Course and Predictive Factors of Incomplete Response to Therapy in Low- and Intermediate-Risk Thyroid Cancer.
Alzahrani Ali S,Moria Yosra,Mukhtar Noha,Aljamei Hadeel,Mazi Sedra,Albalawi Lina,Aljomaiah Abeer
Journal of the Endocrine Society
Context:Controversy surrounds the extent and intensity of the management of American Thyroid Association (ATA) intermediate- and low-risk patients with differentiated thyroid cancer (DTC). Understanding the natural history and factors that predict outcome is important for properly tailoring the management of these patients. Objective:This work aims to study the natural course and predictive factors of incomplete response to therapy in low- and intermediate-risk DTC. Patients and Methods:We studied a cohort of 506 consecutive patients [418 women (82.6%) and 88 men (17.4%)] with low and intermediate risk with a median age of 35 years (interquartile range [IQR], 27-46 years). We analyzed the natural course and the predictive factors of biochemically or structurally incomplete response. Results:Of 506 patients studied, 297 (58.7%) patients were in the low-risk group and 209 (41.3%) were in the intermediate-risk group. Over a median follow-up of 102 months (IQR, 66-130 months), 458 (90.5%) patients achieved an excellent response, 17 (3.4%) had a biochemically incomplete status, and 31 (6.1%) had a structurally incomplete status. In univariable and multivariable analyses, age (≥ 33 years) ( < .0001, odds ratio 1.06 [1.04-1.08]) and lateral lymph node metastasis (LNM; < .0001, odds ratio 3.2 [1.7-5.9]) were strong predictive factors for biochemically and structurally incomplete response to therapy. Sex, tumor size, multifocality, extrathyroidal extension, and lymphovascular invasion did not predict incomplete response to therapy. Conclusions:Patients with low- and intermediate-risk DTC have favorable outcomes. Age and lateral LNM are strong predictors of an incomplete response to therapy. This suggests that older patients and those with LNM should be managed and followed up more actively than younger patients and those without LNM.
10.1210/jendso/bvaa178
Evaluation of Risk Factors Associated with Recurrence and Death in Patients with Thyroid Cancer From 2008 to 2023 in the West of Iran.
Journal of research in health sciences
BACKGROUND:Thyroid carcinoma (TC) is a global clinical concern, and its incidence has progressively increased worldwide. Early detection of TC and subsequently decreased age at the diagnosis seem to result from extensive employment of imaging modalities, biopsy techniques, and improvements in the healthcare system. A retrospective cohort study. METHODS:Overall, 400 patients diagnosed with TC following thyroidectomy in the Endocrinology Clinic, who were followed for fifteen years, were investigated in this study. The checklist included patients' demographic characteristics, clinical information, and response to treatment, recurrence, and death. RESULTS:There were 19.25% men and 80.75% women. The mean age was 41.005±15.58 years. The risk of death and recurrence was significantly higher in men, patients>65 years, smokers, patients with a family history of TC, undifferentiated cancer, multifocality, and stages III and IV (<0.001). Each additional year of life was associated with a 21% increase in the risk of death (<0.001). Smoking was associated with a 4.36-fold increase in the risk of death (=0.05). For each additional year of life, the probability of recurrence increased by 3% (=0.009). Men were 4.73 times more likely to recur (<0.001) than women. CONCLUSION:To employ the proper therapeutic intervention and perform meticulous postoperative surveillance, it is crucial to consider the predictive influence of pertinent elements. Diagnosing TC in its early stages is essential for the healthcare system because of the increased incidence, younger age at diagnosis, and overall favorable prognosis of TC.
10.34172/jrhs.2024.167