Pregnancy has no significant impact on the prognosis of differentiated thyroid cancer

Nobre, Gabriela Maia; Tramontin, Mariana Yoshii; Treistman, Natália; Junior, Paulo Alonso Garcia Alves; Andrade, Fernanda Accioly de; Bulzico, Daniel; Corbo, Rossana; Vaisman, Fernanda

doi:10.20945/2359-3997000000413

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…Then, we conducted duplicate elimination ( n = 2098 removed), abstract screening ( n = 3125 excluded), report retrieval ( n = 5 excluded) and full-text screening ( n = 28 excluded). Finally, four studies with a comparison group [ 15 , 16 , 21 , 22 ] and six single-group studies [ 14 23 24 25 26 27 ] were included in our systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, four studies [ 14 24 25 26 ] classified recurrence into structural and biochemical types. The proportion of structural and biochemical recurrence in the pregnant DTC patients was 0.06 (95% CI, 0.03–0.11; I 2 = 0 [no heterogeneity]) and 0.10 (95% CI, 0.04–0.23; I 2 = 62% [substantial heterogeneity]), respectively [Supplementary Figure 2, http://links.lww.com/CM9/B888 ].…”

Section: Resultsmentioning

confidence: 99%

“…The pooled proportion of recurrence in the random effects model was 0.13 (95% con dence intervals [CI], 0.06-0.25; I 2 = 0.58 [substantial heterogeneity]) in the pregnant patients previously treated for DTC [Supplementary Figure 1, http:// links.lww.com/CM9/B888]. Speci cally, four studies [14,[24][25][26] classi ed recurrence into structural and biochemical types. The proportion of structural and biochemical recurrence in the pregnant DTC patients was 0.06 (95% CI, 0.03-0.11; I 2 = 0 [no heterogeneity]) and 0.10 (95% CI, 0.04-0.23; I 2 = 62% [substantial heterogeneity]), respectively [Supplementary Figure 2, http://links.lww.com/CM9/B888].…”

Section: Proportion Of Dtc Recurrence In Pregnant Women Previously Tr...mentioning

confidence: 99%

“…In addition, a total of nine studies reported follow-up time. We found no signi cant differences (P = 0.50) in Leboeuf et al [24] Single-group study USA 36 33.6 ± 3.9 * (33.5, 24.3-42.2) † NR 5.5 ± 3.8 * years 0.3, 0.1-1.7 † years Rosario et al [27] Single-group study Brazil 64 32.0, 23.0-39.0 ‡ NR 30.0, 15.0-74.0 ‡ months NR Hirsch et al [14] Single [21] Study with a comparison group [26] Single-group study USA 235 34.0 ± 0.4 * (34.0, 20.0-45.0) † 4.9 ± 0.3 * (3.0, 0.1-23.0) † years NR 3.0-12.0 § months Driouich et al [22] Study [25] Single-group study Brazil 76 32.0, 21.0-44.0 † 4.8, 0.9-19.0 †, ¶ years NR 11.0, 1.0-47.0 † years Xi et al [16] Study with a comparison group Colombo et al [23] Single-group study Yamazaki et al [15] Furthermore, six studies [14,[23][24][25][26][27] described response to therapy status before pregnancy. The pooled proportion for recurrence in the pregnant DTC patients was 0.00 (95% CI, 0.00-0.05), 0.09 (95% CI, 0.00-0.73), 0.14 (95% CI, 0.11-0.18), and 0.41 (95% CI, 0.06-0.81) for those with excellent (n = 287), indeterminate (n = 44), biochemical incomplete (n = 41), and structural incomplete response (n = 70), respectively [Figure 2].…”

Section: Proportion Of Dtc Recurrence In Pregnant Women Previously Tr...mentioning

confidence: 99%

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Pregnancy and the disease recurrence of patients previously treated for differentiated thyroid cancer: A systematic review and meta analysis

