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Endocrine

, Volume 46, Issue 3, pp 532–537 | Cite as

Biochemical persistence in thyroid cancer: is there anything to worry about?

  • Pitoia FabiánEmail author
  • Abelleira Erika
  • Tala Hernán
  • Bueno Fernanda
  • Urciuoli Carolina
  • Cross Graciela
Original Article

Abstract

To evaluate the outcome of differentiated thyroid cancer (DTC) patients with biochemical persistence of disease (BP) after initial treatment (total thyroidectomy with or without lymph node dissection (LND) and thyroid remnant ablation). BP was defined as suppressed thyroglobulin (Tg) levels <1 ng/ml and rhTSH-stimulated thyroglobulin (St-Tg) >1ng/ml, with no evidence of structural disease. Structural persistence/recurrence (SPR): clinically identifiable disease. We reviewed 278 records of DTC patients. Tg-Ab positive patients (n = 73) were excluded and 32 were included in the analysis (median age 45 years, range 18–77 years); risk of recurrence ATA was: low in 38 %, Intermediate in 47 %, and high in 15 % of patients. All subjects had Tg levels <1 ng/ml under thyroid hormone therapy. Patients were divided into three groups: Group 1: St-Tg 1–2 ng/ml, n = 6; Group 2: St-Tg 2–10 ng/ml, n = 17; Group 3: St-Tg > 10 ng/ml, n = 9. In 5/32 (16 %) patients, SPR was observed after a median follow-up of 6 years (range 2–23 years). In Group 1: all patients were considered with no evidence of disease after a median follow-up of 2 years (range 1–2.5 years). In Group 2: 13/17 (76.5 %) patients continued with only a BP after a median follow-up of 4 years (range 2–10 years) and 4/17 (23.5 %) patients with intermediate risk of recurrence had a structural persistence (lymph nodes metastasis) diagnosed between 1 and 3.5 years after initial assessment. Following LND, all of them remained with BP after a median of 2 years (range 1.5–5 years). In Group 3: 8/9 (89 %) patients had BP after a median follow-up of 7 years (range 2–23 years) and 1/9 (11 %) had a SPR diagnosed 28 months after initial assessment, LND was indicated but he continued with BP, 5 years after the second surgery. Most patients with DTC and BP present an indolent course of the disease. In these patients the diagnosis of the structural recurrence did not change the outcome because all of them continued with BP.

Keywords

Thyroid Cancer Risk of recurrence Biochemical Thyroglobulin 

Notes

Conflict of interest

None.

