Dynamic Risk Stratification for Predicting Treatment Response in Differentiated Thyroid Cancer
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Histological Type/Subtype % n | |
---|---|
Papillary, classical variant (P) | 66.3% (364) |
Papillary, follicular variant or mixed type (FVP) | 29.5% (162) |
Follicular (F) | 8.9% (49) |
Hurthle Cell (HC) | 2.0% (11) |
Insular Cell (IC) | 0.7% (4) |
Trabecular Variant Papillary (TVP) | 1.8% (10) |
Anaplastic (A) | 0.9% (5) |
Medullary Thyroid Cancer (MTC) | 1.1% (6) |
TNM a Stage % n | |
Τ1 | 53.9% (295) |
T2 | 12.8% (70) |
Τ3 | 31.4% (172) |
T4 | 2.0% (11) |
N0 | 33.9% (186) |
Ν1 | 41.1% (225) |
Nx | 25.1% (138) |
M0 | 94.7% (520) |
M1 | 5.3% (29) |
Number of Lesions | Mean (SD): 2.48 (2.52) |
Multifocality: 54.7% (299) | |
Longest Diameter of Primary Tumor | Mean (SD): 1.66 (1.16) |
>1 cm: 65.4% (359) | |
Invasive (I) b | 40.6% (222) |
Number of excised lymph nodes | Mean (SD): 8.59 (12.01) |
Number of metastasized lymph nodes | Mean (SD): 2.98 (6.03) |
Referrals | Median (IQR): 2.0 (1, 4) |
---|---|
Surgeons’ score (among 95 surgeons) | |
1 | 76.84% (73) |
2 | 8.42% (8) |
3 | 6.32% (6) |
4 | 8.42% (8) |
Characteristic | Post-Surgery Scintigraphy a (n = 274) | RAI (n = 539) | 1st WBS (n = 501) | 2nd WBS (n = 55) |
---|---|---|---|---|
Tg-Ab, Median, Mean (IQR) | 20.0, 65.78 (10.34, 32.30) | 20.0, 58.35 (13.0, 34.12) | 20.0, 52.47 (12.93, 27.0) | 21.30, 55.37 (20.40) |
TgAb > 30 IU/mL (n) | 26.6(73) | 28.6 (154) | 21.6 (108) | 30.9 (17) |
Anti-TPO, Median, Mean (IQR) (n = 218) | 20.85, 25.37 (11.43, 59.32) | - | ||
Anti-TPO > 30, % (n) | 38.5% (84) | - | ||
TSH, Median, Mean (IQR) | 95.48, 97.59 (60.90, 126.40) | 120.0, 120.75 (85.0, 146.70) | 108.0, 114.67 (83.46, 140.0) | 116.50, 136.78 (89.0, 161.03) |
Tg, Median, Mean (IQR) | 2.09, 35.25 (0.82, 5.94) | 2.10, 22.47 (0.69, 6.85) | 0.44, 10.27 (0.30, 1.18) | 3.50, 47.03 (0.62, 33.73) |
Tg < 1, % (n) | 30.5 (84) | 33.2 (179) | 73.5 (369) | 37.3 (22) |
Tg 1 < 5, % (n) | 42.5 (117) | 36.5 (197) | 14.5 (73) | 15.3 (9) |
Tg 5–10, % (n) | 9.1 (25) | 10.8 (58) | 4.0 (20) | 10.2 (6) |
Tg > 10, % (n) | 17.8 (49) | 19.5 (105) | 8.0 (40) | 37.3 (22) |
Remnant score, Median (IQR), Mean (St.D.) (n = 218) | 3 (2, 6), 4.37 (3.52) | 6 (3, 8), 6 (4.53) | 0 (0, 2), 1.94 (3.5) | 3 (0, 9), 5.19 (5.2) |
Stimulation method: | ||||
THW | 81.4% (223) | 48.3% (260) | 30.7% (154) | 5.1% (3) |
rh-TSH | 18.6% (51) | 51.7% (279) | 69.3% (347) | 94.9% (52) |
Treatment Response Category | % (n) |
---|---|
ER (Excellent Response) | 37.7% (177) |
BIR (Biochemical Incomplete Response) | 14.7% (69) |
SIR (Structural Incomplete Response) | 21.7% (102) |
IR (Indeterminate Response) | 26% (122) |
Response to Treatment | ||||||
---|---|---|---|---|---|---|
BIR | ER | IR | SIR | |||
n (%) | n (%) | n (%) | n (%) | |||
Main Characteristics | Gender, n (%) | F | 59 (16.5) | 139 (38.9) | 87 (24.4) | 72 (20.2) |
M | 10 (8.8) | 38 (33.6) | 35 (31) | 30 (26.5) | ||
PTC, n (%) | No | 23 (14.2) | 56 (34.6) | 39 (24.1) | 44 (27.2) | |
Yes | 46 (14.9) | 121 (39.3) | 83 (26.9) | 58 (18.8) | ||
Follicular variant of PTC, n (%) | No | 48 (14.3) | 118 (35.2) | 96 (28.7) | 73 (21.8) | |
Yes | 21 (15.6) | 59 (43.7) | 26 (19.3) | 29 (21.5) | ||
F, n (%) | No | 68 (16) | 166 (39.1) | 107 (25.2) | 84 (19.8) | |
Yes | 1 (2.2) | 11 (24.4) | 15 (33.3) | 18 (40) | ||
HC, n (%) | No | 68 (14.8) | 174 (37.8) | 118 (25.7) | 100 (21.7) | |
