Pitoia Fabián1; Abelleira, Erika1; Bueno, Fernanda1; Smulever, Anabella1
1 Division of Endocrinology- Hospital de Clinicas – University of Buenos Aires, Buenos Aires, Argentina
Background: the therapeutic approach of patients with differentiated thyroid cancer (DTC) is currently individualized according to the risk of recurrence, with a lower tendency to perform remnant ablation (RA). While response to therapy assessment was validated for DTC patients treated with total thyroidectomy (TT) and RA, it has not been widely confirmed in patients treated with TT without RA.
Objectives: describe the characteristics of the population of patients treated with TT without RA, and validate the response to therapy.
Methods: we included 96 patients followed-up at least for 12 months after surgery, 85.4% were female and mean age was 47.5 years old. Based on the American Thyroid Association1, 89.6% and 10.4% were classified as low risk and intermediate risk of recurrence, respectively. Results: patients had an initial excellent response to treatment in 57.3% of the cases, with a disease-free status at the end of follow-up of 74%. A minority of patients (1%) presented with an initial structural incomplete response, which was similar at the end of follow-up. On the other hand, 41.7% of the patients had an initial indeterminate response, although only 22.9% remained with this response at the end of follow-up.
Conclusion: our data validate the responses to treatment in DTC patients treated with TT without RA as an effective tool for the dynamic risk stratification. Patients appropriately selected who did not receive RA have an excellent outcome, with a low frequency of structural incomplete response, even lower to that observed in low risk ablated patients.
- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26:1-133, 2016.