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Schubert L, Mbekwe-Yepnang AM, Wassermann J, Braik-Djellas Y, Jaffrelot L, Pani F, Deniziaut G, Lussey-Lepoutre C, Chereau N, Leenhardt L, Bernier MO, Buffet C. Clinico-pathological factors associated with radioiodine refractory differentiated thyroid carcinoma status. J Endocrinol Invest 2024:10.1007/s40618-024-02352-z. [PMID: 38578580 DOI: 10.1007/s40618-024-02352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Risk factors for developing radioiodine refractory thyroid cancer (RAIR-TC) have rarely been analyzed. The purpose of the present study was to find clinical and pathological features associated with the occurrence of RAIR-disease in differentiated thyroid cancers (DTC) and to establish an effective predictive risk score. METHODS All cases of RAIR-DTC treated in our center from 1990 to 2020 were retrospectively reviewed. Each case was matched randomly with at least four RAI-avid DTC control patients based on histological and clinical criteria. Conditional logistic regression was used to examine the association between RAIR-disease and variables with univariate and multivariate analyses. A risk score was then developed from the multivariate conditional logistic regression model to predict the risk of refractory disease occurrence. The optimal cut-off value for predicting the occurrence of RAIR-TC was assessed by receiver operating characteristic (ROC) curves and Youden's statistic. RESULTS We analyzed 159 RAIR-TC cases for a total of 759 controls and found 7 independent risk factors for predicting RAIR-TC occurrence: age at diagnosis ≥ 55, vascular invasion, synchronous cervical, pulmonary and bone metastases at initial work-up, cervical and pulmonary recurrence during follow-up. The predictive score of RAIR-disease showed a high discrimination power with a cut-off value of 8.9 out of 10 providing 86% sensitivity and 92% specificity with an area under the curve (AUC) of 0.95. CONCLUSION Predicting the occurrence of RAIR-disease in DTC patients may allow clinicians to focus on systemic redifferentiating strategies and/or local treatments for metastatic lesions rather than pursuing with ineffective RAI-therapies.
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Affiliation(s)
- L Schubert
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - A M Mbekwe-Yepnang
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - J Wassermann
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Y Braik-Djellas
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - L Jaffrelot
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - F Pani
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - G Deniziaut
- Pathology Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - C Lussey-Lepoutre
- Nuclear Medicine Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
- PARCC-Inserm U970, 56 rue leblanc, 75015, Paris, France
| | - N Chereau
- Department of Endocrine Surgery, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - L Leenhardt
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M- O Bernier
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - C Buffet
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France.
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS UMR 7371, INSERM U1146, Paris, France.
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Attanasio R, Žarković M, Papini E, Nagy EV, Negro R, Perros P, Akarsu E, Alevizaki M, Ayvaz G, Bednarczuk T, Beleslin BN, Berta E, Bodor M, Borissova AM, Boyanov M, Buffet C, Burlacu MC, Ćirić J, Díez JJ, Dobnig H, Fadeyev V, Field BCT, Fliers E, Führer-Sakel D, Galofré JC, Hakala T, Jiskra J, Kopp PA, Krebs M, Kršek M, Kužma M, Lantz M, Lazúrová I, Leenhardt L, Luchytskiy V, Marques Puga F, McGowan A, Metso S, Moran C, Morgunova T, Niculescu DA, Perić B, Planck T, Poiana C, Robenshtok E, Rosselet PO, Ruchala M, Ryom Riis K, Shepelkevich A, Tronko MD, Unuane D, Vardarli I, Visser WE, Vryonidou A, Younes YR, Hegedüs L. Patients' Persistent Symptoms, Clinician Demographics, and Geo-Economic Factors Are Associated with Choice of Therapy for Hypothyroidism by European Thyroid Specialists: The "THESIS" Collaboration. Thyroid 2024; 34:429-441. [PMID: 38368541 DOI: 10.1089/thy.2023.0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Background: Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. Methods: Seventeen thousand two hundred forty-seven thyroid specialists from 28 countries were invited to participate in an online questionnaire survey. The survey included respondent demographic data and treatment choices for hypothyroid patients with persistent symptoms. Geo-economic data for each country were included in the analyses. Results: The response rate was 32.9% (6058 respondents out of 17,247 invitees). Levothyroxine (LT4) was the initial treatment preferred by the majority (98.3%). Persistent symptoms despite normal serum thyrotropin (TSH) while receiving LT4 treatment were reported to affect up to 10.0% of patients by 75.4% of respondents, while 28.4% reported an increasing such trend in the past 5 years. The principal explanations offered for patients' persistent symptoms were psychosocial factors (77.1%), comorbidities (69.2%), and unrealistic patient expectations (61.0%). Combination treatment with LT4+liothyronine (LT3) was chosen by 40.0% of respondents for patients who complained of persistent symptoms despite a normal TSH. This option was selected more frequently by female thyroid specialists, with high-volume practice, working in countries with high gross national income per capita. Conclusions: The perception of patients' dissatisfaction reported by physicians seems lower than that described by hypothyroid patients in previous surveys. LT4+LT3 treatment is used frequently by thyroid specialists in Europe for persistent hypothyroid-like symptoms even if they generally attribute such symptoms to nonendocrine causes and despite the evidence of nonsuperiority of the combined over the LT4 therapy. Pressure by dissatisfied patients on their physicians for LT3-containing treatments is a likely explanation. The association of the therapeutic choices with the clinician demographic characteristics and geo-economic factors in Europe is a novel information and requires further investigation.
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Affiliation(s)
- Roberto Attanasio
- Scientific Committee Associazione Medici Endocrinologi, Milan, Italy
| | - Miloš Žarković
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome, Italy
| | - Endre Vezekenyi Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Roberto Negro
- Division of Endocrinology, Ospedale Fazzi, Lecce, Italy
| | - Petros Perros
- Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ersin Akarsu
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Maria Alevizaki
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Göksun Ayvaz
- Department of Endocrinology and Metabolism, Koru Ankara Hospital, Çankaya, Turkey
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Biljana Nedeljković Beleslin
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Eszter Berta
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklos Bodor
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anna Maria Borissova
- Clinic of Endocrinology and Metabolism, University Hospital "Sofiamed," Medical Faculty, Sofia University "Saint Kliment Ohridski," Sofia, Bulgaria
| | - Mihail Boyanov
- Clinic of Endocrinology and Metabolism, University Hospital "Alexandrovska," Sofia, Bulgaria
- Department of Internal Medicine, Medical University Sofia, Sofia, Bulgaria
| | - Camille Buffet
- GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France
| | - Maria-Cristina Burlacu
- Department of Endocrinology Diabetology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jasmina Ćirić
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Calle Manuel de Falla, Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Harald Dobnig
- Thyroid and Osteoporosis Praxis, Kumberg, Austria
- Thyroid Practice for Radiofrequency Ablation, Vienna, Austria
| | - Valentin Fadeyev
- Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Benjamin C T Field
- Section of Clinical Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Eric Fliers
- Department of Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Führer-Sakel
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Juan Carlos Galofré
- Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Tommi Hakala
- Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Jan Jiskra
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Peter A Kopp
- Division of Endocrinology, Diabetes and Metabolism, University of Lausanne, Lausanne, Switzerland
| | - Michael Krebs
- Division of Endocrinology and Metabolism, Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michal Kršek
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Martin Kužma
- 5th Department of Internal Medicine, Medical Faculty of Comenius University and University Hospital, Bratislava, Slovakia
| | - Mikael Lantz
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Ivica Lazúrová
- 1st Department of Internal Medicine of the Medical Faculty, P.J. Šafárik University Košice, Košice, Slovakia
| | - Laurence Leenhardt
- GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France
| | - Vitaliy Luchytskiy
- Department of Reproductive Endocrinology, Institute of Endocrinology and Metabolism named after V.P. Komissarenko, National Academy of Medical Science of Ukraine, Kyiv, Ukraine
| | - Francisca Marques Puga
- Endocrinology, Diabetes and Metabolism Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Anne McGowan
- Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland
| | - Saara Metso
- Department of Endocrinology, Tampere University Hospital, Tampere, Finland
| | - Carla Moran
- Diabetes & Endocrinology Section, Beacon Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tatyana Morgunova
- Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Dan Alexandru Niculescu
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Božidar Perić
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sisters of Mercy," Zagreb, Croatia
| | - Tereza Planck
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Catalina Poiana
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Eyal Robenshtok
- Thyroid Cancer Service, Endocrinology and Metabolism Institute, Beilinson Hospital and Davidoff Cancer Center, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel
| | | | - Marek Ruchala
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Kamilla Ryom Riis
- Department of Endocrinology, Odense University Hospital, Odense C, Denmark
| | - Alla Shepelkevich
- Department of Endocrinology, Belarusian State Medical University, Minsk, Republic of Belarus
| | - Mykola D Tronko
- V.P. Komisarenko Institute of Endocrinology and Metabolism of Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - David Unuane
- Department of Internal Medicine, Endocrine Unit, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Irfan Vardarli
- Department of Medicine I, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Academic Teaching Hospital, Ruhr-University Bochum, Recklinghausen, Germany
- Division of Endocrinology and Diabetes, 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - W Edward Visser
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Andromachi Vryonidou
- Department of Endocrinology and Diabetes Centre, Hellenic Red Cross Hospital, Athens, Greece
| | | | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense C, Denmark
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Theodon H, Guillerm E, Wassermann J, Deniziaut G, Jaffrelot L, Denis JA, Chereau N, Bigorgne C, Potonnier W, Coulet F, Leenhardt L, Buffet C. Next-Generation-Sequencing on fine needle aspirates in neck recurrence of thyroid cancers. Eur Thyroid J 2024; 13:ETJ-23-0164. [PMID: 38236745 PMCID: PMC10895307 DOI: 10.1530/etj-23-0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVES Tumor molecular genotyping plays a key role in improving the management of advanced thyroid cancers. Molecular tests are classically performed on Formalin-Fixed Paraffin-Embedded (FFPE) carcinoma tissue. However alternative molecular testing strategies are needed when FFPE tumoral tissue is unavailable. The objective of our study was to retrospectively assess the performance of targeted DNA and RNA-based Next Generation Sequencing (NGS) on the fine needle aspirate from thyroid cancer cervical recurrences to determine if this strategy is efficient in clinical practice. DESIGN/METHODS A retrospective study of 33 patients who had had DNA and/or RNA-based NGS on ultrasound (US)-guided fine needle aspirates of cervical thyroid cancer recurrences in our Department from July 2019 to September 2022. RESULTS In total, 34 DNA and 32 RNA-based NGS analyses were performed. Out of the 34 DNA-based NGS performed, 27 (79%) were conclusive allowing the identification of an oncogenic driver for 18 patients (53%). The most common mutation (n = 13) was BRAF c.1799T>A. Out of the 32 RNA-based NGS performed, 26 were interpretable (81%) and no gene fusion was found. The identification of a BRAFV600E mutation was decisive for one patient in our series, who was prescribed dabrafenib and trametinib. CONCLUSIONS NGS performed on fine needle aspirates of neck lymph node metastases enabled the identification of an oncogenic driver alteration in 53% of the cases in our series of advanced thyroid cancer patients and could significantly alter patient management.
