Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes

Although most patients with differentiated thyroid cancer (DTC) and biochemical incomplete response (BIR) follow a good clinical outcome, progression to structural disease may occur in 8–17% of patients. We aimed to identify factors that could predict the long-term outcomes of BIR patients. To this...

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Autores principales:	Miriam Steinschneider, Jacob Pitaro, Shlomit Koren, Yuval Mizrakli, Carlos Benbassat, Limor Muallem Kalmovich
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	papillary thyroid cancer biochemical incomplete response thyroglobulin prognosis survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c25d8de3d649403d97f0a7088c5623da
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spelling	oai:doaj.org-article:c25d8de3d649403d97f0a7088c5623da2021-11-11T15:31:02ZDifferentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes10.3390/cancers132154222072-6694https://doaj.org/article/c25d8de3d649403d97f0a7088c5623da2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5422https://doaj.org/toc/2072-6694Although most patients with differentiated thyroid cancer (DTC) and biochemical incomplete response (BIR) follow a good clinical outcome, progression to structural disease may occur in 8–17% of patients. We aimed to identify factors that could predict the long-term outcomes of BIR patients. To this end, we conducted a retrospective review study of 1049 charts from our Differential Thyroid Cancer registry of patients who were initially treated with total thyroidectomy between 1962 and 2019. BIR was defined as suppressed thyroglobulin (Tg) > 1 ng/mL, stimulated Tg > 10 ng/mL or rising anti-Tg antibodies, who did not have structural evidence of disease, and who were assessed 12–24 months after initial treatment. We found 83 patients (7.9%) matching the definition of BIR. During a mean follow-up of 12 ± 6.6 years, 49 (59%) patients remained in a state of BIR or reverted to no evidence of disease, while 34 (41%) progressed to structural disease. At the last follow-up, three cases (3.6%) were recorded as disease-related death. The American Thyroid Association (ATA) Initial Risk Stratification system and/or AJCC/TNM (8th ed.) staging system at diagnosis predicted the shift from BIR to structural disease, irrespective of their postoperative Tg levels. We conclude that albeit 41% of BIR patients may shift to structural disease, and most have a rather indolent disease. Specific new individual data enable the Response to Therapy reclassification to become a dynamic system to allow for the better management of BIR patients in the long term.Miriam SteinschneiderJacob PitaroShlomit KorenYuval MizrakliCarlos BenbassatLimor Muallem KalmovichMDPI AGarticlepapillary thyroid cancerbiochemical incomplete responsethyroglobulinprognosissurvivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5422, p 5422 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	papillary thyroid cancer biochemical incomplete response thyroglobulin prognosis survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	papillary thyroid cancer biochemical incomplete response thyroglobulin prognosis survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Miriam Steinschneider Jacob Pitaro Shlomit Koren Yuval Mizrakli Carlos Benbassat Limor Muallem Kalmovich Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
description	Although most patients with differentiated thyroid cancer (DTC) and biochemical incomplete response (BIR) follow a good clinical outcome, progression to structural disease may occur in 8–17% of patients. We aimed to identify factors that could predict the long-term outcomes of BIR patients. To this end, we conducted a retrospective review study of 1049 charts from our Differential Thyroid Cancer registry of patients who were initially treated with total thyroidectomy between 1962 and 2019. BIR was defined as suppressed thyroglobulin (Tg) > 1 ng/mL, stimulated Tg > 10 ng/mL or rising anti-Tg antibodies, who did not have structural evidence of disease, and who were assessed 12–24 months after initial treatment. We found 83 patients (7.9%) matching the definition of BIR. During a mean follow-up of 12 ± 6.6 years, 49 (59%) patients remained in a state of BIR or reverted to no evidence of disease, while 34 (41%) progressed to structural disease. At the last follow-up, three cases (3.6%) were recorded as disease-related death. The American Thyroid Association (ATA) Initial Risk Stratification system and/or AJCC/TNM (8th ed.) staging system at diagnosis predicted the shift from BIR to structural disease, irrespective of their postoperative Tg levels. We conclude that albeit 41% of BIR patients may shift to structural disease, and most have a rather indolent disease. Specific new individual data enable the Response to Therapy reclassification to become a dynamic system to allow for the better management of BIR patients in the long term.
format	article
author	Miriam Steinschneider Jacob Pitaro Shlomit Koren Yuval Mizrakli Carlos Benbassat Limor Muallem Kalmovich
author_facet	Miriam Steinschneider Jacob Pitaro Shlomit Koren Yuval Mizrakli Carlos Benbassat Limor Muallem Kalmovich
author_sort	Miriam Steinschneider
title	Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
title_short	Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
title_full	Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
title_fullStr	Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
title_full_unstemmed	Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes
title_sort	differentiated thyroid cancer with biochemical incomplete response: clinico-pathological characteristics and long term disease outcomes
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c25d8de3d649403d97f0a7088c5623da
work_keys_str_mv	AT miriamsteinschneider differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes AT jacobpitaro differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes AT shlomitkoren differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes AT yuvalmizrakli differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes AT carlosbenbassat differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes AT limormuallemkalmovich differentiatedthyroidcancerwithbiochemicalincompleteresponseclinicopathologicalcharacteristicsandlongtermdiseaseoutcomes
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Differentiated Thyroid Cancer with Biochemical Incomplete Response: Clinico-Pathological Characteristics and Long Term Disease Outcomes

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