|
1
|
Kao YH, Gan HK, Zaheer S, Lam WWC, Loke KSH, Wong WY, Ng DCE, Goh ASW. Gender, Race, and Age at Diagnosis as Risk Factors for Metastasis or Recurrence among 1,657 Thyroid Cancer Patients Treated with Radioiodine across 40 Years in Singapore. Oncol Res Treat 2015; 38:679-82. [PMID: 26633801 DOI: 10.1159/000442114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND To obtain descriptive data on Singaporean thyroid cancer patients treated with radioiodine and to assess gender, race, and age at diagnosis as risk factors for metastasis or recurrence. METHODS This is a retrospective study of all thyroid cancer patients treated with radioiodine of any prescribed activity at our institution. Data collected included: age at diagnosis, gender, race, histopathological type, duration of follow-up, and metastasis at diagnosis (locoregional or distant) or recurrence at any time. Gender, race, and age at diagnosis were analyzed for possible associations with metastasis or recurrence. RESULTS A total of 1,657 thyroid cancer patients were treated with radioiodine across a 40-year period; mean follow-up 6.4 ± 6.9 years (median 4.2 years). 656 (39.6%) patients had metastasis or recurrence over the duration of their follow-up. Male gender (odds ratio (OR) 1.38; p = 0.006), Malay race (OR 1.71; p < 0.0001), and age at diagnosis of > 46 years (OR 1.31; p = 0.007) were significantly associated with metastasis or recurrence. CONCLUSION Male gender, Malay race, and age at diagnosis of > 46 years were significant risk factors for metastasis or recurrence in Singaporean thyroid cancer patients treated with radioiodine.
Collapse
Affiliation(s)
- Yung Hsiang Kao
- Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore
| | | | | | | | | | | | | | | |
Collapse
|
|
2
|
Clement SC, Kremer LCM, Links TP, Mulder RL, Ronckers CM, van Eck-Smit BLF, van Rijn RR, van der Pal HJH, Tissing WJE, Janssens GO, van den Heuvel-Eibrink MM, Neggers SJCMM, van Dijkum EJMN, Peeters RP, van Santen HM. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis? Cancer Treat Rev 2014; 41:9-16. [PMID: 25544598 DOI: 10.1016/j.ctrv.2014.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/22/2014] [Accepted: 10/30/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We addressed the evidence for the question: 'is outcome of DTC influenced by tumor stage at diagnosis?'. METHODS A multidisciplinary working group answered the sub-questions: 'is recurrence or mortality influenced by DTC stage at diagnosis? Does detection of DTC at an early stage contribute to a decline in adverse events of treatment?' The literature was systematically reviewed, and conclusions were drawn based on the level of evidence (A: high, B: moderate to low, C: very low). RESULTS In children, level C evidence was found that detection of DTC at an early stage is associated with lower recurrence and mortality rates. No evidence was found that it influences morbidity rates. In adults, clear evidence was found that less advanced staged DTC is a favorable prognostic factor for recurrence (level B) and mortality (level A). Additionally, it was found that more extensive surgery increases the risk to develop transient hypoparathyroidism (level A) and that higher doses of radioiodine increases the risk to develop second primary malignancies (level B). CONCLUSION Identification of DTC at an early stage is beneficial for children (very low level evidence) and adults (moderate to high level evidence), even considering that the overall outcome is excellent. These results are an important cornerstone for the development of guidelines for childhood cancer survivors at risk for DTC.
Collapse
Affiliation(s)
- S C Clement
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - L C M Kremer
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands; Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands
| | - T P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - R L Mulder
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - C M Ronckers
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands; Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands
| | - B L F van Eck-Smit
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - R R van Rijn
- Department of Radiology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - H J H van der Pal
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands; Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands; Department of Oncology, Academic Medical Center, Amsterdam, University of Amsterdam, PO Box 22660 1100 DD Amsterdam, The Netherlands
| | - W J E Tissing
- Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands; Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
| | - G O Janssens
- Department of Radiation Oncology, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - M M van den Heuvel-Eibrink
- Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands; Department of Pediatric Hematology and Oncology, Erasmus MC/Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - S J C M M Neggers
- Dutch Childhood Oncology Group (DCOG-LATER), PO Box 43515, 2504 AM The Hague, The Netherlands; Department of Internal Medicine/Endocrinology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - E J M Nieveen van Dijkum
- Department of Pediatric Surgery, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - R P Peeters
- Department of Internal Medicine/Endocrinology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Rotterdam Thyroid Center, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - H M van Santen
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital/University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands
| |
Collapse
|