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Endocrine Abstracts (2019) 63 GP90 | DOI: 10.1530/endoabs.63.GP90

ECE2019 Guided Posters Thyroid Nodules and Cancer (12 abstracts)

Treatment modalities in DTC patients with neck disease persistence. Second surgical intervention is more beneficial than only radioiodine (RAI) treatment

Katerina Saltiki , George Simeakis , Panagiota Konstantakatou , Spyros Sapounas & Maria Alevizaki


Endocrine Unit, Department Clinical Therapeutics, Medical School National Kapodistrian University, Athens, Greece.

Objectives: DTC has a favorable clinical course. A small percentage of patients undergoing surgery and RAI ablation may have local disease persistence and further therapeutic interventions may be needed such as further RAI administration following or not a second surgery. We investigated whether additional therapeutic interventions may be beneficial for the clinical course in DTC patients with disease persistence.

Methods: 812 DTC patients (men 25.7%, age at diagnosis 42.4±15.5 yrs) who received RAI ablation were followed-up in our department for 1–44 yrs (median 3 yrs). 206 of them received further RAI treatment with or without additional cervical surgery. They were classified in 3 groups according to the treatment modality that was followed: RAI-only (n=47, 22.8%), RAI+Surgery (n=86, 41.7%) multiple-interventions group (n=73, 35.4%). Clinical and histological characteristics were compared between groups.

Results: One year after diagnosis and before further intervention, stimulated thyroglobulin levels (sTG, median (IQR)) were in the groups RAI-only 4.9(23) vs RAI+surgery 6.7(47) vs multiple-interventions 62(179) ng/mL (P=0.01). After the additional interventions sTG changed to 5.3(26), 2.4(21), 33(143) respectively in the 3 groups (P<0.001). Patients in the RAI-only group showed less frequently disease remission compared to RAI+Surgery group (24.4% vs 43.5%, P<0.001). The occurence of distant metastases during follow up was higher in RAI-only group (33.3% vs 16.0%, P=0.002). Age at diagnosis, histology type, tumour size, multifocality, presence of lymph node infiltration, capsular invasion, soft tissue invasion, did not differ significantly between groups. The 10-year probability of lack of progression of disease was: RAI-only 67.4% vs RAI+Surgery 89.5% (x2=18.06, P<0.001). Disease progression, RAI refractory DTC and distant metastases were more prevalent in the group of multiple interventions (P<0.001).

Conclusions: In DTC patients with disease persistence a second RAI administration without prior surgical intervention may not be beneficial in the majority of cases. Surgical removal of the metastatic disease prior to RAI administration could be a better therapeutic option for these patients.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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