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Affiliation(s)
- Helene Theodon
- H Theodon, Thyroïde et tumeurs endocrines, University Hospital Pitié Salpêtrière, Paris, 75013, France
| | | | - Johanna Wassermann
- J Wassermann, Oncolgy, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Loic Jaffrelot
- L Jaffrelot, Oncology, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Nathalie Chereau
- N Chereau, Surgery, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Claude Bigorgne
- C Bigorgne, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Wiame Potonnier
- W Potonnier, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Florence Coulet
- F Coulet, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Laurence Leenhardt
- L Leenhardt, Hopital Universitaire Pitie Salpetriere Bibliotheque de La Pitié, Paris, 75651, France
| | - Camille Buffet
- C Buffet, Thyroid and Endocrine Tumors Department, AP-HP, Paris, 75184, France
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4
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Žarković M, Attanasio R, Nagy EV, Negro R, Papini E, Perros P, Cohen CA, Akarsu E, Alevizaki M, Ayvaz G, Bednarczuk T, Berta E, Bodor M, Borissova AM, Boyanov M, Buffet C, Burlacu MC, Ćirić J, Díez JJ, Dobnig H, Fadeyev V, Field BCT, Fliers E, Frølich JS, Führer D, Galofré JC, Hakala T, Jiskra J, Kopp P, Krebs M, Kršek M, Kužma M, Lantz M, Lazúrová I, Leenhardt L, Luchytskiy V, McGowan A, Melo M, Metso S, Moran C, Morgunova T, Mykola T, Beleslin BN, Niculescu DA, Perić B, Planck T, Poiana C, Puga FM, Robenshtok E, Rosselet P, Ruchala M, Riis KR, Shepelkevich A, Unuane D, Vardarli I, Visser WE, Vrionidou A, Younes YR, Yurenya E, Hegedüs L. Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative. Front Endocrinol (Lausanne) 2023; 14:1225202. [PMID: 38027187 PMCID: PMC10660282 DOI: 10.3389/fendo.2023.1225202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors. Methods Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita). Results 5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p <0·001). Respondent work volume, university affiliation and private practice differed significantly between countries (p<0·001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p<0·01). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p<0·011) and the proportion of respondents who treated >100 patients annually (p<0·01). Discussion THESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study.
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Affiliation(s)
- Miloš Žarković
- University of Belgrade Faculty of Medicine, Internal Medicine, Belgrade, Serbia
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Belgrade, Serbia
| | - Roberto Attanasio
- Associazione Medici Endocrinologi, Scientific Committee, Milan, Italy
| | - Endre V. Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Roberto Negro
- Ospedale Vito Fazzi, Department of Endocrinology, Lecce, Italy
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale, Roma, Italy
| | - Petros Perros
- Institute of Translational and Clinical Research, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | | | - Ersin Akarsu
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Maria Alevizaki
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Faculty of Medicine, Athens, Greece
| | - Göksun Ayvaz
- Department of Endocrinology and Metabolism, Koru Ankara Hospital, Ankara, Türkiye
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Eszter Berta
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklos Bodor
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anna Maria Borissova
- Sofia University Saint Kliment Ohridski, Medical Faculty, Clinic of Endocrinology and Metabolism, University Hospital “Sofiamed”, Sofia, Bulgaria
| | - Mihail Boyanov
- University Hospital Alexandrovska, Clinic of Endocrinology and Metabolism, Medical University-Sofia, Internal Medicine, Sofia, Bulgaria
| | - Camille Buffet
- GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne University, Paris, France
| | - Maria-Cristina Burlacu
- Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique De Louvain, Brussels, Belgium
| | - Jasmina Ćirić
- University of Belgrade Faculty of Medicine, Internal Medicine, Belgrade, Serbia
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Belgrade, Serbia
| | - Juan J. Díez
- Department of Endocrinology, Hospital Universitario Puerta De Hierro Majadahonda, Madrid, Spain
- Instituto De Investigación Sanitaria Puerta De Hierro Segovia De Arana, Majadahonda, Madrid, Spain
- Department of Medicine, Universidad Autónoma De Madrid, Madrid, Spain
| | - Harald Dobnig
- Thyroid Endocrinology, Osteoporosis Institute Dobnig, Graz, Austria
| | - Valentin Fadeyev
- Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Benjamin C. T. Field
- University of Surrey Faculty of Health and Medical Sciences, Section of Clinical Medicine, Prague, United Kingdom
| | - Eric Fliers
- Department of Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Dagmar Führer
- University Hospital Essen, Department of Endocrinology, Diabetes and Metabolism, University-Duisburg-Essen, Essen, Germany
| | - Juan Carlos Galofré
- Departmento De Endocrinologia e Nutrición, Clínica Universidad De Navarra, Pamplona, Spain
| | - Tommi Hakala
- Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Jan Jiskra
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czechia
| | - Peter Kopp
- Division of Endocrinology, Diabetology and Metabolism, University of Lausanne, Lausanne, Switzerland
| | - Michael Krebs
- Department of Medicine III, Division of Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Michal Kršek
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czechia
| | - Martin Kužma
- 5th Department of Internal Medicine, Medical Faculty of Commenius University and University Hospital, Bratislava, Slovakia
| | - Mikael Lantz
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Ivica Lazúrová
- P. J. Šafárik University Košice, 1st Department of Internal Medicine of the Medical Faculty, Košice, Slovakia
| | - Laurence Leenhardt
- Hopital Pitie-Salpetriere, Thyroid and Endocrine Tumors Unit, Institut of Endocrinology, Sorbonne University, Paris, France
| | - Vitaliy Luchytskiy
- Department of Reproductive Endocrinogy, Institute of Endocrinology and Metabolism named after V.P. Komissarenko, National Academy of Medical Science of Ukraine, Kyiv, Ukraine
| | - Anne McGowan
- Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland
| | - Miguel Melo
- Department of Endocrinology, Diabetes and Metabolism, Medical Faculty, University of Coimbra, Coimbra, Portugal
| | - Saara Metso
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Carla Moran
- Diabetes & Endocrinology Section, Beacon Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tatyana Morgunova
- Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tronko Mykola
- Institute of Endocrinology and Metabolism named after V.P. Komissarenko, National Academy of Medical Science of Ukraine, Kyiv, Ukraine
| | - Biljana Nedeljković Beleslin
- University of Belgrade Faculty of Medicine, Internal Medicine, Belgrade, Serbia
- Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Belgrade, Serbia
| | - Dan Alexandru Niculescu
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Božidar Perić
- Department of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sisters of Mercy”, Zagreb, Croatia
| | - Tereza Planck
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Catalina Poiana
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Francisca Marques Puga
- Endocrinology, Diabetes and Metabolism Service, Porto Hospital and University Centre, Porto, Portugal
| | - Eyal Robenshtok
- Endocrinology Institute, Rabin Medical Center, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | | | - Marek Ruchala
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamilla Ryom Riis
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Alla Shepelkevich
- Department of Endocrinology, Belarusian State Medical University, Minsk, Belarus
| | - David Unuane
- Department of Internal Medicine, Endocrine Unit, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - Irfan Vardarli
- Department of Medicine I, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany
- 5th Medical Department, Division of Endocrinology and Diabetes, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - W. Edward Visser
- Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands
| | - Andromachi Vrionidou
- Department of Endocrinology and Diabetes Centre, Hellenic Red Cross Hospital, Athens, Greece
| | - Younes R. Younes
- East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust, Redhill, Surrey, United Kingdom
| | | | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
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5
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Baudin C, Bressand A, Buffet C, Menegaux F, Soret M, Lê AT, Cardon T, Broggio D, Bassinet C, Huet C, Armengol G, Richardson DB, Leenhardt L, Bernier MO, Lussey-Lepoutre C. Dysfunction of the Salivary and Lacrimal Glands After Radioiodine Therapy for Thyroid Cancer: Results of the START Study After 6-Months of Follow-Up. Thyroid 2023; 33:1100-1109. [PMID: 37300484 DOI: 10.1089/thy.2023.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background: Understanding of changes in salivary and lacrimal gland functions after radioactive iodine therapy (131I-therapy) remains limited, and, to date, no studies have evaluated dose-response relationships between absorbed dose from 131I-therapy and dysfunctions of these glands. This study investigates salivary/lacrimal dysfunctions in differentiated thyroid cancer (DTC) patients six months after 131I-therapy, identifies 131I-therapy-related risk factors for salivary/lacrimal dysfunctions, and assesses the relationships between 131I-therapy radiation dose and these dysfunctions. Methods: A cohort study was conducted involving 136 DTC patients treated by 131I-therapy of whom 44 and 92 patients received 1.1 and 3.7 GBq, respectively. Absorbed dose to the salivary glands was estimated using a dosimetric reconstruction method based on thermoluminescent dosimeter measurements. Salivary and lacrimal functions were assessed at baseline (T0, i.e., immediately before 131I-therapy) and six months later (T6) using validated questionnaires and salivary samplings, with and without stimulation of the salivary glands. Statistical analyses included descriptive analyses and random-effects multivariate logistic and linear regressions. Results: There was no difference between T0 and T6 in the level of parotid gland pain, nor was there difference in the number of patients with hyposalivation, but there were significantly more patients with dry mouth sensation and dry eyes after therapy compared with baseline. Age, menopause, depression and anxiety symptoms, history of systemic disease, and not taking painkillers in the past three months were found to be significantly associated with salivary or lacrimal disorders. Significant associations were found between 131I-exposure and salivary disorders adjusted on the previous variables: for example, per 1-Gy increase in mean dose to the salivary glands, odds ratio = 1.43 [CI 1.02 to 2.04] for dry mouth sensation, ß = -0.08 [CI -0.12 to -0.02] mL/min for stimulated saliva flow, and ß = 1.07 [CI 0.42 to 1.71] mmol/L for salivary potassium concentration. Conclusions: This study brings new knowledge on the relationship between the absorbed dose to the salivary glands from 131I-therapy and salivary/lacrimal dysfunctions in DTC patients six months after 131I-therapy. Despite the findings of some dysfunctions, the results do not show any obvious clinical disorders after the 131I-therapy. Nevertheless, this study raises awareness of the risk factors for salivary disorders, and calls for longer follow-up. Clinical Trials Registration: Number NCT04876287 on the public website (ClinicalTrials.gov).
