ECE2018 Guided Posters Thyroid Cancer - Diagnostics & Treatments (12 abstracts)
Background and objective: Incidence of differentiated thyroid cancer (DTC) is increasing but not its mortality. Knowing recurrence factors is essential to plan its treatment. Recurrence related factors in our area were reviewed and compared with ATA risk stratification system.
Patients and Methods: The Cadit-CAM study was designed to evaluate characteristics of patients diagnosed of DTC in Castilla La Mancha, a region in the central part of Spain, during 15 years (from 2001 to 2015). The cohort in Cadit-CAM study included 1434 patients from seven regional hospitals. The variables analyzed were: sex, age, size, histopathologic subtype, multifocality, involved lymph nodes, lymphadenectomy, extrathyroidal extension, metastases at diagnosis (MTS), intentionally total thyroidectomy (ITT), anti-thyroglobulin antibodies with rising titers (TG-Ab). Treatments and evolution of patients who recurred were also evaluated.
Results: 324 patients recurred (23%), being 82% ATA high risk (71 patients), 33% ATA intermediate risk (160) and 9% ATA low risk (93). Factors independently related to recurrence were MTS with OR 46.7 (95% CI 13165); TG-Ab 4.86 (2.49.9); positive lymph nodes 4.38 (2.76.9), multifocality 2.2 (1.593.05), extrathyroidal extension 2.09 (1.43.1), size >3 cm 1.83 (1.232.72); male 1.64 (1.152.32). Those not statistically related to recurrence were ITT 1.33 (0.822.1); age 0.99 (0.981); lymphadenectomy 0.8 (0.51.28) and histology 0.7 (0.341.41). Recurrence treatments were: Iodine-131 (56%); surgery (31%), both (23%), kinase inhibitors (5%), observation (8%), and palliative surveillance, radiotherapy, cementation, and chemotherapy (<1%), For patients with recurrence the outcome at the end of the follow up was: 26% alive without evidence of disease, 24% alive with structural disease, 27% indeterminate or biochemically incomplete response and 10% died for DTC
Conclusion: 23% of the patients with DTC recurred. Recurrence poor prognosis factors were MTS, TG-Ab, involved lymph nodes, multifocality, extrathyroidal extention, tumor size and male sex. ATA Risk stratification predicts recurrence, however two third of these patients were in ATA intermediate and low risk groups.
19 May 2018 - 22 May 2018