Clinical outcome in differentiated thyroid carcinoma and microcarcinoma
Abstract Introduction Due to the frequent use of neck ultrasonography, the incidence of differentiated thyroid microcarcinoma (DTMC), defined as a lesion with greatest dimension ≤1 cm, is increasing worldwide. Although DTMC generally has a lower aggressivity and a better prognosis than differentiate...
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| Veröffentlicht in: | International journal of surgery (London, England) England), 2014, Vol.12, p.S148-S151 |
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| creator | Lupoli, Roberta Cacciapuoti, Marianna Tortora, Anna Barba, Livia Verde, Nunzia Romano, Fiammetta Vastarella, Maria Fonderico, Francesco Masone, Stefania Milone, Marco Lupoli, Giovanni Lupoli, Gelsy Arianna |
| description | Abstract Introduction Due to the frequent use of neck ultrasonography, the incidence of differentiated thyroid microcarcinoma (DTMC), defined as a lesion with greatest dimension ≤1 cm, is increasing worldwide. Although DTMC generally has a lower aggressivity and a better prognosis than differentiated thyroid carcinoma (DTC), some cases of clinically aggressive DTMC were found. The aim of this study is to compare the rate of recurrence in DTMC and DTC, during a 3-year follow-up. Methods Patients with differentiated thyroid carcinoma, who underwent total thyroidectomy and postoperative131 I-RAI ablation, were stratified according to lesion diameter (DTC for diameter > 1 cm or DTMC ≤ 1 cm). After surgery, patients underwent a 3-year follow-up. Recurrent disease was defined on the basis of positive biochemical (Tg > 2 ng/ml under TSH-suppression or after rhTSH-stimulation) and/or imaging (US, WBS, CT, PET/CT) findings. Results 449 patients have been included in the final analysis. Linfoadenectomy rate and RAI ablative dose were significantly higher in DTC than in DTMC (32.7% vs. 22.4%, p = 0.018 and112.3 ± 21 vs. 68.3 ± 24.1 mCi, p |
| doi_str_mv | 10.1016/j.ijsu.2014.05.024 |
| format | Article |
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Although DTMC generally has a lower aggressivity and a better prognosis than differentiated thyroid carcinoma (DTC), some cases of clinically aggressive DTMC were found. The aim of this study is to compare the rate of recurrence in DTMC and DTC, during a 3-year follow-up. Methods Patients with differentiated thyroid carcinoma, who underwent total thyroidectomy and postoperative131 I-RAI ablation, were stratified according to lesion diameter (DTC for diameter > 1 cm or DTMC ≤ 1 cm). After surgery, patients underwent a 3-year follow-up. Recurrent disease was defined on the basis of positive biochemical (Tg > 2 ng/ml under TSH-suppression or after rhTSH-stimulation) and/or imaging (US, WBS, CT, PET/CT) findings. Results 449 patients have been included in the final analysis. Linfoadenectomy rate and RAI ablative dose were significantly higher in DTC than in DTMC (32.7% vs. 22.4%, p = 0.018 and112.3 ± 21 vs. 68.3 ± 24.1 mCi, p < 0.001). During the follow-up, 50 carcinoma recurrences occurred, more frequent in DTC than in DTMC (15.6% vs. 7.6%, p = 0.010). After adjustment for gender, age, rate of lymph node dissection and 131I dose of RAI treatment, the difference in the risk of recurrence was no longer significant among DTC and DTMC patients (HR: 1.585, 95% CI 0874–2877, p = 0.130). Conclusions The prediction of disease severity cannot be based exclusively on lesion diameter. A more careful therapeutic approach and follow-up should be recommended in DTMC patients.</description><identifier>ISSN: 1743-9191</identifier><identifier>EISSN: 1743-9159</identifier><identifier>DOI: 10.1016/j.ijsu.2014.05.024</identifier><identifier>PMID: 24859408</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes - therapeutic use ; Lymphadenectomy ; Male ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - etiology ; Prognosis ; Radiopharmaceuticals - therapeutic use ; Radiotherapy, Adjuvant ; Recurrence ; Risk Factors ; Surgery ; Thyroid carcinoma ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - radiotherapy ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Tumor Burden</subject><ispartof>International journal of surgery (London, England), 2014, Vol.12, p.S148-S151</ispartof><rights>2014</rights><rights>Copyright © 2014. