ETA2024 Poster Presentations Clinical thyroid cancer research-1 (10 abstracts)
Differentiated thyroid carcinoma: preliminary results of a randomized clinical trial on the impact of transitioning care to primary healthcare supported by telemedicine
Rafael Selbach Scheffel 1 , Henrique Cabral Scherer 2 , Paula Fernandes 2 , Victor Olaves 2 , André B. Zanella 2 , Carla Vaz Ferreira 3 , Marcelo Gonçalves 4 , Natan Katz 4 , José Miguel Dora 2 , Dimitris V. Rados 4 & Ana Luiza Maia 5
1Unidade de Tireoide, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil., Brazil; 2Unidade de Tireoide, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil.; 3Hospital de Clínicas de Porto Alegre, Brazil; 4Telessaúders-Ufrgs, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brasil.; 5Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Thyroid Unit, Porto Alegre, Brazil
Introduction: Differentiated thyroid cancer (DTC) has low recurrence rates (2-5%). Despite this, the CDT consensus recommends long-term follow-up with specialists without defining a maximum follow-up time. Telemedicine is a strategy that aims to optimize the transition of care for patients from tertiary care to primary health care (PHC) and can help in the follow-up of these patients.
Objective: To evaluate the impact of the transition of care between specialized care and PHC for patients with DTC supported by telemedicine.
Methods: Patients with DTC and excellent response to initial treatment were randomized to follow-up in-person consultations in a tertiary service or transfer of care with telemedicine support. This support was provided through telephone calls to patients and health units to ensure linkage in PHC and offer support through teleconsultations. The primary outcome was DTC recurrence, assessed in a face-to-face consultation through thyroglobulin measurement and neck ultrasound. Outcomes related to the use of the healthcare system and control of hypothyroidism were also evaluated.
Results: To date, 206 patients have been included, the majority of whom are female (n = 175; 85%) and with papillary thyroid carcinoma (n = 176; 85.4%). Concerning the ATA risk classification, 110 patients were low risk (54.2%), 91 were intermediate risk (44.8%), and 2 were high risk (1.0%). All patients were treated with total thyroidectomy, 133 (64.6%) received radioactive iodine. The median follow-up before randomization was 6 years (P25-P75 3-12). Both groups have similar demographic and oncological characteristics. One hundred and twenty-nine patients were reevaluated in face-to-face consultations with a median of 31 months (P25-P75 28-35) after randomization, 70 from the intervention group and 59 from the control group. In the intervention group, one patient presented DTC recurrence, and one presented indeterminate response. In the control group, three patients presented indeterminate response. The rates of euthyroidism in the control and intervention groups were 54.2% and 55.7%, respectively (P = 0.51).
Conclusion: Transferring care to PHC for patients with DTC with excellent response after initial treatment appears to be safe, not increasing relapse rates or inadequate control of hypothyroidism.
Funding: Departamento de Tireoide da SBEM / Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Volume 101
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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