ECE2014 Poster Presentations Thyroid Cancer (70 abstracts)
Prognostic implications of stage pT3 in well differentiated thyroid cancer
Carolina Moreno 1, , Miguel Melo 1, , Luís Pires 2 , Luís Cardoso 1 , Cristina Ribeiro 1 , Luísa Ruas 1 , Joana Saraiva 1, , Daniela Guelho 1 , Nuno Vicente 1 , Gracinda Costa 2 & Francisco Carrilho 1
1Endocrinology Department, Coimbra’s Hospital and University Center, Coimbra, Portugal; 2Nuclear Medicine Department. Coimbra’s Hospital and University Center, Coimbra, Portugal; 3Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Introduction: The TNM staging system for well differentiated thyroid cancer (WDTC) considers tumours over 4 cm diameter limited to the thyroid or tumours with minimal extra-thyroid extension to be classified as pT3. This stage can be considered quite heterogeneous, as different clinical and pathologic characteristics seem to have distinct prognosis value.
Aims: To determine prognostic factors amongst clinical, laboratorial, histologic and radiologic characteristics of WDTC pT3 patients followed in our department.
Materials and methods: A retrospective observational study of 129 patients with WDTC pT3 treated in our institution between January 2006 and December 2011 was performed. The following parameters were analysed: age, gender, personal and family history, histologic type, size, number of foci, presence of capsule, extra-thyroid extension, 131I activity administered, post-131I whole-body scintigraphy, using SPSS 21.0®. Patients were considered disease-free if there was no uptake outside the thyroid area in the post-dose scintigraphy, normal cervical ultrasound and stimulated thyroglobulin <2 ng/ml 9–15 months after initial treatment.
Results: Patients were followed for 48.2±16 months. At the end, 72.1% (n=93) patients were disease-free – group A, and 27.9% (n=36) had residual disease or relapse – group B. The size of primary tumour was significantly inferior in group A compared with group B (21.5±12.9 vs 30.6±20.8 cm; P=0.004), as the vascular invasion (36.4 vs 63.6%; P<0.001) and tumoral extension to adipose and fibromuscular tissue (38.5 vs 61.5%; P<0.001). In the post-131I whole-body scintigraphy, the latero-cervical uptake was significantly less in group A (19 vs 81%; P<0.001). Mediastinic and distant metastasis were found only in group B (100 vs 0%; P<0.001). Thyroglobulin 3 months after surgery was significantly inferior in group A (0.3±0.3 vs 15±42.9; P=0.001). By logistic regression were identified as the most important independent factors predictive of cure: absence of latero-cervical uptake in post-131I whole-body scintigraphy (OR=0.048; P<0.001) and tumour extension to adipose and fibromuscular tissues (OR=0.255; P=0.021).
Conclusions: In our cohort several clinical, pathological and radiological factors were associated with good prognosis (disease-free). In pT3 tumours, absence of node involvement and considerable extra-thyroid extension were the most relevant factors predictive of cure.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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