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Affiliation(s)
- Clémence Baudin
- Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | - Camille Buffet
- Department of Thyroid Disease and Endocrine Tumor, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Fabrice Menegaux
- Department of Thyroid Disease and Endocrine Tumor, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Department of General and Endocrine Surgery, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Department of Nuclear Medicine, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Marine Soret
- Department of Thyroid Disease and Endocrine Tumor, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Biomedical Imaging Laboratory, CNRS, INSERM, Sorbonne University, Paris, France
| | - Anh Thu Lê
- Internal Dose Assessment Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Thomas Cardon
- Internal Dose Assessment Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - David Broggio
- Internal Dose Assessment Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Céline Bassinet
- Ionizing Radiation Dosimetry Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Christelle Huet
- Ionizing Radiation Dosimetry Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Gemma Armengol
- Department of Animal Biology, Plant Biology and Ecology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Bellaterra, Catalonia, Spain
| | - David B Richardson
- Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Laurence Leenhardt
- Department of Thyroid Disease and Endocrine Tumor, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Marie-Odile Bernier
- Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Charlotte Lussey-Lepoutre
- Department of Thyroid Disease and Endocrine Tumor, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Unit of Radionuclide Treatment, Department of Nuclear Medicine, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
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6
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Tran TVT, Kitahara CM, Leenhardt L, de Vathaire F, Boutron-Ruault MC, Journy N. The effect of thyroid dysfunction on breast cancer risk: an updated meta-analysis. Endocr Relat Cancer 2023; 30:ERC-22-0155. [PMID: 36256851 DOI: 10.1530/erc-22-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022]
Abstract
In a previous systematic review and meta-analysis of studies reporting associations between hyper-/hypothyroidism and breast cancer incidence published through 29 January 2019, we identified a higher risk with diagnosed hyperthyroidism compared to euthyroidism, but no association with diagnosed hypothyroidism. This 2-year updated meta-analysis aims to investigate the role of menopause in this association and the dose-response relationship with blood levels of thyroid-stimulating hormone (TSH) and thyroid hormones. After the exclusion of studies with only mortality follow-up, with thyroid dysfunction evaluated as a cancer biomarker or after prior breast cancer diagnosis, we reviewed 25 studies that were published up to 01 December 2021 and identified in MEDLINE, the COCHRANE library, Embase, or Web of Science; of these, 9 were included in the previous meta-analysis. Risk estimates from 22 of the 25 studies were included in the meta-analysis and pooled using random-effects models. Compared to euthyroidism, hyperthyroidism and hypothyroidism diagnoses were associated with higher (pooled risk ratio (RR): 1.12, 95% CI: 1.06-1.18, 3829 exposed cases) and lower risks (RR = 0.93, 95% CI: 0.86-1.00, 5632 exposed cases) of breast cancer, respectively. The increased risk after hyperthyroidism was greater among postmenopausal women (RR = 1.19, 95% CI 1.09-1.30) and the decreased risk after hypothyroidism was more pronounced among premenopausal women (RR = 0.69, 95% CI 0.53-0.89). Among women with no prior history of thyroid disease, every 1 mIU/L increase in TSH level was associated with a 0.8% (95% CI > 0-1.5%) lower risk of breast cancer. In conclusion, this meta-analysis supports an association between thyroid hormone levels and breast cancer risk, which could be modified by menopausal status.
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Affiliation(s)
- Thi-Van-Trinh Tran
- Cancer and Radiation Group, Center for Research in Epidemiology and Population Health, INSERM, Paris Sud-Paris Saclay University, Gustave Roussy, Villejuif, France
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cari Meinhold Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Florent de Vathaire
- Cancer and Radiation Group, Center for Research in Epidemiology and Population Health, INSERM, Paris Sud-Paris Saclay University, Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Health across Generations Team, Center for Research in Epidemiology and Population Health, INSERM, Paris Sud-Paris Saclay University, Gustave Roussy, Villejuif, France
| | - Neige Journy
- Cancer and Radiation Group, Center for Research in Epidemiology and Population Health, INSERM, Paris Sud-Paris Saclay University, Gustave Roussy, Villejuif, France
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7
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Wassermann J, Bagnis CI, Leenhardt L, Ederhy S, Buffet C. Pre-therapeutic evaluation and practical management of cardiovascular and renal toxicities in patients with metastatic radioiodine-refractory thyroid cancer treated with lenvatinib. Expert Opin Drug Saf 2022; 21:1401-1410. [DOI: 10.1080/14740338.2022.2153115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Johanna Wassermann
- Medical Oncology Department and Thyroïd and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, APHP Sorbonne University, Pitié-Salpêtrière Hospital, Paris
| | - Corinne Isnard Bagnis
- Nephrology Department, APHP Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Laurence Leenhardt
- Thyroïd and Endocrine Tumors Department, Sorbonne Université, Groupe de Recherche Clinique n°16GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Stéphane Ederhy
- UNICO-GRECO Cardio-oncology Program, Sorbonne University, Cardiology Department, , Hôpital Saint Antoine 184 rue du FaubourgSaint Antoine, 75012 Paris, France
| | - Camille Buffet
- Thyroïd and Endocrine Tumors Department, Sorbonne Université, Groupe de Recherche Clinique n°16GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
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8
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Ben Hamou A, Ghanassia E, Muller A, Ladsous M, Paladino NC, Brunaud L, Leenhardt L, Russ G. SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Thermal ablation. Ann Endocrinol (Paris) 2022; 83:423-430. [PMID: 36306894 DOI: 10.1016/j.ando.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with thermal ablation, which may constitute an alternative to thyroid surgery in selected patients.
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Affiliation(s)
- Adrien Ben Hamou
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital AP-HP, Sorbonne University, 75013 Paris, France; American Hospital of Paris, Thyroid Unit, 92200 Neuilly-sur-Seine, France
| | - Edouard Ghanassia
- American Hospital of Paris, Thyroid Unit, 92200 Neuilly-sur-Seine, France; Polyclinique Sainte-Thérèse, 34200 Sète, France
| | - Arnaud Muller
- Department of Imaging, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite, France; Imagerie Médicale Val d'Ouest - Charcot, 53 Rue du Commandant Charcot, 69110 Sainte-Foy-Lès-Lyon, France
| | - Miriam Ladsous
- CHU Lille, Service d'Endocrinologie, Diabétologie, Métabolisme et Nutrition, Hôpital Claude Huriez, 59000 Lille, France
| | - Nunzia Cinzia Paladino
- Aix Marseille Univ, APHM, Department of General Endocrine and Metabolic Surgery, Conception University Hospital, 13005 Marseille, France
| | - Laurent Brunaud
- Department of Gastrointestinal, Metabolic and Cancer Surgery (CVMC), CHRU Nancy, 54511 Vandœuvre-Lès-Nancy, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital AP-HP, Sorbonne University, 75013 Paris, France; Institute of Cancer IUC Sorbonne University GRC N°16, 75013 Paris, France.
| | - Gilles Russ
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital AP-HP, Sorbonne University, 75013 Paris, France; Institute of Cancer IUC Sorbonne University GRC N°16, 75013 Paris, France; Centre de Pathologie et d'Imagerie, 14, Avenue René-Coty, 75014 Paris, France
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9
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Borson-Chazot F, Borget I, Mathonnet M, Leenhardt L. SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Epidemiology and challenges in the management of thyroid nodules. Annales d'Endocrinologie 2022; 83:378-379. [PMID: 36283463 DOI: 10.1016/j.ando.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with epidemiology and challenges in the management of thyroid nodules.
