Abstract:
BACKGROUND:Although survival rate in papillary thyroid cancer (PTC) is high, the risk of persistence and recurrence together with the dramatic rise in its incidence cannot be overemphasized. Filipinos are considered to be at greater risk for negative outcomes. A paradigm shift in the management of PTC introduces re-stratification based on response to therapy which was reported to have better correlation with long-term outcome. The study aimed to identify predictors of incomplete response after thyroidectomy and radioiodine therapy among patients with PTC. The results of the study may have important implications in our understanding of the disease process allowing more aggressive treatment and monitoring of certain subgroups of patients. METHODOLOGY:Retrospective review of 225 patients with PTC (59% ATA low risk, 30 % ATA intermediate risk and 11% ATA high risk) who underwent thyroidectomy and radioiodine therapy was performed. Thirteen variables were considered (age, gender, histopathological variant, stage, extent of disease, MACIS score, AMES score, primary tumour size, lymph node, lymphovascular invasion, bilaterality, multifocality and preoperative TSH level). Logistic regression analysis using Backward Wald algorithm was used to identify independent predictors of incomplete response to therapy after 24 months. RESULTS:Of the 225 patients, 69 (31%) had incomplete response. Biochemical and structural (predominantly thyroid bed, lung and bone) incomplete response was observed in 6 and 63 patients, respectively. Incomplete response was documented in 8, 54 and 92% of low-, intermediate- and high-risk patients based on ATA recommendation. Incomplete response was significantly dependent on gender, lymph node involvement and location, extent of malignancy and multifocality taking into account the size of concurrent tumours (p < 0.05). The model was found to have high sensitivity (71%) and specificity (96%). CONCLUSION:A significant fraction of PTC patients experienced incomplete response to therapy. Our data suggest that male gender, lateral or mediastinal lymph node involvement, class III extent of disease by De Groot and multifocality with concurrent tumour or tumours more than 1 cm are major predictors of incomplete response. Not all predictors of recurrence and mortality are consistent predictors of treatment response which may be equally important in a disease with low mortality but significant morbidity like PTC.
journal_name
J Endocrinol Investjournal_title
Journal of endocrinological investigationauthors
Mendoza ES,Lopez AA,Valdez VA,Cunanan EC,Matawaran BJ,Kho SA,Sero-Gomez MHdoi
10.1007/s40618-015-0319-2subject
Has Abstractpub_date
2016-01-01 00:00:00pages
55-62issue
1eissn
0391-4097issn
1720-8386pii
10.1007/s40618-015-0319-2journal_volume
39pub_type
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章
doi:10.1007/BF03343842
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abstract::The enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) is higher in thyrotoxicosis. Bile-salt sequestrants bind iodothyronines and thereby increase their fecal excretion. We, therefore, evaluated the effect of colestipol-hydrochloride administration on clinical and biochemical indices of patients wi...
journal_title:Journal of endocrinological investigation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF03348036
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abstract::The possible role of the renin-angiotensin system and ACTH in controlling the temporal organization of circadian rhythm of aldosterone was studied in patients with mesor-hypertension (MH) by simultaneous radioimmunological determinations of within-day changes in plasma renin, aldosterone and cortisol. Thirty-nine unco...
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doi:10.1007/BF03348241
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abstract::E-cadherin and catenins play a major role in neoplastic cell behavior as a suppressor of invasion and/or metastasis. The aim of this study was to determine E-cadherin, alpha-catenin and beta-catenin expressions in papillary thyroid carcinoma (PTC) and to correlate the results of expression to initial clinicopathologic...
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pub_type: 杂志文章,评审
doi:10.3275/8647
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doi:10.1007/BF03345141
更新日期:2003-02-01 00:00:00
abstract::Anatomy studies normally precede physiology. While the anatomy of the penis and the biochemical and molecular regulation of erection are largely known, the exact anatomical description of the human clitoris was produced in 1998, the taxonomy of female sexual dysfunctions classified in 1999, and biochemistry of female ...
journal_title:Journal of endocrinological investigation
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更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Agents capable of increasing radioiodine concentration by stimulating the sodium/iodide symporter (NIS) expression have been extensively investigated for the treatment of certain well-differentiated breast cancers. AIM:In this study, we analyzed the regulation of the NIS and lactoperoxidase (LPO) gene expre...
journal_title:Journal of endocrinological investigation
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journal_title:Journal of endocrinological investigation
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::The present study investigated whether trophoblast, decidua and fetal membranes express nerve growth factor (NGF) mRNA and peptide. Tissue specimens were collected in the first and third trimester of pregnancy from women undergoing voluntary pregnancy interruption (no.= 6; from 8 to 12 gestational weeks) and from wome...
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pub_type: 杂志文章
doi:10.1007/BF03344105
更新日期:2006-04-01 00:00:00
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章
doi:10.1007/BF03348894
更新日期:1993-07-01 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of endocrinological investigation
pub_type: 临床试验,杂志文章
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更新日期:2001-04-01 00:00:00
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章,评审
doi:10.1007/s40618-014-0225-z
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Chronic alcohol abuse is a risk factor for osteoporosis and fractures, whose pathogenesis is still unclear. We investigated the influence of alcoholism and other risk factors on calcium and skeletal metabolism, bone mineral density (BMD), and fractures. MATERIALS AND METHODS:In 51 chronic male alcoholics wi...
journal_title:Journal of endocrinological investigation
pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章
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更新日期:1980-07-01 00:00:00
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journal_title:Journal of endocrinological investigation
pub_type: 杂志文章,评审
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更新日期:2016-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-03-01 00:00:00