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Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study

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Abstract

Background

For differentiated thyroid cancer (DTC) patients with thyroglobulin (Tg) elevation and negative iodine scintigraphy (commonly termed "TENIS" syndrome) after thyroidectomy, radioactive iodine (RAI) therapy, and thyroid-stimulating hormone (TSH) suppression therapy, empirical RAI therapy may be considered. However, the outcome data of TENIS syndrome without structural disease after empirical RAI therapy have not shown clear evidence of improvement in survival. We assessed the efficacy of such empirical RAI therapy in TENIS syndrome without structural disease and evaluated the progression-free survival (PFS).

Methods

A total of 80 papillary thyroid cancer (PTC) patients with TENIS syndrome without structural disease were included in this retrospective study. 52 patients were treated with empirical RAI therapy while another 28 patients were untreated. The progression-free survival (PFS) of both groups was defined as the main outcome. The secondary outcome was the comparison of serum Tg levels 12 months after being diagnosed as TENIS syndrome.

Results

The PFS of the empirical RAI therapy group was better than the untreated group (p < 0.001). Moreover, there was significant difference in Tg normalization between patients treated with empirical therapy and without treatment (p = 0.001). Empirical RAI therapy (p = 0.001) predicts better PFS. Male gender (p = 0.041) and empirical RAI therapy (p = 0.002) predict better remission in serum Tg level.

Conclusion

Patients with TENIS syndrome without structural disease can benefit from empirical RAI therapy in both PFS and Tg normalization.

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Acknowledgements

The authors are grateful to Zekun Tan for his help with the assistance of statistics in this paper.

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Author notes

  1. Liyi Yuan and Jing Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, 253 Gongye Road, Guangzhou, 510282, Guangdong Province, China

    Liyi Yuan, Jing Wang, Liqin Pan, Huijuan Feng, Pan Chen, Jiaxin Luo, Jiahao Xie, Xiaoli Xiong, Juqing Wu & Wei Ouyang

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  1. Liyi Yuan
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  2. Jing Wang
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Contributions

Conceptualization: LY, HF, LP, WO. Methodology: LY, LP, JL, WO. Formal analysis and investigation: LY, JX, XX, JW. Writing-original draft preparation: LY, JW, JX, PC. Writing-review and editing: LY, JW, JL, WO. Supervision: LY, JW, HF, WO.

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Correspondence to Wei Ouyang.

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Yuan, L., Wang, J., Pan, L. et al. Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study. Ann Nucl Med 37, 18–25 (2023). https://doi.org/10.1007/s12149-022-01799-5

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  • DOI: https://doi.org/10.1007/s12149-022-01799-5

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