Yes | 1 (10) | 3 (30) | 4 (40) | 2 (20) | ||
Insular, n (%) | No | 68 (14.6) | 177 (38) | 120 (25.8) | 101 (21.7) | |
Yes | 1 (25) | 0 (0) | 2 (50) | 1 (25) | ||
TVP, n (%) | No | 68 (14.7) | 174 (37.7) | 122 (26.4) | 98 (21.2) | |
Yes | 1 (12.5) | 3 (37.5) | 0 (0) | 4 (50) | ||
A, n (%) | No | 69 (14.8) | 176 (37.7) | 121 (25.9) | 101 (21.6) | |
Yes | 0 (0) | 1 (33.3) | 1 (33.3) | 1 (33.3) | ||
MTC, n (%) | No | 45 (14.4) | 139 (44.6) | 65 (20.8) | 63 (20.2) | |
Yes | 2 (33.3) | 2 (33.3) | 1 (16.7) | 1 (16.7) | ||
StatusN, n (%) | N0 | 29 (18.4) | 64 (40.5) | 35 (22.2) | 30 (19) | |
N1 | 21 (11) | 72 (37.7) | 50 (26.2) | 48 (25.1) | ||
Nx | 19 (15.8) | 40 (33.3) | 37 (30.8) | 24 (20) | ||
StatusM, n (%) | M0 | 67 (15.1) | 177 (39.9) | 118 (26.6) | 82 (18.5) | |
M1 | 2 (7.7) | 0 (0) | 4 (15.4) | 20 (76.9) | ||
Μ0 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
StageT_new, n (%) | Any T1 | 40 (16.1) | 107 (43.1) | 52 (21) | 49 (19.8) | |
T2 | 10 (18.2) | 17 (30.9) | 14 (25.5) | 14 (25.5) | ||
Any T3 | 19 (11.9) | 52 (32.7) | 53 (33.3) | 35 (22) | ||
Any T4 | 0 (0) | 1 (12.5) | 3 (37.5) | 4 (50) | ||
Stimulation method, n (%) | rhTSH | 25 (21.2) | 42 (35.6) | 30 (25.4) | 21 (17.8) | |
THW | 23 (10.7) | 79 (36.9) | 64 (29.9) | 48 (22.4) | ||
Age at diagnosis mean (St. D.) | 46.86 (14.5) | 46.18 (14.43) | 46.63 (14.26) | 45.3 (14.55) | ||
Multifocality, % (n) | 56.5 (39) | 54.5 (96) | 48.4 (59) | 63.7 (65) | ||
Invasiveness % (n) | 14.7 (28) | 33.0 (63) | 28.8 (55) | 23.6 (45) | ||
Surgeons’score, % (n) | 1 | 21.7 (15) | 14.7 (26) | 27 (33) | 19.6 (20) | |
2 | 7.2 (5) | 10.7 (19) | 13.9 (17) | 6.9 (7) | ||
3 | 15.9 (11) | 9.6 (17) | 11.5 (14) | 18.6 (19) | ||
4 | 55.1 (38) | 65 (115) | 47.5 (58) | 54.9 (56) | ||
RAI | Activity administrated, mean (St.d) | 96.30 (16.13) | 96.05 (11.29) | 95.57 (13.85) | 97.84 (19.68) | |
remnant_score, mean (St.d) | 4.16 (3.08) | 3.08 (1.93) | 4.55 (3.19) | 7.09 (4.79) | ||
Tg, mean (St.d) | 3.47 (3.87) | 2.86 (4.05) | 17.47 (87.77) | 141.37 (369.66) | ||
Tg-Ab, mean (St.d) | 28.28 (29.83) | 39.38 (69.54) | 53.89 (214.17) | 155.87 (569.77) | ||
TM, median (IQR) | 27.10 (9.81, 199.30) | 19.50 (13.56, 59.81) | 21.30 (9.93, 56.32) | 19.00 (11.31, 58.90) | ||
WBS | remnant_score, mean (St.d) | 0.58 (0.34) | 0.74 (0.45) | 2.8 (2.95) | 5.6 (5.1) | |
Tg, mean (St.d) | 1.15 (4.48) | 0.52 (0.79) | 1.8 (2.98) | 49.15 (152.42) | ||
Tg-Ab, mean (St.d) | 42.06 (32.71) | 20.96 (20.04) | 57.98 (183.67) | 119.84 (439.81) |
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Giannoula, E.; Melidis, C.; Papadopoulos, N.; Bamidis, P.; Raftopoulos, V.; Iakovou, I. Dynamic Risk Stratification for Predicting Treatment Response in Differentiated Thyroid Cancer. J. Clin. Med. 2020, 9, 2708. https://doi.org/10.3390/jcm9092708
Giannoula E, Melidis C, Papadopoulos N, Bamidis P, Raftopoulos V, Iakovou I. Dynamic Risk Stratification for Predicting Treatment Response in Differentiated Thyroid Cancer. Journal of Clinical Medicine. 2020; 9(9):2708. https://doi.org/10.3390/jcm9092708
Chicago/Turabian StyleGiannoula, Evanthia, Christos Melidis, Nikitas Papadopoulos, Panagiotis Bamidis, Vasilios Raftopoulos, and Ioannis Iakovou. 2020. "Dynamic Risk Stratification for Predicting Treatment Response in Differentiated Thyroid Cancer" Journal of Clinical Medicine 9, no. 9: 2708. https://doi.org/10.3390/jcm9092708