References

  1. 1.
    D.S. Cooper, G.M. Doherty, B.R. Haugen, R.T. Kloos, S.L. Lee, S.J. Mandel, E.L. Mazzaferri, B. McIver, F. Pacini, M. Schlumberger, S.I. Sherman, D.L. Steward, R.M. Tuttle, Thyroid 19, 1167 (2009)PubMedCrossRefGoogle Scholar
  2. 2.
    F. Pitoia, L. Ward, N. Wohllk, C. Friguglietti, E. Tomimori, A. Gauna, R. Camargo, M. Vaisman, R. Harach, F. Munizaga, S. Corigliano, E. Pretell, H. Niepomnizcze, Arq. Bras. Endocrinol. Metabol. 53, 884 (2009)PubMedCrossRefGoogle Scholar
  3. 3.
    F. Pitoia, F. Bueno, C. Urciuoli, E. Abelleira, G. Cross, R.M. Tuttle, Thyroid (2013). doi: 10.1089/thy.2013.0011
  4. 4.
    F. Vaisman, D. Momesso, D.A. Bulzico, C.H. Pessoa, F. Dias, R. Corbo, M. Vaisman, R.M. Tuttle, Clin. Endocrinol. (Oxf). 77, 132 (2012)PubMedCrossRefGoogle Scholar
  5. 5.
    M.G. Castagna, F. Maino, C. Cipri, V. Belardini, A. Theodoropoulou, G. Cevenini, F. Pacini, Eur. J. Endocrinol. 165, 441 (2011)PubMedCrossRefGoogle Scholar
  6. 6.
    R.M. Tuttle, H. Tala, J. Shah, R. Leboeuf, R. Ghossein, M. Gonen, M. Brokhin, G. Omry, J.A. Fagin, A. Shaha, Thyroid 20, 1341 (2010)PubMedCrossRefGoogle Scholar
  7. 7.
    B.R. Haugen, E.C. Ridgway, B.A. McLaughlin, M.T. McDermott, Thyroid 12, 37 (2002)PubMedCrossRefGoogle Scholar
  8. 8.
    E.L. Mazzaferri, R.T. Kloos, J. Clin. Endocrinol. Metab. 87, 1490 (2002)PubMedCrossRefGoogle Scholar
  9. 9.
    R.J. Robbins, J.T. Chon, M. Fleisher, S.M. Larson, R.M. Tuttle, J. Clin. Endocrinol. Metab. 87, 3242 (2002)PubMedCrossRefGoogle Scholar
  10. 10.
    L. Wartofsky, Thyroid 12, 583 (2002)PubMedCrossRefGoogle Scholar
  11. 11.
    A. David, A. Blotta, M. Bondanelli, R. Rossi, E. Roti, L.E. Braverman, L. Busutti, E.C. degli Uberti, J. Nucl. Med. 42, 1470 (2001)PubMedGoogle Scholar
  12. 12.
    F. Pacini, E. Molinaro, F. Lippi, M.G. Castagna, L. Agate, C. Ceccarelli, D. Taddei, R. Elisei, M. Capezzone, A. Pinchera, J. Clin. Endocrinol. Metab. 86, 5686 (2001)PubMedCrossRefGoogle Scholar
  13. 13.
    B.R. Haugen, F. Pacini, C. Reiners, M. Schlumberger, P.W. Ladenson, S.I. Sherman, D.S. Cooper, K.E. Graham, L.E. Braverman, M.C. Skarulis, T.F. Davies, L.J. DeGroot, E.L. Mazzaferri, G.H. Daniels, D.S. Ross, M. Luster, M.H. Samuels, D.V. Becker, H.R. Maxon 3rd, R.R. Cavalieri, C.A. Spencer, K. McEllin, B.D. Weintraub, E.C. Ridgway, J. Clin. Endocrinol. Metab. 84, 3877 (1999)PubMedGoogle Scholar
  14. 14.
    R. Schulz, H. Bethäuser, L. Stempka, B. Heilig, A. Moll, M. Hüfner, Eur. J. Clin. Invest. 19, 459 (1989)PubMedCrossRefGoogle Scholar
  15. 15.
    A.S. Alzahrani, G. Mohamed, A. Al Shammary, S. Aldasouqi, S. Abdal Salam, M. Shoukri, J. Endocrinol. Invest. 28, 540 (2005)PubMedGoogle Scholar
  16. 16.
    E. Baudin, C. Do Cao, A.F. Cailleux, S. Leboulleux, J.P. Travagli, M. Schlumberger, J. Clin. Endocrinol. Metab. 88, 1107 (2003)PubMedCrossRefGoogle Scholar
  17. 17.
    J. Biko, C. Reiners, M.C. Kreissl, F.A. Verburg, Y. Demidchik, V. Drozd, Eur. J. Nucl. Med. Mol. Imaging 38, 123 (2011)CrossRefGoogle Scholar
  18. 18.
    E.G. Black, M.C. Sheppard, R. Hoffenberg, Clin. Endocrinol. (Oxf). 27, 115 (1987)PubMedCrossRefGoogle Scholar
  19. 19.
    A.L. Gutierrez Cardo, J.R. Rodriguez, I. Borrego Dorado, E. Navarro Gonzalez, J.L. Tirado, R. Vazquez Albertino, Rev. Esp. Med. Nucl. 26, 138 (2007)PubMedCrossRefGoogle Scholar
  20. 20.
    S.H. Huang, P.W. Wang, Y.E. Huang, F.F. Chou, R.T. Liu, S.C. Tung, J.F. Chen, M.C. Kuo, J.R. Hsieh, H.H. Hsieh, Thyroid 16, 1273 (2006)PubMedCrossRefGoogle Scholar
  21. 21.
    W.G. Kim, J.S. Ryu, E.Y. Kim, J.H. Lee, J.H. Baek, J.H. Yoon, S.J. Hong, E.S. Kim, T.Y. Kim, W.B. Kim, Y.K. Shong, J. Clin. Endocrinol. Metab. 95, 1169 (2011)CrossRefGoogle Scholar
  22. 22.
    M. Ozata, S. Suzuki, T. Miyamoto, R.T. Liu, F. Fierro-Renoy, L.J. De Groot, J. Clin. Endocrinol. Metab. 79, 98 (1994)PubMedGoogle Scholar
  23. 23.
    F. Vaisman, H. Tala, R. Grewal, Thyroid 21, 1317–1322 (2011)PubMedCrossRefGoogle Scholar
  24. 24.
    R.P. Padovani, E. Robenshtok, M. Brokhin, R.M. Tuttle, Thyroid 22, 778 (2012)PubMedCrossRefGoogle Scholar
  25. 25.
    H. Tala, R.M. Tuttle, Clin. Oncol. 22, 419 (2010)CrossRefGoogle Scholar
  26. 26.
    A. Miyauchi, T. Kudo, A. Miya, K. Kobayashi, Y. Ito, Y. Takamura, T. Higashiyama, M. Fukushima, M. Kihara, H. Inoue, C. Tomoda, T. Yabuta, H. Masuoka, Thyroid 21, 707 (2011)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Pitoia Fabián
    • 1
    Email author
  • Abelleira Erika
    • 1
  • Tala Hernán
    • 2
  • Bueno Fernanda
    • 1
  • Urciuoli Carolina
    • 1
  • Cross Graciela
    • 1
  1. 1.División of Endocrinología, Hospital de ClínicasUniversity of Buenos AiresBuenos AiresArgentina
  2. 2.Clínica Alemana de SantiagoUniversidad del DesarrolloSantiagoChile

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