EFFICACY AND PROGNOSIS IN PATIENTS WITH PAPILLARY THYROID CANCER WITH POSTOPERATIVE PREABLATIVE STIMULATED...

Area of Science:

• Endocrinology
• Oncology
• Nuclear Medicine

Background:

• Papillary thyroid cancer (PTC) is the most common type of thyroid malignancy.
• Prognostic analyses for PTC patients with preablative stimulated thyroglobulin (Tg) >10 ng/mL are limited.
• Understanding therapeutic responses and prognosis in this specific patient group is crucial for effective management.

Purpose of the Study:

• To investigate the therapeutic responses and prognosis of papillary thyroid cancer patients with preablative stimulated Tg >10 ng/mL after initial radioiodine (RAI) therapy.
• To identify independent risk factors associated with incomplete therapeutic response (IR).
• To determine optimal cutoff values for predicting IR.

Main Methods:

• Retrospective assessment of 256 PTC patients with preablative stimulated Tg >10 ng/mL who underwent RAI remnant ablation.
• Evaluation of therapeutic responses (excellent, indeterminate, biochemically incomplete, structurally incomplete) 6-12 months post-RAI.
• Kaplan-Meier analysis for progression-free survival (PFS) and univariate/multivariate analyses for risk factors.

Main Results:

• Incomplete response (IR) was observed in 72.3% of patients (BIR + SIR).
• Independent risk factors for IR included preablative Tg level (OR=1.047), male sex (OR=3.356), and tumor size (OR=1.431).
• Optimal cutoff values for predicting IR were preablative Tg of 24.4 ng/mL and tumor size of 2.3 cm. Patients with initial structurally incomplete response (SIR) had significantly shorter PFS.

Conclusions:

• Preablative Tg level, tumor size, and male sex are significant predictors of incomplete response to RAI therapy in PTC.
• Patients with an initial structurally incomplete response (SIR) face the poorest prognosis.
• Individualized treatment strategies are essential to improve outcomes for patients with initial SIR.