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Citation
Tags
HERO ID
9821198
Reference Type
Journal Article
Title
Papillary thyroid cancer: time course of recurrences during postsurgery surveillance
Author(s)
Durante, C; Montesano, T; Torlontano, M; Attard, M; Monzani, F; Tumino, S; Costante, G; Meringolo, Atilla; Bruno, R; Trulli, F; Massa, M; Maniglia, A; D'Apollo, R; Giacomelli, L; Ronga, G; Filetti, S; PTC Study Group
Year
2013
Is Peer Reviewed?
Yes
Journal
Journal of Clinical Endocrinology and Metabolism
ISSN:
0021-972X
EISSN:
1945-7197
Volume
98
Issue
2
Page Numbers
636-642
Language
English
PMID
23293334
DOI
10.1210/jc.2012-3401
Web of Science Id
WOS:000316270900059
Abstract
CONTEXT:
The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largely on the study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20% and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly.
OBJECTIVES:
The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort.
PATIENTS AND DESIGN:
We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography.
RESULTS:
At the initial posttreatment (≤ 12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4%) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation.
CONCLUSION:
In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients.
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