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Affiliation(s)
- Francoise Borson-Chazot
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France; Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
| | - Isabelle Borget
- Service de Biostatistiques et d'Epidémiologie, Direction de la Recherche Clinique, Gustave Roussy, Paris-Saclay University, 114 Rue Edouard Vaillant, Villejuif, France; Oncostat, Université Paris-Saclay U1018, Inserm, Université Paris-Saclay, Equipe labélisée "Ligue Contre le Cancer", Villejuif, France
| | - Muriel Mathonnet
- Chirurgie Digestive et Endocrinienne CHU Dupuytren, Limoges, France; Research on CAPTuR, INSERM UMR 1308, Université de Limoges, Limoges, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University GRC N°16, 75013 Paris, France
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10
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Borson-Chazot F, Buffet C, Decaussin-Petrucci M, Cao CD, Drui D, Leboulleux S, Leenhardt L, Menegaux F, Pattou F, Lussey-Lepoutre C. SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Synthesis and algorithms. Ann Endocrinol (Paris) 2022; 83:440-453. [PMID: 36336101 DOI: 10.1016/j.ando.2022.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid with benign and non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies, the French Society of Endocrinology (SFE), the French Association of Endocrine Surgery (AFCE) and the French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This specific text is a summary chapter taking up the recommendations from specific sections and presenting algorithms for the exploration and management of thyroid nodules.
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Affiliation(s)
- F Borson-Chazot
- Fédération d'endocrinologie, groupement hospitalier Est, hospices civils de Lyon, Lyon, France; Inserm U1290, université Claude-Bernard Lyon 1, Lyon, France.
| | - C Buffet
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France; Institute of Cancer IUC Sorbonne University GRC No. 16, 75013 Paris, France
| | - M Decaussin-Petrucci
- Pathology Department, centre hospitalier Lyon Sud, hospices civils de Lyon, Pierre-Bénite, France; EA 3738, Lyon 1 University, Lyon, France
| | - C Do Cao
- Department of Endocrinology, Diabetology and Metabolism, CHU de Lille, Lille, France
| | - D Drui
- Service d'endocrinologie-diabétologie et nutrition, l'institut du thorax, CHU de Nantes, Nantes Université, 44000 Nantes, France
| | - S Leboulleux
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France; Service d'endocrinologie, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland
| | - L Leenhardt
- Institute of Cancer IUC Sorbonne University GRC No. 16, 75013 Paris, France
| | - F Menegaux
- Service de chirurgie endocrinienne, hôpital de la pitié Salpetrière, AP-HP, 75013 Paris, France
| | - F Pattou
- Inserm, service de chirurgie générale et endocrinienne, EGID, U1190, Lille Pasteur Institute, CHU de Lille, université Lille, Lille, France
| | - C Lussey-Lepoutre
- Inserm U970, service de médecine nucléaire, Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, Paris, France
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11
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Martinod E, Radu DM, Onorati I, Portela AMS, Peretti M, Guiraudet P, Destable MD, Uzunhan Y, Freynet O, Chouahnia K, Duchemann B, Kabbani J, Maurer C, Brillet PY, Fath L, Brenet E, Debry C, Buffet C, Leenhardt L, Clero D, Julien N, Vénissac N, Tronc F, Dutau H, Marquette CH, Juvin C, Lebreton G, Cohen Y, Zogheib E, Beloucif S, Planès C, Trésallet C, Bensidhoum M, Petite H, Rouard H, Miyara M, Vicaut E. Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients. Am J Transplant 2022; 22:2961-2970. [PMID: 35778956 DOI: 10.1111/ajt.17137] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 01/25/2023]
Abstract
Over the past 25 years, we have demonstrated the feasibility of airway bioengineering using stented aortic matrices experimentally then in a first-in-human trial (n = 13). The present TRITON-01 study analyzed all the patients who had airway replacement at our center to confirm that this innovative approach can be now used as usual care. For each patient, the following data were prospectively collected: postoperative mortality and morbidity, late airway complications, stent removal and status at last follow-up on November 2, 2021. From October 2009 to October 2021, 35 patients had airway replacement for malignant (n = 29) or benign (n = 6) lesions. The 30-day postoperative mortality and morbidity rates were 2.9% (n = 1/35) and 22.9% (n = 8/35) respectively. At a median follow-up of 29.5 months (range 1-133 months), 27 patients were alive. There have been no deaths directly related to the implanted bioprosthesis. Eighteen patients (52.9%) had stent-related granulomas requiring a bronchoscopic treatment. Ten among 35 patients (28.6%) achieved a stent free survival. The actuarial 2- and 5-year survival rates (Kaplan-Meier estimates) were respectively 88% and 75%. The TRITON-01 study confirmed that airway replacement using stented aortic matrices can be proposed as usual care at our center. Clinicaltrials.gov Identifier: NCT04263129.
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Affiliation(s)
- Emmanuel Martinod
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Dana M Radu
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Ilaria Onorati
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Ana Maria Santos Portela
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Marine Peretti
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Patrice Guiraudet
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Marie-Dominique Destable
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Yurdagül Uzunhan
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Pneumologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Olivia Freynet
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Pneumologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Kader Chouahnia
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Oncologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Boris Duchemann
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Oncologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Jamal Kabbani
- Hôpital Le Raincy-Montfermeil, Pneumologie, Montfermeil, France
| | - Cyril Maurer
- Hôpital Le Raincy-Montfermeil, Pneumologie, Montfermeil, France
| | - Pierre-Yves Brillet
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Radiologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Léa Fath
- Hôpitaux Universitaires de Strasbourg, Oto-Rhino-Laryngologie, Strasbourg, France
| | - Esteban Brenet
- Centre Hospitalier Universitaire de Reims, Oto-Rhino-Laryngologie, Reims, France
| | - Christian Debry
- Hôpitaux Universitaires de Strasbourg, Oto-Rhino-Laryngologie, Strasbourg, France
| | - Camille Buffet
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Endocrinologie, Paris, France
| | - Laurence Leenhardt
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Endocrinologie, Paris, France
| | - Dominique Clero
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Oto-Rhino-Laryngologie, Paris, France
| | - Nicolas Julien
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Oto-Rhino-Laryngologie, Paris, France
| | - Nicolas Vénissac
- Hôpitaux Universitaires de Lille, Chirurgie Thoracique, Lille, France
| | - François Tronc
- Hôpitaux Universitaires de Lyon, Chirurgie Thoracique, Lyon, France
| | - Hervé Dutau
- Assistance Publique - Hôpitaux de Marseille, Pneumologie, Hôpital Universitaire Nord, Marseille, France
| | | | - Charles Juvin
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Chirurgie Cardiaque, Paris, France
| | - Guillaume Lebreton
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Chirurgie Cardiaque, Paris, France
| | - Yves Cohen
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Elie Zogheib
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Anesthésie-Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Sadek Beloucif
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Anesthésie-Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Carole Planès
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Christophe Trésallet
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Digestive, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | | | - Hervé Petite
- B3OA UMR CNRS 7052, Université Paris Cité CNRS, Paris, France
| | - Hélène Rouard
- AP-HP, EFS Ile de France, Banque des Tissus, La Plaine Saint-Denis, France
| | - Makoto Miyara
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique, Hôpitaux Saint Louis-Lariboisière-Fernand Widal, Université Paris Cité, Paris, France
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12
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Leboulleux S, Lamartina L, Lecornet Sokol E, Menegaux F, Leenhardt L, Russ G. SFE-AFCE-SFMN 2022 Consensus on the management of thyroid nodules : Follow-up: How and how long? Ann Endocrinol (Paris) 2022; 83:407-414. [PMID: 36283461 DOI: 10.1016/j.ando.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians, surgeons, and other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with the follow-up of thyroid nodules, low-grade tumors and microcarcinomas.
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Affiliation(s)
- Sophie Leboulleux
- Service d'Endocrinologie, Hôpitaux Universitaires de Genève, 4 Rue Gabrielle Perret-Gentil, 1205 Genève, Switzerland.
| | - Livia Lamartina
- Endocrine Oncology, Gustave Roussy and University Paris Saclay, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | | | - Fabrice Menegaux
- Endocrine Surgery Department, Pitié-Salpêtrière Hospital APHP, Institute of Cancer IUC, Sorbonne University GRC N°16, 83 Boulevard de l'Hôpital, 75013 Paris, France; Centre de Pathologie et d'Imagerie, 14 Avenue René Coty, 75014 Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Department, Pitié Salpêtrière Hospital, APHP, Institute of Cancer IUC, Sorbonne University, 83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Gilles Russ
- Centre de Pathologie et d'Imagerie, 14 Avenue René Coty, 75014 Paris, France; Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital APHP, Institute of Cancer IUC, Sorbonne University GRC N°16, 83 Boulevard de l'Hôpital, 75013 Paris, France
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13
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Scherman N, Wassermann J, Tlemsani C, Guillerm E, Deniziaut G, Cochand-Priollet B, Shan L, Chereau N, Gaujoux S, Simon JM, Leenhardt L, Groussin L, Buffet C. Possible Primary Thyroid Nuclear Protein in Testis Carcinomas with NSD3::NUTM1 Translocation Revealed by RNA Sequencing: A Report of Two Cases. Thyroid 2022; 32:1271-1276. [PMID: 35880417 DOI: 10.1089/thy.2022.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Nuclear protein in testis (NUT) carcinomas (NC) are a rare, highly aggressive, subset of squamous cell carcinomas, characterized by a translocation involving the NUTM1 gene. Thyroid location of NUT carcinomas has rarely been described. Methods: We report here two cases of thyroid NC with NSD3::NUTM1 translocation. Results: The first case presented as a very aggressive undifferentiated thyroid carcinoma in a 38-year-old man who died 21 months after the diagnosis. The second case was diagnosed after multiple lymphadenopathy recurrences mainly in the neck in a 37-year-old woman 7 years after total thyroidectomy for papillary thyroid carcinoma with a classic and a solid/trabecular component. Conclusions: Our case reports highlight the challenges in diagnosing these exceptional carcinomas. The therapeutic impact of the administration of pharmacological compounds with epigenetic action, in line with the physiopathology of these carcinomas, is also discussed.