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-5d8ef288a0840163e2bf7876311dbee2a060656fc8f02d067438ab9eaebe58303</citedby><cites>FETCH-LOGICAL-c525t-5d8ef288a0840163e2bf7876311dbee2a060656fc8f02d067438ab9eaebe58303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S174391911400123X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,4009,27902,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24859408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lupoli, Roberta</creatorcontrib><creatorcontrib>Cacciapuoti, Marianna</creatorcontrib><creatorcontrib>Tortora, Anna</creatorcontrib><creatorcontrib>Barba, Livia</creatorcontrib><creatorcontrib>Verde, Nunzia</creatorcontrib><creatorcontrib>Romano, Fiammetta</creatorcontrib><creatorcontrib>Vastarella, Maria</creatorcontrib><creatorcontrib>Fonderico, Francesco</creatorcontrib><creatorcontrib>Masone, Stefania</creatorcontrib><creatorcontrib>Milone, Marco</creatorcontrib><creatorcontrib>Lupoli, Giovanni</creatorcontrib><creatorcontrib>Lupoli, Gelsy Arianna</creatorcontrib><title>Clinical outcome in differentiated thyroid carcinoma and microcarcinoma</title><title>International journal of surgery (London, England)</title><addtitle>Int J Surg</addtitle><description>Abstract Introduction Due to the frequent use of neck ultrasonography, the incidence of differentiated thyroid microcarcinoma (DTMC), defined as a lesion with greatest dimension ≤1 cm, is increasing worldwide. Although DTMC generally has a lower aggressivity and a better prognosis than differentiated thyroid carcinoma (DTC), some cases of clinically aggressive DTMC were found. The aim of this study is to compare the rate of recurrence in DTMC and DTC, during a 3-year follow-up. Methods Patients with differentiated thyroid carcinoma, who underwent total thyroidectomy and postoperative131 I-RAI ablation, were stratified according to lesion diameter (DTC for diameter > 1 cm or DTMC ≤ 1 cm). After surgery, patients underwent a 3-year follow-up. Recurrent disease was defined on the basis of positive biochemical (Tg > 2 ng/ml under TSH-suppression or after rhTSH-stimulation) and/or imaging (US, WBS, CT, PET/CT) findings. Results 449 patients have been included in the final analysis. Linfoadenectomy rate and RAI ablative dose were significantly higher in DTC than in DTMC (32.7% vs. 22.4%, p = 0.018 and112.3 ± 21 vs. 68.3 ± 24.1 mCi, p < 0.001). During the follow-up, 50 carcinoma recurrences occurred, more frequent in DTC than in DTMC (15.6% vs. 7.6%, p = 0.010). After adjustment for gender, age, rate of lymph node dissection and 131I dose of RAI treatment, the difference in the risk of recurrence was no longer significant among DTC and DTMC patients (HR: 1.585, 95% CI 0874–2877, p = 0.130). Conclusions The prediction of disease severity cannot be based exclusively on lesion diameter. A more careful therapeutic approach and follow-up should be recommended in DTMC patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Iodine Radioisotopes - therapeutic use</subject><subject>Lymphadenectomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Prognosis</subject><subject>Radiopharmaceuticals - therapeutic use</subject><subject>Radiotherapy, Adjuvant</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Thyroid carcinoma</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - radiotherapy</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Tumor Burden</subject><issn>1743-9191</issn><issn>1743-9159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1q3DAUhUVJaNJJX6CL4GU2dq5ky5YhBMKQTgIDWaSF7IQsXVO5tpVKdmDePjIznUUWWemHcy73fIeQHxQyCrS87jLbhTljQIsMeAas-ELOaVXkaU15fXK81_SMfAuhAyhAUPGVnLFC8Do-zslm3dvRatUnbp60GzCxY2Js26LHcbJqQpNMf3beWZNo5bUd3aASNZpksNq749cFOW1VH_D74VyR3z_vf60f0u3T5nF9t001Z3xKuRHYMiEUiCJGyJE1bSWqMqfUNIhMQQklL1stWmAGyhhAqKZGhQ1ykUO-Ilf7ua_e_ZsxTHKwQWPfqxHdHCTlnAmoKs6jlO2lcc8QPLby1dtB-Z2kIBeAspMLQLkAlMBlBBhNl4f5czOgOVr-E4uCm70AY8o3i14GbXHUaKxHPUnj7Ofzbz_Y9aGAv7jD0LnZj5GfpDIwCfJ5qXBpkBYAlOUv-TvBwJbK</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Lupoli, Roberta</creator><creator>Cacciapuoti, Marianna</creator><creator>Tortora, Anna</creator><creator>Barba, Livia</creator><creator>Verde, Nunzia</creator><creator>Romano, Fiammetta</creator><creator>Vastarella, Maria</creator><creator>Fonderico, Francesco</creator><creator>Masone, Stefania</creator><creator>Milone, Marco</creator><creator>Lupoli, Giovanni</creator><creator>Lupoli, Gelsy Arianna</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2014</creationdate><title>Clinical outcome in differentiated thyroid carcinoma and microcarcinoma</title><author>Lupoli, Roberta ; Cacciapuoti, Marianna ; Tortora, Anna ; Barba, Livia ; Verde, Nunzia ; Romano, Fiammetta ; Vastarella, Maria ; Fonderico, Francesco ; Masone, Stefania ; Milone, Marco ; Lupoli, Giovanni ; Lupoli, Gelsy Arianna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-5d8ef288a0840163e2bf7876311dbee2a060656fc8f02d067438ab9eaebe58303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Iodine Radioisotopes - therapeutic use</topic><topic>Lymphadenectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Prognosis</topic><topic>Radiopharmaceuticals - therapeutic use</topic><topic>Radiotherapy, Adjuvant</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Thyroid carcinoma</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - radiotherapy</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroidectomy</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lupoli, Roberta</creatorcontrib><creatorcontrib>Cacciapuoti, Marianna</creatorcontrib><creatorcontrib>Tortora, Anna</creatorcontrib><creatorcontrib>Barba, Livia</creatorcontrib><creatorcontrib>Verde, Nunzia</creatorcontrib><creatorcontrib>Romano, Fiammetta</creatorcontrib><creatorcontrib>Vastarella, Maria</creatorcontrib><creatorcontrib>Fonderico, Francesco</creatorcontrib><creatorcontrib>Masone, Stefania</creatorcontrib><creatorcontrib>Milone, Marco</creatorcontrib><creatorcontrib>Lupoli, Giovanni</creatorcontrib><creatorcontrib>Lupoli, Gelsy Arianna</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of surgery (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lupoli, Roberta</au><au>Cacciapuoti, Marianna</au><au>Tortora, Anna</au><au>Barba, Livia</au><au>Verde, Nunzia</au><au>Romano, Fiammetta</au><au>Vastarella, Maria</au><au>Fonderico, Francesco</au><au>Masone, Stefania</au><au>Milone, Marco</au><au>Lupoli, Giovanni</au><au>Lupoli, Gelsy Arianna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcome in differentiated thyroid carcinoma and microcarcinoma</atitle><jtitle>International journal of surgery (London, England)</jtitle><addtitle>Int J Surg</addtitle><date>2014</date><risdate>2014</risdate><volume>12</volume><spage>S148</spage><epage>S151</epage><pages>S148-S151</pages><issn>1743-9191</issn><eissn>1743-9159</eissn><abstract>Abstract Introduction Due to the frequent use of neck ultrasonography, the incidence of differentiated thyroid microcarcinoma (DTMC), defined as a lesion with greatest dimension ≤1 cm, is increasing worldwide. Although DTMC generally has a lower aggressivity and a better prognosis than differentiated thyroid carcinoma (DTC), some cases of clinically aggressive DTMC were found. The aim of this study is to compare the rate of recurrence in DTMC and DTC, during a 3-year follow-up. Methods Patients with differentiated thyroid carcinoma, who underwent total thyroidectomy and postoperative131 I-RAI ablation, were stratified according to lesion diameter (DTC for diameter > 1 cm or DTMC ≤ 1 cm). After surgery, patients underwent a 3-year follow-up. Recurrent disease was defined on the basis of positive biochemical (Tg > 2 ng/ml under TSH-suppression or after rhTSH-stimulation) and/or imaging (US, WBS, CT, PET/CT) findings. Results 449 patients have been included in the final analysis. Linfoadenectomy rate and RAI ablative dose were significantly higher in DTC than in DTMC (32.7% vs. 22.4%, p = 0.018 and112.3 ± 21 vs. 68.3 ± 24.1 mCi, p < 0.001). During the follow-up, 50 carcinoma recurrences occurred, more frequent in DTC than in DTMC (15.6% vs. 7.6%, p = 0.010). After adjustment for gender, age, rate of lymph node dissection and 131I dose of RAI treatment, the difference in the risk of recurrence was no longer significant among DTC and DTMC patients (HR: 1.585, 95% CI 0874–2877, p = 0.130). Conclusions The prediction of disease severity cannot be based exclusively on lesion diameter. A more careful therapeutic approach and follow-up should be recommended in DTMC patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>24859408</pmid><doi>10.1016/j.ijsu.2014.05.024</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Female Follow-Up Studies Humans Iodine Radioisotopes - therapeutic use Lymphadenectomy Male Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - etiology Prognosis Radiopharmaceuticals - therapeutic use Radiotherapy, Adjuvant Recurrence Risk Factors Surgery Thyroid carcinoma Thyroid Neoplasms - pathology Thyroid Neoplasms - radiotherapy Thyroid Neoplasms - surgery Thyroidectomy Tumor Burden |
| title | Clinical outcome in differentiated thyroid carcinoma and microcarcinoma |
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