well-Differentiated Thyroid Cancer

Abstract

In this cohort, recent pregnancy was not associated with high-risk pathological features of differentiated thyroid cancer. These findings provide reassurance with regards to the concern that pregnancy may act as a potential stimulus for thyroid cancer growth.

Clinical course and outcome of differentiated thyroid cancer patients with pregnancy after diagnosis of distant metastasis

“…DM was diagnosed based on CT, PET/CT, therapeutic 131 I-whole body-scan ( 131 I-WBS), and serum Tg levels [12]. Dosage of 131 I of 25 mCi or higher was considered as therapeutic doses.…”

“…Pregnancy-related hormones, such as estrogen and human chorionic gonadotropin, may favor the growth, progression, and spread of thyroid tumors [10,11]. However, to our knowledge, there is no evidence showing that pregnancy worsens the prognosis of thyroid cancer [12,13]. Xi et al revealed that pregnancy does not affect the prognoses in DTC patients with lung metastasis [13].…”

Incidence and Survival of Thyroid Cancer with Lung Metastasis

“…Referring to other studies [5][6][7], this may be explained by better social support, including medicare. But other experts considered it as an independent prognostic factor of recurrence and metastasis in thyroid cancers [8].…”

Thyroid diseases in pregnancy: guidelines of the Polish Society of Endocrinology [Choroby tarczycy w ciąży: zalecenia postępowania Polskiego Towarzystwa Endokrynologicznego]

“…More importantly, none of the above studies indicate that postponing surgery until after delivery has a negative impact on survival. There was also no evidence of an effect of recent pregnancy on the presence of high-risk features, including tumour size, presence of extrathyroidal infiltration, stage of disease (lymph node metastases, distant metastases), as well as disease status at the time of the last visit and 5-year cancer-specific survival in women diagnosed with thyroid cancer between 5 years before and 9 months after pregnancy [174]. However, there are also analyses in which the risk of recurrence or persistent disease is significantly higher in the group of patients diagnosed with thyroid cancer during pregnancy than in the group of other thyroid cancer patients [167,171].…”

“…Co ważniejsze, żadne z powyższych badań nie wskazuje, że odroczenie terminu operacji na okres po porodzie ma negatywny wpływ na przeżycie. Nie stwierdzono również wpływu niedawno przebytej ciąży na obecność cech wysokiego ryzyka, w tym na guidelines wielkość guza, obecność nacieku pozatarczycowego, stopień zaawansowania choroby (przerzuty do węzłów chłonnych, przerzuty odległe) oraz stan choroby w chwili ostatniej wizyty i 5-letnie przeżycie zależne od raka u kobiet, u których raka tarczycy rozpoznano w okresie 5 lat przed do 9 miesięcy po ciąży [174]. Jednak dostępne są również wyniki analiz, w których ryzyko nawrotu lub przetrwałej choroby jest istotnie wyższe w grupie chorych, u których raka tarczycy rozpoznano w ciąży, niż w grupie pozostałych chorych na raka tarczycy [167,171].…”