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Affiliation(s)
- Noémie Scherman
- Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Johanna Wassermann
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Cochin Hospital, Paris Cancer Institute CARPEM, Université de Paris, Paris, France
| | - Erell Guillerm
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncogenetic Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Gabrielle Deniziaut
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Pathology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | | | - Larrys Shan
- Endocrine Department, Centre Hospitalier de Polynésie Française, Papeete, French Polynesia
| | - Nathalie Chereau
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Sébastien Gaujoux
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Jean-Marc Simon
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Radiotherapy Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Laurence Leenhardt
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Lionel Groussin
- Endocrine Department; Cochin Hospital, Université de Paris, Paris, France
| | - Camille Buffet
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
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14
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Pani F, Caria P, Yasuda Y, Makoto M, Mariotti S, Leenhardt L, Roshanmehr S, Caturegli P, Buffet C. The Immune Landscape of Papillary Thyroid Cancer in the Context of Autoimmune Thyroiditis. Cancers (Basel) 2022; 14:cancers14174287. [PMID: 36077831 PMCID: PMC9454449 DOI: 10.3390/cancers14174287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/26/2022] Open
Abstract
Simple Summary The association between papillary thyroid cancer and Hashimoto’s thyroiditis went through a long-standing human debate recently elucidated by the establishment of a novel mouse model. Papillary thyroid carcinoma is an excellent model for studying the tumor immune microenvironment because it is naturally accompanied by immune cells, making it a good candidate for the treatment with immune checkpoint inhibitors. Abstract Papillary thyroid cancer (PTC) often co-occurs with Hashimoto’s thyroiditis, an association that has long been reported in clinical studies, remaining controversial. Experimental evidence has recently shown that pre-existing thyroiditis has a beneficial effect on PTC growth and progression by a distinctive expansion of effector memory CD8 T cells. Although the link between inflammation and PTC might involve different components of the immune system, a deep characterization of them which includes T cells, B cells and tertiary lymphoid structures, Mye-loid cells, Neutrophils, NK cells and dendritic cells will be desirable. The present review article considers the role of the adaptive and innate immune response surrounding PTC in the context of Hashimoto’s thyroiditis. This review will focus on the current knowledge by in vivo and in vitro studies specifically performed on animals’ models; thyroid cancer cells and human samples including (i) the dual role of tumor-infiltrating lymphocytes; (ii) the emerging role of B cells and tertiary lymphoid structures; (iii) the role of myeloid cells, dendritic cells, and natural killer cells; (iv) the current knowledge of the molecular biomarkers implicated in the complex link between thyroiditis and PTC and the potential implication of cancer immunotherapy in PTC patients in the context of thyroiditis.
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Affiliation(s)
- Fabiana Pani
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
- Correspondence: or
| | - Paola Caria
- Department of Biomedical Sciences, Biochemistry, Biology and Genetics Unit, University of Cagliari, Cittadella Universitaria di Monserrato, SP 8, Km 0.700, Monserrato, 09042 Cagliari, Italy
| | - Yoshinori Yasuda
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Miyara Makoto
- Inserm, Centre d’Immunologie et des Maladies Infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | - Stefano Mariotti
- Department of Medical Sciences and Public Health, Endocrinology Unit, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Laurence Leenhardt
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
| | - Solmaz Roshanmehr
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Patrizio Caturegli
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Camille Buffet
- Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, 75013 Paris, France
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15
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Buffet C, Allard L, Guillerm E, Ghander C, Mathy E, Lussey-Lepoutre C, Julien N, Touma E, Quilhot P, Godiris-Petit G, Lacorte JM, Leenhardt L, Denis JA. Detection of BRAFV600E by digital PCR on fine-needle aspirate enables rapid initiation of dabrafenib and trametinib in unresectable anaplastic thyroid carcinoma. Eur J Endocrinol 2022; 187:K33-K38. [PMID: 35900324 DOI: 10.1530/eje-22-0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Recently, targeted therapies using BRAFV600E and MEK inhibitors (dabrafenib and trametinib, respectively) have been recommended in BRAF-mutated anaplastic thyroid carcinoma (ATC). Considering the fast development of ATC, droplet digital PCR (ddPCR) performed on fine-needle aspirate (FNA), which is a rapid, reliable, and low-cost method, appears interesting for the detection of BRAFV600E mutation in these patients and allows early initiation of targeted therapies. RESULTS In our two patients, both presenting extensive cervical masses inaccessible to surgery, ddPCR results were available in less than 24 h. Therefore, dabrafenib and trametinib were started only a few days after first contact. CONCLUSIONS We suggest that ddPCR on FNA be used in non-resectable cervical masses for rapid BRAFV600E mutation detection in the hope that starting targeted therapies early might improve outcomes.
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Affiliation(s)
- Camille Buffet
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lucie Allard
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, UF d'Onco-angiogénétique et Génomique des Tumeurs Solides, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Ghander
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elise Mathy
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Fonctionnelle de Radiothérapie Interne Vectorisée, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Nicolas Julien
- Service d'ORL, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eliane Touma
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pauline Quilhot
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service d'Anatomo-Pathologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gaelle Godiris-Petit
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Chirurgie Générale et Endocrinienne, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Marc Lacorte
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
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16
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Baudin C, Lussey-Lepoutre C, Bressand A, Buffet C, Menegaux F, Soret M, Broggio D, Bassinet C, Huet C, Armengol G, Leenhardt L, Bernier MO. Salivary Dysfunctions and Consequences After Radioiodine Treatment for Thyroid Cancer: Protocol for a Self-Controlled Study (START Study). JMIR Res Protoc 2022; 11:e35565. [PMID: 35867385 PMCID: PMC9356333 DOI: 10.2196/35565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/04/2022] [Accepted: 04/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Following radioiodine (131I) therapy of differentiated thyroid cancer, the salivary glands may become inflamed, leading to dysfunctions and decreases in patients’ nutritional status and quality of life. The incidence of these dysfunctions after 131I-therapy is poorly known, and no clinical or genetic factors have been identified to date to define at-risk patients, which would allow the delivered activity to be adapted to the expected risk of salivary dysfunctions. Objective The aims of this study are to estimate the incidence of salivary dysfunctions, and consequences on the quality of life and nutritional status for patients after 131I-therapy; to characterize at-risk patients of developing posttreatment dysfunctions using clinical, biomolecular, and biochemical factors; and to validate a dosimetric method to calculate the dose received at the salivary gland level for analyzing the dose-response relationship between absorbed doses to salivary glands and salivary dysfunctions. Methods This prospective study aims to include patients for whom 131I-therapy is indicated as part of the treatment for differentiated thyroid cancer in a Paris hospital (40 and 80 patients in the 1.1 GBq and 3.7 GBq groups, respectively). The follow-up is based on three scheduled visits: at inclusion (T0, immediately before 131I-therapy), and at 6 months (T6) and 18 months (T18) posttreatment. For each visit, questionnaires on salivary dysfunctions (validated French tool), quality of life (Hospital Anxiety and Depression scale, Medical Outcomes Study 36-Item Short Form Survey), and nutritional status (visual analog scale) are administered by a trained clinical research associate. At T0 and T6, saliva samples and individual measurements of the salivary flow, without and with salivary glands stimulation, are performed. External thermoluminescent dosimeters are positioned on the skin opposite the salivary glands and at the sternal fork immediately before 131I administration and removed after 5 days. From the doses recorded by the dosimeters, an estimation of the dose received at the salivary glands will be carried out using physical and computational phantoms. Genetic and epigenetic analyses will be performed to search for potential biomarkers of the predisposition to develop salivary dysfunctions after 131I-therapy. Results A total of 139 patients (99 women, 71.2%; mean age 47.4, SD 14.3 years) were enrolled in the study between September 2020 and April 2021 (45 and 94 patients in the 1.1 GBq and 3.7G Bq groups, respectively). T6 follow-up is complete and T18 follow-up is currently underway. Statistical analyses will assess the links between salivary dysfunctions and absorbed doses to the salivary glands, accounting for associated factors. Moreover, impacts on the patients’ quality of life will be analyzed. Conclusions To our knowledge, this study is the first to investigate the risk of salivary dysfunctions (using both objective and subjective indicators) in relation to organ (salivary glands) doses, based on individual dosimeter records and dose reconstructions. The results will allow the identification of patients at risk of salivary dysfunctions and will permit clinicians to propose a more adapted follow-up and/or countermeasures to adverse effects. Trial Registration ClinicalTrials.gov NCT04876287; https://clinicaltrials.gov/ct2/show/NCT04876287 International Registered Report Identifier (IRRID) DERR1-10.2196/35565
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Affiliation(s)
- Clémence Baudin
- Ionizing Radiation Epidemiology Laboratory, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | - Charlotte Lussey-Lepoutre
- Department of Nuclear Medicine, Sorbonne University, Pitié-Salpêtrière Hospital APHP, Paris, France.,Equipe Labellisée par la Ligue Contre le Cancer, Paris Research Center Cardiovascular, Institut National de la Santé et de la Recherche Médicale, University Paris City, Paris, France
| | | | - Camille Buffet
- Thyroid and Endocrine Tumors Unit, Groupe de Recherche Clinique Tumeurs Thyroïdiennes no. 16, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Fabrice Menegaux
- Thyroid and Endocrine Tumors Unit, Groupe de Recherche Clinique Tumeurs Thyroïdiennes no. 16, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.,Department of General and Endocrine Surgery, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Marine Soret
- Department of General and Endocrine Surgery, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.,Biomedical Imaging Laboratory, French National Centre for Scientific Research, Institut National de la Santé et de la Recherche Médicale, Sorbonne University, Paris, France
| | - David Broggio
- Internal Dose Assessment Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Céline Bassinet
- Ionizing Radiation Dosimetry Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Christelle Huet