Shan,

Li,

Tao

et al. 2024

Chinese Medical Journal

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Background: Differentiated thyroid cancer (DTC) is commonly diagnosed in women of child-bearing age, but whether pregnancy in uences the prognosis of DTC remains controversial. This study aimed to summarize existing evidence regarding the association of pregnancy with recurrence risk in patients previously treated for DTC. Methods: We searched PubMed, Embase, Web of Science, Cochrane, and Scopus based on the prespeci ed protocol registered at PROSPERO (CRD42022367896). After study selection, two researchers independently extracted data from the included studies. For quantitative data synthesis, we used random-effects meta-analysis models to pool the proportion of recurrence (for pregnant women only) and odds ratio (OR; comparing the risk of recurrence between the pregnancy group and the nonpregnancy group), respectively. Then we conducted subgroup analyses to explore whether risk of recurrence differed by response to therapy status or duration of follow-up time. We also assessed quality of the included studies. Results: A total of ten studies were included. The sample size ranged from 8 to 235, with participants' age at pregnancy or delivery ranging from 28 to 35 years. The follow-up time varied from 0.1 to 36.0 years. The pooled proportion of recurrence in all pregnant patients was 0.13 (95% con dence intervals [CI]: 0.06-0.25; I 2 : 0.58). Among six included studies reporting response to therapy status before pregnancy, we observed a trend for increasingly higher risk of recurrence from excellent, indeterminate, and biochemically incomplete to structurally incomplete response to therapy (P trend <0.05). The pooled risk of recurrence in the pregnancy group showed no evidence of a signi cant difference from that in the nonpregnancy group (OR: 0.75; 95% CI: 0.45-1.23; I 2 : 0). The difference in follow-up time (below/above ve years) was not associated with either the proportion of recurrence in all pregnant patients (P >0.05) or the OR of recurrence in studies with a comparison group (P >0.05). Two included studies that focused on patients with distant metastasis also did not show a signi cant difference in disease recurrence between pregnancy and nonpregnancy groups (OR: 0.51 [95% CI: 0.14-1.87; I 2 : 59%]). Conclusion:In general, pregnancy appears to have a minimal association with the disease recurrence of DTC with initial treatment. Clinicians should pay more attention to progression of DTC among pregnant women with biochemical and/or structural persistence. Registration: PROSPERO, https://www.crd.york.ac.uk/PROSPERO/; No. CRD42022367896.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Proportion Of Dtc Recurrence In Pregnant Women Previously Tr...mentioning

confidence: 99%

Section: Proportion Of Dtc Recurrence In Pregnant Women Previously Tr...mentioning

confidence: 99%

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Pregnancy and the disease recurrence of patients previously treated for differentiated thyroid cancer: A systematic review and meta analysis

Shan,

Li,

Tao

et al. 2024

Chinese Medical Journal

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“…After screening, 38 studies were assessed for eligibility, from which 28 studies that failed to meet inclusion criteria were excluded. Ultimately, 10 studies were included, consisting of 4 studies with a comparison group 10,13,16,17 and 6 single-group studies 12,[18][19][20][21][22] (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

Pregnancy and the prognosis of patients previously treated for differentiated thyroid cancer: a systematic review and meta-analysis

