ETA2023 Poster Presentations Treatment 2 (9 abstracts)
Tailored mortality risk in stage I-II DTC patients by integrating ata stratification and response to initial therapy
Cristina Dalmiglio 1 , Raffaella Forleo 1 , Noemi Fralassi 1 , Fabio Maino 1 , Lucia Brilli 1 , Laura Valerio 1 , Andrea Trimarchi 1 , Tania Pilli 1 , Alessandra Cartocci 2 & Maria Grazia Castagna 1
1University of Siena, Medical, Surgical and Neurological Sciences, Siena, Italy; 2University of Siena, Medical Biotechnologies, Siena, Italy
Objectives: AJCC/TNM staging system provides an estimate of mortality risk in differentiated thyroid cancer (DTC) patients and recent evidence showed that ATA risk stratification may improve the definition of this risk. We speculated that the integration of the response to the initial therapy (RIT) could better define the mortality risk.
Methods: We retrospectively evaluated 891 consecutive DTC patients followed at the Section of Endocrinology, University of Siena, Italy from January 2006 to December 2020. Patients were classified according to the eighth edition of AJCC/TNM, ATA risk classes and response to RIT.
Results: The mortality rate in the whole cohort was 3.5%, decreased to 1% in Stage I and raised up to 21.6% in Stage II patients (P < 0.0001). After dividing by ATA risk stratification, the mortality rate in Stage I was 0.3% in low risk and 2.9% in intermediate-high risk patients (P = 0.005). Finally, considering the RIT, Stage I-low risk patients with excellent response (ER) showed a lower mortality rate than Stage I-low risk patients with persistent disease (PD) after initial therapy (0% vs 4.4%, P = 0.0058). Similar trend was observed in Stage I patients with intermediate-high risk class (P = 0.0013). In Stage II-intermediate-high risk patients, the mortality rate was 6.4% and 50% in patients with ER and PD, respectively (P < 0.001). The corresponding Kaplan–Meier curves showed six subgroups of patients with increasing disease specific mortality (P < 0.001).
Conclusion: Mortality risk estimated by AJCC/TNM staging system could be improved by integrating ATA risk classes and RIT and that the patient management could be tailored accordingly.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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