Lithium as an Adjuvant in the Postoperative Ablation of Remnant Tissue in Low Risk Thyroid Carcinoma

Yamazaki, C; Padovani, Rosália do Prado; Biscolla, Rosa Paula M.; Ikejri, Elza Setsuko; Matsumura, Luiza K.; Maciel, Rui M. B.; Furlanetto, Reinaldo P.; Marchetti, Renata Rosa; Castiglioni, Mario Luiz Vieira

doi:10.1089/thy.2011-0372

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…In the remainder of patients, recombinant TSH is recommended whenever it is available (Recommendation A). In patients with low risk of persistent or recurrent disease and in whom a total thyroidectomy was properly performed, an activity of 30 mCi of 131 I is efficacious to achieve remnant ablation (108,109,(115)(116)(117)(118) and exhibits low medium-and long-term relapse rates (67,93,117,119). In this regard, two major randomized trials with 438 (108) and 756 (109) patients stand out.…”

Section: Recommendation 37mentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

123

147

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Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Keywords Thyroid nodules; thyroid cancer; Brazilian consensus; update RESUMO Nódulos tireoidianos são muito frequentes, sobretudo quando se empregam métodos sensí-veis de imagem. Embora o câncer seja proporcionalmente raro, sua incidência vem aumentando, especialmente de tumores pequenos, cuja evolução clínica é incerta. A maioria dos pacientes com carcinoma diferenciado de tireoide evolui bem quando adequadamente tratada, com índices de mortalidade similares à população geral. Por outro lado, um percentual não desprezível apresenta recidivas e alguns eventualmente não respondem às terapias convencionais, evoluindo para óbito. Assim, o desafio é distinguir os pacientes merecedores de condutas mais agressivas e, ao mesmo tempo e não menos importante, poupar a maioria de tratamentos e procedimentos desnecessários. Atualizamos o Consenso Brasileiro publicado em 2007, ressaltando os avanços diagnósticos e terapêuticos que os participantes, de diferentes Centros Universitários do Brasil, consideram mais relevantes para prática clínica. A elaboração dessas diretrizes foi baseada na experiência dos participantes e revisão da literatura pertinente. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Descritores

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Section: Recommendation 37mentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

123

147

View full text Add to dashboard Cite

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“…Similarly, Haq et al documented that metastatic disease confined to the lungs is associated with improved disease‐specific survival (HR 0.37, CI 0.19‐0.72). In contrast to lack of superiority of Li‐aided RAI therapy in metastatic thyroid cancer patients, Yamazaki et al documented that addition of Li improved the rate of remnant ablation with 30 mCi of RAI in low‐risk thyroid cancer patients.…”

Section: Discussionmentioning

confidence: 99%

The effect of lithium on the progression‐free and overall survival in patients with metastatic differentiated thyroid cancer undergoing radioactive iodine therapy

Luo

Tobey

Auh

et al. 2018

Clinical Endocrinology

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“…Radioidine therapy has been used since 1960 for remnant ablation [28] , but became more popular in the 1990s, being considered the standard of care [29,30] . For low-risk thyroid cancer, studies suggest using 30 mCi for RRA, with the aim of achieving negative Tg levels for accurate surveillance [11,31,32] . Our study shows that the use of RRA just to turn Tg into an accurate marker is not necessary, because it is not a single Tg value that most matters, but rather the Tg trend during the follow-up, as others have also demonstrated [33,34] .…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study Showing an Excellent Response of Patients with Low-Risk Differentiated Thyroid Cancer Who Did Not Undergo Radioiodine Remnant Ablation after Total Thyroidectomy

et al. 2015

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ment, measuring Tg and making a WBS. The patients were then annually monitored with neck US and Tg measurement under TSH between 0.5 and 2.0 mIU/l for 36-84 months. Results: Neck US of all patients, 3 months after TT, presented no evidence of abnormal residual tissues or metastatic lymph nodes (negative neck US); at this time, the mean Tg level was 0.42 ng/ml. Six months after surgery, after rhTSH, the mean thyroid bed uptake was 1.82%, and Tg levels ranged from 0.10 to 22.30 ng/ml (mean, 2.89 ng/ml). The patients were followed up without any sign of recurrence (negative neck US and stable or decreasing Tg levels). During the ongoing follow-up, the Tg trend was stable or decreasing, independently of the initial suppressed or stimulated Tg level, or WBS uptake. Conclusions: In patients with low-risk differentiated thyroid cancer, who were operated by TT and who did not undergo RRA, an excellent response to treatment may be confirmed by annual neck US and Tg trend. Key WordsLow-risk thyroid carcinoma · Thyroglobulin · Thyroglobulin temporal trend · Radioiodine remnant ablation · Neck ultrasound Abstract Objectives: To prospectively evaluate the outcome of patients with low-risk papillary thyroid carcinoma treated with total thyroidectomy (TT) who did not undergo radioiodine remnant ablation (RRA). Study Design: We prospectively followed up 57 patients; 3 months after TT, thyroglobulin (Tg) assessment and neck ultrasonography (US) were performed while patients were taking L -T 4 , presenting suppressed TSH. Six months after TT, patients underwent stimulated Tg testing and whole-body scan (WBS) after recombinant TSH (rhTSH). Then, 18 months after TT, the patients were evaluated by neck US and Tg under TSH between 0.5 and 2.0 mIU/ ml. Two years after TT, we performed another rhTSH assess-

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Lithium as an Adjuvant in the Postoperative Ablation of Remnant Tissue in Low Risk Thyroid Carcinoma

Cited by 8 publications

References 12 publications

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

The effect of lithium on the progression‐free and overall survival in patients with metastatic differentiated thyroid cancer undergoing radioactive iodine therapy

A Prospective Study Showing an Excellent Response of Patients with Low-Risk Differentiated Thyroid Cancer Who Did Not Undergo Radioiodine Remnant Ablation after Total Thyroidectomy

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