Shan

Xiao

et al. 2023

Preprint

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IMPORTANCE Differentiated thyroid cancer (DTC) is commonly diagnosed in women of child-bearing age, but whether pregnancy influences the prognosis of DTC remained controversial. OBJECTIVE This systematic review and meta-analysis aimed to summarize and appraise the existing evidence of the impact of pregnancy on the prognosis of patients previously treated for DTC. DATA SOURCES We searched PubMed, Embase, Web of Science, Cochrane, and Scopus until February 2023. STUDY SELECTION Studies of patients diagnosed and treated for DTC before pregnancy reporting the recurrence/progression condition of DTC were included. Case reports and studies failing to identify the time of diagnosis or initial treatment were excluded. DATA EXTRACTION AND SYNTHESIS Meta-analyses were conducted according to MOOSE guideline. Data extraction was conducted by two independent investigators with a standard form. Pooled effect estimates were calculated in a random-effects model. MAIN OUTCOMES AND MEASURES DTC recurrence/progression and the type of recurrence/progression (structural or biochemical). RESULTS Among the 10 included studies (n = 625), 4 (n = 143) of them compared the pregnancy group with the non-pregnancy group while the remaining 6 (n = 482) only included the pregnant patients. The pooled proportion of recurrence/progression in all pregnant patients was 13% (95% CI, 6%, 25%). Compared with the non-pregnancy group, the pooled odds ratio of recurrence/progression in the pregnancy group was 0.75 (95% CI, 0.45, 1.23). Two included studies focused on patients with distant metastasis and also did not observe difference in disease recurrence/progression between the pregnancy group and the non-pregnancy group [OR, 0.51 (95% CI, 0.14-1.87)]. Six included studies also reported response to therapy status prior to pregnancy, and the pooled proportion for recurrence/progression in pregnant DTC patients with excellent response (n=287), indeterminate response (n=44), biochemical incomplete response (n=41) and structural incomplete response (n=70) was 0.00 (95% CI, 0.00-0.86), 0.09 (95% CI, 0.00-0.99), 0.20 (95% CI, 0.06-0.46) and 0.45 (95% CI, 0.17-0.76), respectively. There was a trend for an increasingly higher risk of recurrence/progression from excellent, indeterminate, biochemical incomplete to structural incomplete response to therapy (P<0.05). CONCLUSIONS AND RELEVANCE: Pregnancy appears to have a minimal impact on the prognosis of DTC with initial treatment. Clinicians may pay more attention to the progression of DTC among pregnant women with biochemical and/or structural persistence.

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Thyroid cancer and pregnancy: a systematic ten-year-review

Panagiotakopoulos,

Chorti,

Pliakos

et al. 2024

Gland Surg

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Background Thyroid cancer is the second most common malignancy during pregnancy, especially the well-differentiated thyroid cancer (well-DTC). Therefore, complex medical and social dilemmas arise, dealing with which requires deep knowledge of the nature and characteristics of the disease and pregnancy as a whole. The purpose of this review is to present the diagnostic and therapeutic strategies of thyroid cancer during pregnancy and the postpartum period. Methods Extended review of the literature [2011–2023] was performed. Two hundred ninety-six articles were found, from which 225 were excluded due to irrelevant subjects. Seventy-one articles were assessed for eligibility, from which 33 articles were cohort studies and case reports and were included in the review. Results From the 33 included studies, 18 were retrospective cohort studies, 1 was cohort study, 2 were case control studies, 1 was meta-analysis and 11 were case reports. The primary endpoints of these studies refer to the progression and recurrence of DTC during pregnancy, the prevalence of thyroid cancer in pregnancy and the most appropriate time for surgical intervention. Conclusions The majority of the studies agree that well-differentiated tumors with mild clinical and imaging characteristics do not require immediate surgical treatment, but mere monitoring. Surgery can be delayed after childbirth. In contrast, tumors with aggressive behavior as well as non-differentiated ones, require immediate surgery because delay under these circumstances can dramatically reduce survival rates. Finally, a history of thyroid cancer does not seem to affect future deliveries, on condition that no residual disease exists at the onset of pregnancy.

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Pregnancy has no significant impact on the prognosis of differentiated thyroid cancer

Cited by 5 publications

References 20 publications

Pregnancy and the disease recurrence of patients previously treated for differentiated thyroid cancer: A systematic review and meta analysis

Pregnancy and the disease recurrence of patients previously treated for differentiated thyroid cancer: A systematic review and meta analysis

Pregnancy and the prognosis of patients previously treated for differentiated thyroid cancer: a systematic review and meta-analysis

Thyroid cancer and pregnancy: a systematic ten-year-review

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