ECE2020 Audio ePoster Presentations Thyroid (144 abstracts)
Diagnostic patterns of relapsed differentiated thyroid cancer (DTC) and the efficacy of rescue therapies (ERUDIT Study)
Marcel Sambo 1 , Elena Navarro 2 , Javier Aller 3 , Sonsoles Guadalix 4 , Carlos Zafón 5 , Cristina González 6 , Javier Santamaría 7 , Marcelino González 8 , Manel Puig 9 , Juan C. Galofré 10 , Iñaki Argüelles 11 , Juan A. Vallejo 12 , Virginia Pubul 13 , Rita Santos 14 , Marta Llanos 15 , Guillermo Crespo 16 , Ángel Segura 17 , Miguel Navarro 18 , Pablo Gajate 19 , Javier Valdivia 20 , Carlos López 21 , Beatriz Castelo 22 , María J. Villanueva 23 , Fábia Araujo 24 , Lorenzo Orcajo 24 & Julio Rodríguez-Villanueva 24
1Gregorio Marañón Hospital, Endocrinology, Madrid, Spain; 2Hospital Universitario Virgen del Rocío, Endocrinology, Sevilla, Spain; 3Hospital Puerta de Hierro-Majadahonda, Endocrinology, Majadahonda, Spain; 4Hospital 12 De Octubre, Endocrinology, Madrid, Spain; 5Vall d’Hebron University Hospital, Endocrinology, Barcelona, Spain; 6Hospital de la Santa Creu i Sant Pau, Endocrinology, Barcelona, Spain; 7Hospital Universitario Cruces, Endocrinology, Barakaldo, Spain; 8Hospital Universitario Doctor Peset, Endocrinology, València, Spain; 9Hospital Universitari Germans Trias i Pujol, Endocrinology, Badalona, Spain; 10Clinica Universidad de Navarra, Endocrinology, Pamplona, Spain; 11Hospital Universitario Son Espases, Endocrinology, Palma, Spain; 12Hospital Universitario Reina Sofia, Nuclear Medicine, Córdoba, Spain; 13Complejo Hospitalario Universitario de Santiago, Nuclear Medicine, Santiago de Compostela, Spain; 14Institute of Oncology Francisco Gentil, Oncology, Lisboa, Portugal; 15Hospital Universitario de Canarias, Oncology, Cuesta (La, Spain; 16Hospital Universitario de Burgos, Oncology, Burgos, Spain; 17Hospital Universitario y Politécnico La Fe, Oncology, València, Spain; 18Hospital Universitario de Salamanca, Oncology, Salamanca, Spain; 19Hospital Ramón y Cajal, Oncology, Madrid, Spain; 20Hospital Universitario Virgen de las Nieves, Oncology, Granada, Spain; 21Marqués de Valdecilla University Hospital, Oncology, Santander, Spain; 22Hospital La Paz, Oncology, Madrid, Spain; 23Álvaro Cunqueiro Hospital, Oncology, Vigo, Spain; 24Eisai Farmaceutica S.A., Oncology, Madrid, Spain
Introduction: Advanced differentiated thyroid carcinoma (aDTC) – herein defined as locally unresectable or metastatic disease – is one of the most common late-stage endocrine neoplasias. However, available data about its natural history is limited. ERUDIT is a multicenter, observational, retrospective study of patients diagnosed with aDTC in Spain and Portugal. The study describes its natural history from the initial diagnosis until the advanced stages of disease, focusing on specific characteristics of this subpopulation of DTC, as well as its treatment, response patterns and medical specialties involved in its management.
Objectives: To describe diagnostic demographics of DTC patients whose disease have relapsed after initial treatment, the usage patterns and efficacy of rescue therapies, and the medical services involved in patient care.
Materials and methods: Clinical records from patients ≥ 18 y-o diagnosed with aDTC (including poorly differentiated DTC) with first evidence of advanced disease documented between January 2007 and August 2017 were retrospectively reviewed until death or lost to follow-up.
Results: 213 patients were identified in 23 centres. Median age at initial diagnosis was 63 y-o, 59% were females. During the follow-up 46% progressed to advanced disease through previous relapse episodes after first treatment (surgery ± 131radioiodine [RAI]). Median (95% CI) relapse-free survival (RFS) from the initial treatment was 2.3 (1.7–2.9) years. Computed tomography (CT) and whole-body scan (WBS) were the most commonly used methods for relapse diagnosis (59% and 29%, respectively), being metastatic in 90% of the cases. Most frequent localization was lung (41%), and the rescue therapies, when indicated, were mainly RAI (62%) and surgery (14%). Specifically, 20% of the patients treated with RAI received up to 3 courses with median dose of 138 mCi each and cumulative dose of 518 mCi. Persistent structural disease was frequently reported after RAI (average 15% after three doses). Use of ablative interventions and radiotherapy was anecdotal (5%). Post relapse radiological follow-up mostly relied on CT (38%), positron-emission CT (18%), and WBS (16%). Endocrinology was the leading medical specialty responsible for patient monitoring (61%), while two thirds of the patients were evaluated by multidisciplinary committees.
Conclusions: Almost half of this cohort of aDTC tumours progressed onto advanced stage through previous relapses, with median RFS of 2.3 years and 62% being RAI-treatable. From this group, still 15% shows persistent disease after three RAI treatments. This suggests an unfavorable atypical evolution of some aDTC already since their initial treatment stages.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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