- Ionizing Radiation Dosimetry Laboratory, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Gemma Armengol
- Department of Animal Biology, Plant Biology and Ecology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Bellaterra, Catalonia, Spain
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Groupe de Recherche Clinique Tumeurs Thyroïdiennes no. 16, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Marie-Odile Bernier
- Ionizing Radiation Epidemiology Laboratory, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
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17
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Bertin JB, Buffet C, Leenhardt L, Menegaux F, Chereau N. Effect of skip metastasis to lateral neck lymph nodes on outcome of patients with papillary thyroid carcinoma. Langenbecks Arch Surg 2022; 407:3025-3030. [PMID: 35819485 DOI: 10.1007/s00423-022-02604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/03/2022] [Indexed: 11/26/2022]
Abstract
CONTEXT Lymph node metastasis (N1) is a prognostic factor for disease recurrence in papillary thyroid carcinoma (PTC) patients. Skip metastasis is defined as only lateral N1 with negative central lymph nodes (LNs). OBJECTIVE The aim of this study was to explore the outcome of PTC patients with skip N1. PATIENTS AND DESIGN All patients who underwent a total thyroidectomy with ipsilateral central and lateral LN dissection for PTC from 1999 to 2019 in a high-volume endocrine surgery centre were included in this study. MAIN OUTCOME MEASURE Demographic and outcomes-recurrence and disease-specific survival (DSS)-were compared between three groups: N1a (central N1 only), N1b-CL (central and lateral N1), and N1b-Skip (lateral N1 without central LN involvement). RESULTS During the study period, 3046 patients had surgery for PTC, including 1138 with N1 (37%, 860 women, mean age: 44.8 years) comprising 474 N1a (42%), 513 N1b-CL (45%), and 151 N1b-Skip (13%). The median follow-up was 74 months (range 12-216 months). The recurrence rate in the N1b-Skip group was 13% (20/151) and 10% (47/474) in the N1a group. This was significantly lower than that in the N1b-CL group (27%, 140/513) (p < 0.0001). DSS at 10 years was 99% for group N1a, 98% for the N1b-CL, and 99% in the N1b-Skip group. CONCLUSION The recurrence rate of N1b-Skip patients was lower than that of N1b-CL patients and similar to that of N1a patients. This result could be used as an indication for the modality of radioiodine therapy, and for the pattern of follow-up procedures.
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Affiliation(s)
- Jean Baptiste Bertin
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Camille Buffet
- Thyroid and Endocrine Tumor Unit, Pitié Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumor Unit, Pitié Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
| | - Fabrice Menegaux
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
| | - Nathalie Chereau
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France.
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Leboulleux S, Bournaud C, Chougnet CN, Zerdoud S, Al Ghuzlan A, Catargi B, Do Cao C, Kelly A, Barge ML, Lacroix L, Dygai I, Vera P, Rusu D, Schneegans O, Benisvy D, Klein M, Roux J, Eberle MC, Bastie D, Nascimento C, Giraudet AL, Le Moullec N, Bardet S, Drui D, Roudaut N, Godbert Y, Morel O, Drutel A, Lamartina L, Schvartz C, Velayoudom FL, Schlumberger MJ, Leenhardt L, Borget I. Thyroidectomy without Radioiodine in Patients with Low-Risk Thyroid Cancer. N Engl J Med 2022; 386:923-932. [PMID: 35263518 DOI: 10.1056/nejmoa2111953] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND In patients with low-risk differentiated thyroid cancer undergoing thyroidectomy, the postoperative administration of radioiodine (iodine-131) is controversial in the absence of demonstrated benefits. METHODS In this prospective, randomized, phase 3 trial, we assigned patients with low-risk differentiated thyroid cancer who were undergoing thyroidectomy to receive ablation with postoperative administration of radioiodine (1.1 GBq) after injections of recombinant human thyrotropin (radioiodine group) or to receive no postoperative radioiodine (no-radioiodine group). The primary objective was to assess whether no radioiodine therapy was noninferior to radioiodine therapy with respect to the absence of a composite end point that included functional, structural, and biologic abnormalities at 3 years. Noninferiority was defined as a between-group difference of less than 5 percentage points in the percentage of patients who did not have events that included the presence of abnormal foci of radioiodine uptake on whole-body scanning that required subsequent treatment (in the radioiodine group only), abnormal findings on neck ultrasonography, or elevated levels of thyroglobulin or thyroglobulin antibodies. Secondary end points included prognostic factors for events and molecular characterization. RESULTS Among 730 patients who could be evaluated 3 years after randomization, the percentage of patients without an event was 95.6% (95% confidence interval [CI], 93.0 to 97.5) in the no-radioiodine group and 95.9% (95% CI, 93.3 to 97.7) in the radioiodine group, a difference of -0.3 percentage points (two-sided 90% CI, -2.7 to 2.2), a result that met the noninferiority criteria. Events consisted of structural or functional abnormalities in 8 patients and biologic abnormalities in 23 patients with 25 events. Events were more frequent in patients with a postoperative serum thyroglobulin level of more than 1 ng per milliliter during thyroid hormone treatment. Molecular alterations were similar in patients with or without an event. No treatment-related adverse events were reported. CONCLUSIONS In patients with low-risk thyroid cancer undergoing thyroidectomy, a follow-up strategy that did not involve the use of radioiodine was noninferior to an ablation strategy with radioiodine regarding the occurrence of functional, structural, and biologic events at 3 years. (Funded by the French National Cancer Institute; ESTIMABL2 ClinicalTrials.gov number, NCT01837745.).
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Affiliation(s)
- Sophie Leboulleux
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Claire Bournaud
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Cecile N Chougnet
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Slimane Zerdoud
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Abir Al Ghuzlan
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Bogdan Catargi
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Christine Do Cao
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Antony Kelly
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Marie-Luce Barge
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Ludovic Lacroix
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Inna Dygai
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Pierre Vera
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Daniela Rusu
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Olivier Schneegans
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Danielle Benisvy
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Marc Klein
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Julie Roux
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Marie-Claude Eberle
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Delphine Bastie
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Camila Nascimento
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Anne-Laure Giraudet
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Nathalie Le Moullec
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Stéphane Bardet
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Delphine Drui
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Nathalie Roudaut
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Yann Godbert
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Olivier Morel
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Anne Drutel
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Livia Lamartina
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Claire Schvartz
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Fritz-Line Velayoudom
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Martin-Jean Schlumberger
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Laurence Leenhardt
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
| | - Isabelle Borget
- From the Department of Nuclear Medicine and Endocrine Oncology (S.L., L. Lamartina, M.-J.S.), the Department of Medical Biology and Pathology (A.A.G., L. Lacroix), and the Biostatistics and Epidemiology Office, Oncostat, INSERM Unité 1018 (I.B.), Gustave Roussy and Université Paris-Saclay, Villejuif, the Nuclear Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron (C.B.), the Endocrine Oncology Department, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Saint-Louis (C.N.C.), and the Thyroid and Endocrine Tumors Unit, Pitié-Salpétrière Hospital AP-HP, Institute of Cancer IUC Sorbonne University (L. Leenhardt), Paris, the Department of Medical Imaging, Nuclear Medicine, IUCT Oncopole Toulouse-Institut Claudius Regaud (S.Z.), and the Nuclear Medicine Department, CHU Rangueil (D. Bastie), Toulouse, the Department of Endocrinology-Metabolic Diseases, Hôpital Saint-André, Centre Hospitalier Universitaire (CHU) de Bordeaux (B.C.), and the Thyroid Oncology and Nuclear Medicine Department, Institut Bergonié (Y.G.), Bordeaux, the Endocrine Department, CHRU de Lille-Hôpital Claude Huriez, Lille (C.D.C.), the Nuclear Medicine Department, Centre Jean Perrin, Clermont-Ferrand (A.K.), the Nuclear Medicine Department, Centre Eugene Marquis, Rennes (M.-L.B.), the Nuclear Medicine Department, Centre Georges François Leclerc, Dijon (I.D.), the Nuclear Medicine Department, Centre Henri Becquerel and Laboratoire QUANTif, Rouen (P.V.), the Nuclear Medicine Department, Centre René Gauducheau, Saint Herblain (D.R.), the Nuclear Medicine Department, Centre Paul Strauss, Strasbourg (O.S.), the Nuclear Medicine Department, Antoine Lacassagne, Nice (D. Benisvy), the Endocrine Department, Centre Hospitalier Régional Universitaire (CHRU) de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy (M.K.), the Nuclear Medicine Department, CHU Grenoble-Alpes, Grenoble (J.R.), the Nuclear Medicine Department, Institut du Cancer de Montpellier, Institut Régional du Cancer Val d'Aurelle, Montpellier (M.-C.E.), the Nuclear Medicine Department, Institut Curie Site Saint-Cloud, Saint-Cloud (C.N.), the Nuclear Medicine Department, Centre Léon Bérard, Lyon (A.-L.G.), the Endocrine Department, CHU Saint Pierre, Saint Pierre (N.L.M.), the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.), the Endocrine Department, Institut du Thorax, CHU de Nantes-Hopital Laennec Saint-Herblain, Nantes (D.D.), the Endocrine Department, CHU La Cavale Blanche, Brest (N.R.), the Nuclear Medicine Department, Institut de Cancérologie de l'Ouest, Angers (O.M.), the Endocrine Department, CHU Dupuytren, Limoges (A.D.), the Thyroid Unit, Institut Jean Godinot, Reims (C.S.), and the Endocrine Department, CHU de Guadeloupe, Hôpital Ricou, Les Abymes (F.-L.V.) - all in France
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19
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Allard L, Denis JA, Godiris Petit G, Deniziaut G, Ghander C, Mathy E, Guillerm E, Lussey-Lepoutre C, Leenhardt L, Buffet C. Complete resection of ulcerating, infiltrative, voluminous differentiated thyroid carcinoma. Eur Thyroid J 2022; 11:e210091. [PMID: 35113038 PMCID: PMC8963168 DOI: 10.1530/etj-21-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
An 87-year-old woman was referred to our department for a 15 cm right-sided cervical tumor with bleeding and skin ulceration, developed on a 6 cm papillary thyroid carcinoma diagnosed two years earlier. Surprisingly, there were no other compressive symptoms. Unexpectedly, but successfully, total thyroidectomy and neck dissection were performed. There were no poorly differentiated or anaplastic components in the final histological analysis. Impressive dehiscence occurred shortly after surgery and was also successfully managed. Our case highlights the benefit of considering surgery in the context of a tertiary care center even for an apparent massive aggressive cervical mass and despite old age.
