Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy

Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel; Pessoa, Cencita H. C. N.; Dias, Fernando Luiz; Corbo, Rossana; Vaisman, Mário; Tuttle, R. Michael

doi:10.1111/j.1365-2265.2012.04342.x

Cited by 242 publications

(177 citation statements)

References 21 publications

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“…This practical approach effectively estimates the risk of recurrent disease in DTC patients. This system has been validated in three large cohort studies in the United States and Brazil (11,12,13). However, this dynamic risk assessment did not take into consideration the status of serum anti-Tg antibody (TgAb) even though 10-25% of patients with DTC have a positive serum TgAb level (14).…”

Section: Introductionmentioning

confidence: 99%

Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma

Jeon

Kim

Park

et al. 2014

European Journal of Endocrinology

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Objective: A new risk stratification system was proposed to estimate the risk of recurrence in patients with differentiated thyroid carcinoma (DTC) using the response to initial therapy. Here, we describe the modified dynamic risk stratification system, which takes into consideration the status of serum anti-Tg antibody (TgAb), and validate this system for assessing the risk of recurrence in patients with DTC. Patients and methods: Patients who underwent total thyroidectomy with radioiodine remnant ablation due to DTC between 2000 and 2005 were included. We classified patients into four groups based on the response to the initial therapy ('excellent', 'acceptable', 'biochemical incomplete', and 'structural incomplete' response). Results: The median follow-up period of 715 patients with DTC was 8 years. The response to initial therapy was an important risk predictor for recurrent/persistent DTC. The relative risks (95% CI) of recurrence were 16.5 (6.3-43.0) in the 'acceptable response ' group, 41.3 (15.4-110.8) in the 'biochemical incomplete response' group, and 281.2 (112.9-700.5) in the 'structural incomplete response' group compared with the 'excellent response' group (P!0.001, P!0.001, and P!0.001 respectively). The disease-free survival rate of the 'excellent response' group to initial therapy was 98.3% whereas that of the 'structural incomplete response' group was only 6.8%. Conclusions: Our study validates the usefulness of the modified dynamic risk stratification system including the status of serum TgAb for predicting recurrent/persistent disease in patients with DTC. Personalized risk assessment using the response to initial therapy could be useful for the follow-up and management of patients with DTC.

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Section: Introductionmentioning

confidence: 99%

Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma

Jeon

Kim

Park

et al. 2014

European Journal of Endocrinology

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“…(15). These authors showed that 72% and 34% of patients categorized within the group of indeterminate and biochemical incomplete response respectively, were reclassified as NED without further additional therapy beyond continued levothyroxine suppression (15), similarly, Pitoia and cols. showed that only 16% of patients with biochemical persistence developed structurally identifiable disease over the first 4 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Dynamic prediction of the risk of recurrence in patients over 60 years of age with differentiated thyroid carcinoma

Morosan

Parisi

Urrutia

et al. 2016

Arch. Endocrinol. Metab.

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Objective: The reclassification of the risk according to the response to the initial treatment makes the treatment of differentiated thyroid cancer (DTC) vary in each individual. As the influence of age on this diagnostic strategy is unknown, we have decided to assess it in adults who are over 60 years of age. Subjects and methods: Ninety patients with DTC above 60 years old were enrolled, with total thyroidectomy plus radioiodine ablation, negative anti-thyroglobulin antibodies, follow-up ≥ 2 years and with clinical and pathological information to classify the risk of recurrence according to ATA (American Thyroid Association) and reclassify based on the response to initial therapy according to MSKCC (Memorial Sloan Kettering Cancer Center). The structural persistence at the end of the follow-up was the gold standard of our analysis. Results: The structural persistence in ATA low, intermediate and high risk categories was 0, 38, and 100%, respectively. In the intermediate group, none of those with an excellent response to the initial treatment showed structural persistence, whereas 39% of those with an incomplete/indeterminate response showed structural persistence (p < 0.01). Conclusions: The re-stratification according to the response to the initial treatment in patients over 60 years of age with an ATA intermediate risk of recurrence allowed for the distinction of disease-free patients at the end of the follow-up from those with structural persistence and a worse clinical progression. Arch Endocrinol Metab. 2016;60(4):348-54

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“…Динамическая стратификация риска по-зволяет разделить пациентов на следующие четыре основные группы по результатам проведенного лечения [1, 2, 68, [134][135][136][137].…”

Section: послеоперационное ведение пациентовunclassified

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

et al. 2017

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В представленных клинических рекомендациях обсуждаются современные подходы к диагностике и лечению дифференцированного рака щитовидной железы у взрослых. Изменения в настоящей редакции Клинических рекомендаций касаются показаний к пункционной биопсии, скринингового определения концентрации кальцитонина, унификации заключений цитологического исследования, новых подходах к послеоперационной динамической стратификации риска рецидива, показаний к супрессивной и заместительной терапии, таргетной терапии йоднегативных форм дифференцированного рака щитовидной железы.

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Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy

Abstract: These data validate the ATA risk classification as an excellent initial predictor of recurrent/persistent disease and confirm the clinical utility of the MSKCC dynamic risk assessment system in a cohort of patients evaluated and treated outside the United States.

Cited by 242 publications

References 21 publications

Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma

Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma

Dynamic prediction of the risk of recurrence in patients over 60 years of age with differentiated thyroid carcinoma

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

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