Risk of structural persistent disease in pediatric patients with low or intermediate risk differentiated thyroid cancer
ENDOCRINE(2020)
摘要
Purpose In pediatric patients with differentiated thyroid cancer (DTC), the risk of recurrence is high and the indication for postoperative 131 I administration is still debated. The aim of this study was to assess the outcome in low and intermediate risk pediatric DTC patients. Methods We retrospectively evaluated 45 pediatric patients with low or intermediate risk DTC, treated with surgery and 131 I between 1992 and 2002 and with no detectable antithyroglobulin (Tg) antibodies. Follow-up was performed every 6–12 months with Tg blood level determination and imaging procedures. Results During follow-up (64 ± 53 months), 15 events occurred (33% cumulative event rate, with an annual event rate of 5% person years). Five of these patients were submitted to additional surgery and all these 15 patients underwent a second 131 I treatment course. All patients were alive at the end of the follow-up. Structural persistent disease occurred more frequently in patients at intermediate risk ( p < 0.01) and in those with Tg values after thyroid hormone withdrawal >10 ng/ml before 131 I therapy ( p < 0.01). At multivariate analysis, only a postoperative thyroid stimulating hormone-stimulated Tg level >10 ng/ml was an independent predictor of persistent disease. Conclusions In pediatric patients with DTC, postoperative high stimulated Tg values (>10 ng/ml) should be taken into account for deciding the extent of both initial treatment and follow-up.
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关键词
Differentiated thyroid carcinoma,131I therapy,Prognosis,Pediatric patients
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