Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma

Background: In patients with poorly differentiated thyroid carcinoma, the clinical course and prognostic value of response to initial radioiodine therapy is evaluated. Methods: In 47 patients, clinical and imaging features were analyzed. Patients were stratified in no (NED), biochemical (B-ED) and s...

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Autores principales:	Freba Grawe, Atika Cahya, Matthias P. Fabritius, Leonie Beyer, Vera Wenter, Johannes Ruebenthaler, Thomas Geyer, Caroline Burgard, Peter Bartenstein, Harun Ilhan, Christine Spitzweg, Andrei Todica
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	poorly differentiated thyroid cancer <sup>18</sup>F-FDG-PET/CT radioiodine therapy PDTC risk stratification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1e7d52ebefa349e3b2b089d80590ea7e
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spelling	oai:doaj.org-article:1e7d52ebefa349e3b2b089d80590ea7e2021-11-11T15:28:01ZCourse of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma10.3390/cancers132153092072-6694https://doaj.org/article/1e7d52ebefa349e3b2b089d80590ea7e2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5309https://doaj.org/toc/2072-6694Background: In patients with poorly differentiated thyroid carcinoma, the clinical course and prognostic value of response to initial radioiodine therapy is evaluated. Methods: In 47 patients, clinical and imaging features were analyzed. Patients were stratified in no (NED), biochemical (B-ED) and structural evidence of disease (S-ED) assessed at the first diagnostic control and its impact on survival was evaluated. Further, possible risk factors for a shorter disease-specific survival rate (DSS) were analyzed. Results: In total, 17/47 patients consisted of NED, 10/47 were B-ED and 20/47 S-ED patients. At the last follow-up, 18/47 patients were NED, 2/47 patients B-ED and 27/47 patients S-ED. The median survival time was only reached for the S-ED group (median 3.9 years, 95%CI 2.8–5.1 years) and was not reached in the B-ED and NED groups. Metastases were diagnosed by a <sup>18</sup>F-FDG-PET/CT scan in all cases and a multivariate analysis showed that the PET-positivity of metastases was the only significant predictor of DSS (<i>p</i> = 0.036). Conclusion: The response to initial surgery and radioiodine therapy in PDTC patients can achieve an excellent outcome and a further follow-up should be refined based on findings at the first diagnostic control. However, patients with an incomplete response and metastatic patients who become mostly radioiodine refractory show a significantly shorter survival, which makes accurate staging by <sup>18</sup>F-FDG-PET/CT imaging crucial.Freba GraweAtika CahyaMatthias P. FabritiusLeonie BeyerVera WenterJohannes RuebenthalerThomas GeyerCaroline BurgardPeter BartensteinHarun IlhanChristine SpitzwegAndrei TodicaMDPI AGarticlepoorly differentiated thyroid cancer<sup>18</sup>F-FDG-PET/CTradioiodine therapyPDTCrisk stratificationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5309, p 5309 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	poorly differentiated thyroid cancer <sup>18</sup>F-FDG-PET/CT radioiodine therapy PDTC risk stratification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	poorly differentiated thyroid cancer <sup>18</sup>F-FDG-PET/CT radioiodine therapy PDTC risk stratification Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Freba Grawe Atika Cahya Matthias P. Fabritius Leonie Beyer Vera Wenter Johannes Ruebenthaler Thomas Geyer Caroline Burgard Peter Bartenstein Harun Ilhan Christine Spitzweg Andrei Todica Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
description	Background: In patients with poorly differentiated thyroid carcinoma, the clinical course and prognostic value of response to initial radioiodine therapy is evaluated. Methods: In 47 patients, clinical and imaging features were analyzed. Patients were stratified in no (NED), biochemical (B-ED) and structural evidence of disease (S-ED) assessed at the first diagnostic control and its impact on survival was evaluated. Further, possible risk factors for a shorter disease-specific survival rate (DSS) were analyzed. Results: In total, 17/47 patients consisted of NED, 10/47 were B-ED and 20/47 S-ED patients. At the last follow-up, 18/47 patients were NED, 2/47 patients B-ED and 27/47 patients S-ED. The median survival time was only reached for the S-ED group (median 3.9 years, 95%CI 2.8–5.1 years) and was not reached in the B-ED and NED groups. Metastases were diagnosed by a <sup>18</sup>F-FDG-PET/CT scan in all cases and a multivariate analysis showed that the PET-positivity of metastases was the only significant predictor of DSS (<i>p</i> = 0.036). Conclusion: The response to initial surgery and radioiodine therapy in PDTC patients can achieve an excellent outcome and a further follow-up should be refined based on findings at the first diagnostic control. However, patients with an incomplete response and metastatic patients who become mostly radioiodine refractory show a significantly shorter survival, which makes accurate staging by <sup>18</sup>F-FDG-PET/CT imaging crucial.
format	article
author	Freba Grawe Atika Cahya Matthias P. Fabritius Leonie Beyer Vera Wenter Johannes Ruebenthaler Thomas Geyer Caroline Burgard Peter Bartenstein Harun Ilhan Christine Spitzweg Andrei Todica
author_facet	Freba Grawe Atika Cahya Matthias P. Fabritius Leonie Beyer Vera Wenter Johannes Ruebenthaler Thomas Geyer Caroline Burgard Peter Bartenstein Harun Ilhan Christine Spitzweg Andrei Todica
author_sort	Freba Grawe
title	Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
title_short	Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
title_full	Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
title_fullStr	Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
title_full_unstemmed	Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma
title_sort	course of disease and clinical management of patients with poorly differentiated thyroid carcinoma
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1e7d52ebefa349e3b2b089d80590ea7e
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Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma

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