EP109 – Clinical and Histopathological Predictors of Recurrence in Patients With Differentiated Thyroid Carcinoma In Colombia: A Multicentric Study

     

    Dueñas, J.P.4; Wandurraga, EA1; Marín Carrillo, L.F.2; Torres, J.L.3; Aristizábal, C.3; Aristizábal, N.3; Sylva, D.I.3; Ospina, D.C.1;  Natera, A.K.2; Gómez, C.M.2; Rondón Sepúlveda, M.A.5
    1 Faculty of Medicine, Autonomous University of Bucaramanga UNAB. Division of Endocrinology, FOSCAL International Clinic. Bucaramanga, Colombia
    2 Faculty of Medicine, Pontifical Xaverian University. Division of Endocrinology, Hospital San Ignacio. Bogotá, Colombia
    3 Faculty of Medicine, Pontifical Bolivarian University. Division of Endocrinology, Clinic of the Americas. Medellin, Colombia
    4 Division of Endocrine Surgery, Clinic of the Americas. Medellin, Colombia
    5 Faculty of Medicine, Pontifical Xaverian University. Division of Epidemiology and Statistics, Hospital San Ignacio. Bogotá, Colombia

     

    Background/Purpose: Differentiated thyroid cancer, despite not having a high mortality rate, entails an important morbidity burden, given mainly by recurrence. It was our objective to determine the associated factors with relapse in patients with thyroid cancer in 3 hospitals in Colombia.

    Methods: A retrospective descriptive study was conducted. Demographic, clinical and histopathological characteristics were collected from medical records of patients attended during 3 years. Recurrence was defined as the evidence of locoregional structural disease confirmed by pathology or distant metastatic involvement through suggestive anatomic or functional images, beyond 12 months with no evidence of disease after the initial therapy.

    Results: 481 patients were included. 14.3% were males and 59.3% were over 45 years. 97% of cases had papillary carcinoma. The mean time of follow-up was 5.1±4.9 years. Tumor relapse was documented in 16.8% of subjects with a median time of 3 years since initial therapy. Association between recurrence and tumor size, extrathyroid extension, metastatic/resected lymph node ratio (central and total) and extranodal extension was found in the univariate analysis. The total amount of metastatic lymph nodes ?2 (HR 4.10, CI95%1.07-4.85) and a value of preablative stimulated thyroglobulin ?7.29 ng/ml (HR 2.28, CI 95%1.07-4.85, p=0.031), were the only two significant features related to recurrence in the multivariate analysis.

    Conclusions: We suggest that patients with 2 or more metastatic total lymph nodes might be classified at least as intermediate recurrence risk. Additionally, we found that a cutoff value of preablative stimulated thyroglobulin less than 7.29 ng/ml was associated with a low recurrence risk.

     

    References:

    1. Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL, et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid 2012 Nov;22(11):1144-52.
    2. Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A. A novel classification system for patients with PTC: addition of the new variables of large (3 cm or greater) nodal metastases and reclassification during the follow-up period. Surgery 2004 Feb;135(2):139-48.
    3. Leboulleux S, Rubino C, Baudin E, Caillou B, Hartl DM, Bidart JM, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 2005 Oct;90(10):5723-9.
    4. Lee J, Song Y, Soh EY. Prognostic significance of the number of metastatic lymph nodes to stratify the risk of recurrence. World J Surg. 2014 Apr;38(4):858-62.
    5. Webb R, Howard RS, Stojadinovic A, Gaitonde D, Wallace MK, Ahmed J, et al. The Utility of Serum Thyroglobulin Measurement at the Time of Remnant Ablation for Predicting DiseaseFree Status in Patients with Differentiated Thyroid Cancer: A Meta-Analysis Involving 3947 Patient. J Clin Endocrin Metab.  2012; 97(8): 2754 – 2763.

 

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  • Upcoming Events

     

    World Congress on Thyroid Cancer 3.5
    June 20 – 22, 2019
    Rome, Italy

    World Congress on Thyroid Cancer 4.0
    July 29 – August 1, 2021
    Boston, Massachusetts

     

  • WCTC3.5 Steering Committee:

     

    Rocco Bellatone, Co-Chair
    Celestino Lombardi, Co-Chair
    Gregory W. Randolph, MD
    Bryan McIver, MD
    Jeremy Freeman, MD
    Ian J. Witterick, MD
    Ashok R. Shaha, MD
    Jatin P. Shah, MD