ECE2019 Poster Presentations Thyroid 1 (70 abstracts)
Outcomes of surgery and radioiodine treatment for neck recurrence in papillary thyroid cancer
Styliani Kalaitzidou 1 , Dimitra Tampouratzi 1 , Georgios Papadakis 2 , Chrysi Karavasili 1 , Eleni Triantafillou 1 , Fotini Kanouta 1 , Aggeliki Sapera 1 , Michalis Kotis 1 , Aggeliki Aravantinou 1 , Zoi Roumpidaki 1 , Anna Dracopoulou 1 , Victoria Kaltzidou 1 , Irini Veniou 1 & Athanasia Tertipi 1
1Metaxa Anticancer Hospital, Piraeus Athens, Greece; 2STEPS Stoffwechselzentrum, Biel/Bienne, Switzerland.
Background: Persistent/recurrent disease in the neck is frequent in patients with papillary thyroid cancer. The main goal of this study was to evaluate the efficacy of the reoperation and radioiodine (RAI) treatment for persistent/recurrent disease after the initial treatment. Patients and Methods: A total of 30 patients (13 M/17 F) with papillary thyroid cancer were enrolled in this study. Seven cases (23.3%) had an aggressive subtype of papillary carcinoma. All had been submitted to reoparation for local persistent/recurrent disease. Mean age at initial thyroidectomy was 41.4±15.2 years and the follow up interval was 5.6±3.6 years, median 4.0 years. Fourteen patients had unifocal and 16 multifocal disease. Initial T status was T1 in 22 cases, T2 in 4 cases and T3 in 4 cases. Initial N status was N0 in 2 cases, N1 in 15 cases and Nx in 13 cases. All patients had M0 status. All patients had normal levels of anti-TG antibodies. Wilcoxon test was used for statistical analysis.
Results: Reoperation: In 17 patients (56.7%) the recurrence was diagnosed after a fine needle aspiration biopsy of the suspicious lymph nodes and in the rest of the patients by neck ultrasound. Persistent/recurrent disease was detected after 1.8±2.6 years with a median time of 1 year (range 3 months to 12 years). The median number of lymph nodes dissected at reoperation was 26 (range 1 to 60). Biochemical Findings: Reoperation reduced significantly the TG serum concentration from 76.13±165.5 to 20.18±28.8 ng/mL, P=0.054. The RAI treatment provided to 19 patients after the lymph nodes resection reduced further the TG values from 30.09±32.74 to 11.93±20.87 ng/mL, P=0.014. After the lymph nodes resection TG levels were reduced in 24 patients (80%), by 13–99%, 2 patients (6.6%) had stable TG levels and 4 patients (13.3%) had increased TG levels up to 30%, 51%, 233% and 253% respectively. Classifying the patients after reoperation according to the dynamic risk stratification, 7 patients (23.3%) had complete response, 4 (13.3%) had biochemically incomplete response, 9 (30.0%) had indeterminate response and 10 (33.3%) had still structural incomplete response.
Conclusions: 1. Surgery for local persistent/recurrent disease in papillary thyroid carcinoma reduces tumour burden, improves the biochemical and structural disease.
2. Administration of therapeutic RAI after lymph node resections appears to further improve biochemical disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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