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Affiliation(s)
- Lucie Allard
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, Pitié Salpêtrière, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gaëlle Godiris Petit
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Chirurgie Générale, Viscérale et Endocrinienne, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gabrielle Deniziaut
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service d’Anatomo-Pathologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Ghander
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elise Mathy
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, UF d’Onco-Angiogénétique et Génomique des Tumeurs Solides, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Médecine Nucléaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Camille Buffet
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- Correspondence should be addressed to C Buffet:
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20
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Buffet C, Belin L, Attanasio R, Hegedüs L, Nagy EV, Papini E, Perros P, Leenhardt L. Real-life practice of thyroid hormone use in hypothyroid and euthyroid patients: a detailed view from the THESIS* questionnaire survey in France. Ann Endocrinol (Paris) 2021; 83:27-34. [PMID: 34861221 DOI: 10.1016/j.ando.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
AIM To describe practices of French physicians regarding thyroid hormone therapy, focusing on available LT4 formulations. MATERIAL AND METHODS Members of the French Endocrine Society (FES) and affiliated societies (the Endocrine Tumor Group, French College of Teachers of Endocrinology, Diabetes and Metabolic Diseases and the Union of Endocrinology, Diabetology, Metabolic Diseases and Nutrition Specialists) were invited to participate in an online survey. RESULTS 534 of the 2,094 persons contacted (25.5%) completed the survey and were included in the analysis. The vast majority (99.4%) reported that levothyroxine (LT4) is the treatment of choice for hypothyroidism. 7.1% and 14.2% of respondents respectively considered liothyronine (LT3) or a combination of LT4 and LT3 for the treatment of hypothyroidism, mainly when symptoms persisted despite achieving normal TSH concentrations with LT4 therapy. For 44% of respondents, thyroid hormone treatment is never indicated in euthyroid patients, while the remainder would consider treating euthyroid patients with a goiter growing over time (40.2%) and/or euthyroid women with positive anti-TPO antibodies and infertility (31.7%). LT4 tablets were the preferred LT4 formulation. A significant proportion of FES members expected no major clinical differences upon changing to formulations such as soft-gel capsules or liquid solutions, even in specific scenarios such as poor biochemical control or suspicion of malabsorption. CONCLUSION The treatment of choice for hypothyroidism in France is LT4. LT3-based therapy is considered by some physicians in case of persistent symptoms of hypothyroidism despite normal TSH level. A significant proportion of respondents (66.0%) would consider treating euthyroid patients, contrary to the present state of knowledge. These outdated practices should be addressed by professional bodies such as the FES.
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Affiliation(s)
- C Buffet
- Sorbonne Université, GRC n°16, GRC Thyroid Tumors, Thyroid Pathology and Endocrine Tumor Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France.
| | - L Belin
- Sorbonne Université, Biostatistics Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - R Attanasio
- Scientific Committee, Associazione Medici Endocrinologi, International Chapter of Clinical Endocrinology, Italy
| | - L Hegedüs
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - E V Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - E Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano, Rome, Italy
| | - P Perros
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - L Leenhardt
- Sorbonne Université, GRC n°16, GRC Thyroid Tumors, Thyroid Pathology and Endocrine Tumor Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
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21
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Giraud P, Blais E, Jouinot A, Wasserman J, Ménégaux F, Leenhardt L, Maingon P, Simon JM. [Efficacy and tolerance of salvage curative radiotherapy for patients with cervical relapse of differentiated thyroid carcinoma]. Cancer Radiother 2021; 26:458-466. [PMID: 34253422 DOI: 10.1016/j.canrad.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Radiation therapy is often the last resource treatment for cervical relapse in iodine refractory differentiated thyroid cancer. We present locoregional control data in patients with cervical relapse treated with curative intent radiation therapy with or without concomitant carboplatin. MATERIAL AND METHODS This monocentric retrospective study gathered data on patients with differentiated thyroid carcinoma - vesicular or papillary - in relapse after thyroidectomy who received a curative intent cervical radiation therapy. Locoregional progression free survival (LRPFS), progression free survival (PFS), overall survival (OS) were gathered as well as acute and chronic adverse events assessed with the CTCAE v4. RESULTS Thirty-nine patients were consecutively included between 2005 and 2019. The median follow-up was 36.6months. Fifteen patients (38%) had a locoregional relapse, locoregional control at 2years was 66.7%. The median LRPFS was 48months [32.9-not reached] and the median overall survival 49months [38.8-not reached]. In multivariate analysis, initial incomplete resection was associated with poorer OS (HR: 24.39 [3.57-166.78], P=0.00113) and LRPFS (HR: 33.91 [4.46-257.61], P=0.00066), extra nodal spread was associated with poorer LRPFS (HR: 13.45 [1.81-99,76], P=0.011). ECOG performance status was associated with OS (HR: 5.11 [1.57-16.66], P=0.00688). Carboplatin association with radiation therapy was not associated with improved survivals (OS: P=0.34, LRPFS: P=0.84). The rate of acute grade 3 toxicities was 14%. CONCLUSION Salvage cervical radiation therapy was associated with a locoregional control of 66.7% at 2years with a reasonable toxicity rate. Carboplatin association with radiation therapy did not improve locoregional control nor overall survival in comparison with radiotherapy alone.
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Affiliation(s)
- P Giraud
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - E Blais
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - A Jouinot
- Université de Paris, institut Cochin, Inserm, CNRS, 22, rue Méchain, 75014 Paris, France
| | - J Wasserman
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie médicale, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - F Ménégaux
- Service de chirurgie générale, viscérale et endocrinienne, Sorbonne université, GRC n(o) 16 tumeurs thyroïdiennes, hôpital de la Pitié, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - L Leenhardt
- Unité thyroïde tumeurs endocrines, Sorbonne université, GRC n(o) 16 tumeurs thyroïdiennes, AP-HP, hôpital de la Pitié-Salpêtrière, 75013 Paris, France
| | - P Maingon
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - J-M Simon
- AP-HP, hôpital universitaire Pitié-Salpêtrière, service d'oncologie radiothérapie, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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22
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Russ G, Ben Hamou A, Poirée S, Ghander C, Ménégaux F, Leenhardt L, Buffet C. Learning curve for radiofrequency ablation of benign thyroid nodules. Int J Hyperthermia 2021; 38:55-64. [PMID: 33491515 DOI: 10.1080/02656736.2021.1871974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: To evaluate the effect of operator experience on the treatment outcomes of radiofrequency ablation (RFA) for benign thyroid nodules (BTN). Methods: Data from the 90 first RFA procedures of a single operator in treating benign thyroid nodules were prospectively collected and retrospectively analyzed. Patients were divided into 3 groups according to their chronological treatment rank: patients 1-30 (G1), 31-60 (G2) and 61-90 (G3). Clinical symptoms, volume reduction ratio (VRR), technique efficacy (TE) defined as a VRR > 50% and ablation ratio (AR) were compared between the three groups at 6 months follow-up. All complications and side effects were recorded. Results: No significant difference was observed in improvement of clinical symptoms after the RFA procedure between the three groups, with higher satisfaction however for pressure symptoms than for esthetic complaints (complete resolution 87.5% and 52.6%, respectively). In groups 1, 2 and 3, TE was 60%, 93.3%, 76.7%, VRR 54%, 65%, 60% and AR 13.1%, 34%, 34.6%, respectively. Thus, all ultrasound efficacy parameters (TE, VRR, AR) improved significantly between G1 and G2, with no difference between G2 and G3. Solely did AR improve in nodules ≤ 30 mL between G2 and G3 to reach a median value of 94.4% in G3 versus 57.1% in G2 and 13.7% in G1. Maximum values of TE and VRR (95.6% and 68%, respectively) were seen in nodules ≤ 30 mL in G2 at 6 months follow-up, with no improvement in G3 (84.2% and 63%, respectively). Both baseline volume and energy per volume were independently associated with VRR and AR. Three minor complications were recorded which all recovered totally after conservative treatment. Conclusion: There was a measurable learning curve in RFA for benign thyroid nodules regarding efficacy until 90 patients. VRR and AR can be used as proficiency markers. Only three transient complications occurred confirming the safety of the procedure.
