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Initial Clinical and Treatment Patterns of Advanced Differentiated Thyroid Cancer. ERUDIT Study.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Vallejo Casas, Juan Antonio
  • Sambo, Marcel
  • Lopez Lopez, Carlos
  • Duran-Poveda, Manuel
  • Rodriguez-Villanueva Garcia, Julio
  • Santos, Rita Joana
  • Llanos, Marta
  • Navarro-Gonzalez, Elena
  • Aller, Javier
  • Pubul, Virginia
  • Guadalix, Sonsoles
  • Crespo, Guillermo
  • Gonzalez, Cintia
  • Zafon, Carles
  • Navarro, Miguel
  • Santamaria-Sandi, Javier
  • Gajate, Pablo
  • Gomez-Balaguer, Marcelino
  • Valdivia, Javier
  • Puig-Domingo, Manel
  • Galofre, Juan Carlos
  • Castelo, Beatriz
  • Villanueva, Maria Jose
  • Argüelles I
  • Orcajo-Rincon, Lorenzo

Grupos

Abstract

BackgroundUp to 30% of differentiated thyroid cancer (DTC) will develop advanced-stage disease (aDTC) with reduced overall survival (OS).ObjectiveThe aim of this study is to characterize initial diagnosis of aDTC, its therapeutic management, and prognosis in Spain and Portugal.MethodsA multicentre, longitudinal, retrospective study of adult patients diagnosed with aDTC in the Iberian Peninsula was conducted between January 2007 and December 2012. Analyses of baseline characteristics and results of initial treatments, relapse- or progression-free survival ((RP)FS) from first DTC diagnosis, OS, and prognostic factors impacting the evolution of advanced disease were evaluated.ResultsTwo hundred and thirteen patients (median age: 63 years; 57% female) were eligible from 23 hospitals. Advanced disease presented at first diagnosis (de novo aDTC) included 54% of patients, while 46% had relapsed from early disease (recurrent/progressive eDTC). At initial stage, most patients received surgery (98%) and/or radioiodine (RAI) (89%), with no differences seen between median OS (95% CI) (10.4 (7.3-15.3) years) and median disease-specific-survival (95% CI) (11.1 (8.7-16.2) years; log-rank test P = 0.4737). Age at diagnosis being < 55 years was associated with a lower risk of death (Wald chi-square (Wc-s) P < 0.0001), while a poor response to RAI to a higher risk of death ((Wc-s) P < 0.05). In the eDTC cohort, median (RP)FS (95% CI) was of 1.7 (1.0-2.0) years after RAI, with R0/R1 surgeries being the only common significant favourable factor for longer (RP)FS and time to aDTC ((Wc-s) P < 0.05).ConclusionIdentification of early treatment-dependent prognostic factors for an unfavourable course of advanced disease is possible. An intensified therapeutic attitude may reverse this trend and should be considered in poor-performing patients. Prospective studies are required to confirm these findings.

Datos de la publicación

ISSN/ISSNe:
2235-0640, 2235-0802

European Thyroid Journal  BIOSCIENTIFICA LTD

Tipo:
Article
Páginas:
-
PubMed:
35900793
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,997 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 6

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Keywords

  • advanced differentiated thyroid cancer; relapsing differentiated thyroid cancer; radioiodine-refractory differentiated thyroid cancer; epidemiological study; relapsing prognostic factors; survival prognostic factors

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