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Affiliation(s)
- Gilles Russ
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.,Centre of Pathology and Radiology, Paris, France.,Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | | | - Sylvain Poirée
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.,Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Cécile Ghander
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.,Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Fabrice Ménégaux
- Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France.,Service de Chirurgie Générale et Digestive, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.,Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Camille Buffet
- Thyroid and Endocrine Tumors Department, Institute of Endocrinology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.,Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
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Bonichon F, de Baere T, Berdelou A, Leboulleux S, Giraudet AL, Cuinet M, Drui D, Liberge R, Kelly A, Tenenbaum F, Legmann P, Do Cao C, Leenhardt L, Toubeau M, Godbert Y, Palussière J. Percutaneous thermal ablation of lung metastases from thyroid carcinomas. A retrospective multicenter study of 107 nodules. On behalf of the TUTHYREF network. Endocrine 2021; 72:798-808. [PMID: 33770383 DOI: 10.1007/s12020-020-02580-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine efficacy and safety of thermal ablation (TA) for the local treatment of lung metastases of thyroid cancer. METHODS We retrospectively studied 47 patients from 10 centers treated by TA (radiofrequency, microwaves, and cryoablation) over 10 years. The endpoints were overall survival (OS), local efficacy, complications (CTCAE classification), and factors associated with survival. OS curves after first TA were built using the Kaplan-Meier method and compared with the log-rank test. RESULTS A total of 107 lung metastases during 75 sessions were treated by radiofrequency (n = 56), microwaves (n = 9), and cryoablation (n = 10). Median follow-up time after TA was 5.2 years (0.2-13.3). OS was 93% at 2 years (95% confidence interval (CI): 86-94) and 79% at 3 years (95% CI: 66-91). On univariate and multivariate analysis with a Cox model, histology was the only significant factor for OS. OS at 3 years was 94% for follicular, oncocytic, or papillary follicular variant carcinomas, compared to 59% for papillary, medullary, insular or anaplastic carcinomas (P = 0.0001). The local control rate was 98.1% at 1 year and 94.8% at 2, 3, 4, and 5 years. Morbidity was low with no major complications (grade 4 and 5 CTCAE) and no complications in 29 of 75 sessions (38.7%). CONCLUSIONS TA is a useful, safe and effective option for local treatment of lung metastases from thyroid carcinoma. Prolonged OS was obtained, especially for lung metastases from follicular, oncocytic, or papillary follicular variant carcinomas. Achieving disease control with TA delays the need for systemic treatment.
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Affiliation(s)
- Françoise Bonichon
- Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France.
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave-Roussy, Villejuif, France
| | - Amandine Berdelou
- Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France
| | | | - Marie Cuinet
- Department of Radiology, Léon Bérard Center, Lyon, France
| | - Delphine Drui
- Department of Endocrinology, Institut du Thorax, University Hospital, Nantes, France
| | - Renan Liberge
- Thoracic and General Radiology Department, University Hospital, Nantes, France
| | - Antony Kelly
- Department of Nuclear Medicine, Jean Perrin Center, Clermont Ferrand, France
| | - Florence Tenenbaum
- Nuclear Medicine Service, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France
| | - Paul Legmann
- Department of radiology, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France
| | | | - Laurence Leenhardt
- Unité Thyroïde Tumeurs Endocrines, Sorbonne Université, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Michel Toubeau
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | - Yann Godbert
- Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France
| | - Jean Palussière
- Department of Radiology, Institut Bergonié, Bordeaux, France
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Leboulleux S, Bournaud C, Chougnet CN, Zerdoud S, Catargi BN, Cao CD, Kelly A, Barge ML, Dygay I, Vera P, Rusu D, Schneegans O, Benisvy D, Klein M, Roux J, Eberle MC, Bastie D, Nascimento C, Giraudet AL, Moullec NL, Bardet S, Drui D, Roudaut N, Godbert Y, Morel O, Anne D, Schwartz C, Velayoudoum F, Schlumberger MJ, Leenhardt L, Borget I. Estimabl2: Is There a Need for Radioiodine Ablation in Low Risk Differentiated Thyroid Cancer (DTC) Patients?: Results From the French Randomized Phase III Prospective Trial on 776 Patients (NCT 01837745). J Endocr Soc 2021. [PMCID: PMC8090335 DOI: 10.1210/jendso/bvab048.1788] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The benefits of post-operative radioactive iodine (RAI) administration have not been demonstrated in patients with low risk differentiated thyroid cancer (DTC). The objective of this randomized phase III trial is to assess in low risk DTC patients the non-inferiority of a follow-up strategy as compared to a systematic adjuvant post-operative RAI administration. Methods: ESTIMABL2 is a French multicentric randomized phase III trial in patients with low-risk DTC treated with total thyroidectomy with or without prophylactic neck lymph node dissection (pT1am N0 or Nx with a sum of the diameters of tumor lesions ≥ 10mm, pT1b N0 or Nx). Two to five months after surgery, in the absence of suspicious lateral neck lymph node on ultrasonography (US), patients were randomized either to the follow-up group (FU, no RAI administration) or to the ablation group and received post-operative RAI (1.1 GBq following rhTSH stimulation). Yearly controls under levothyroxine treatment consisted in thyroglobulin (Tg) and Tg antibodies (TgAb) determinations and neck-US. The primary objective was to assess at 3 years after randomization the non-inferiority of the proportion of patients without tumor-related event in the FU group as compared to the ablation group. Non-inferiority is demonstrated if the rate of patients without event at 3 years does not differ by more than ΔL=-5%. A tumor-related event was defined by the occurrence of subsequent treatment (RAI administration or surgery) for abnormal RAI uptake on the post-therapeutic WBS or by elevated Tg or TgAb levels and/or abnormal neck US during controls. Tg levels on levothyroxine treatment were considered elevated if > 2ng/mL in the FU group and > 1ng/mL in the ablation group. TgAb were considered elevated if > the upper limit range with an increase above 50% on 2 consecutive determinations performed 6 months apart. Results: 776 low-risk DTC patients were included between 2013 and 2017 in 35 French centers within the TUTHYREF network; 83% females, mean age: 52 years, papillary TC: 96%, pT1bNx: 43.6%, pT1bN0: 37.5%, pT1amNx: 12.6%, pT1amN0: 6.3%. Among the 729 patients evaluable at 3 years after randomization, tumor-related events occurred in 18/367 patients (4.9% IC95%=[2.9; 7.6]) in the FU group and in 15/362 patients (4.1% IC95%=[2.3; 6.7]) in the ablation group. Thus, 95.1% of patients in the FU group had no event at 3 years and this percentage is not inferior from the 95.9% of patients observed in the ablation group (difference = -0.8% [95% CI:-3.3%; 1.8%]. The number of subsequent surgery and/or RAI administration was 6 (1.6% IC95%=[0.6; 3.5]) in the FU group and 9 (2.5% IC95%=[1.1; 4.7]) in the ablation group. Conclusion: this phase III trial demonstrates the non-inferiority of a follow-up strategy compared to a systematic adjuvant post-operative administration of RAI (1.1GBq following rhTSH) in low risk DTC patients (PHRC 2012; NCT01837745).
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Affiliation(s)
| | | | | | - Slimane Zerdoud
- IUCT Oncopole - CLCC Institut Claudius Regaud, Toulouse, France
| | | | | | | | | | - Inna Dygay
- Centre Georges François Leclerc, Dijeon, France
| | | | | | | | | | - Marc Klein
- CHRU Brabois, Vandoeuvre Les Nancy, France
| | - Julie Roux
- Hôpital A. Michallon, La Tronche, France
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25
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Rozenbaum A, Buffet C, Bigorgne C, Royer B, Rouxel A, Bienvenu M, Chereau N, Menegaux F, Leenhardt L, Russ G. Outcomes of active surveillance of EU-TIRADS 5 thyroid nodules. Eur J Endocrinol 2021; 184:677-686. [PMID: 33667192 DOI: 10.1530/eje-20-1481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Active surveillance of cytologically proven microcarcinomas has been shown as a safe procedure. However, fine needle aspiration biopsy (FNAB) is not recommended by European Thyroid Association (ETA) and American Thyroid Association (ATA) guidelines for highly suspicious nodules ≤ 10 mm. The aim of the study was to assess the outcomes of active surveillance of EU-TIRADS 5 nodules ≤ 10 mm not initially submitted to FNAB. PATIENTS AND METHODS 80 patients with at least one EU-TIRADS 5 nodule ≤ 10 mm and no suspicious lymph nodes, accepting active surveillance, were included. RESULTS Mean baseline diameter and volume were 5.4 mm (±2.0) and 64.4 mm3 (±33.5), respectively. After a median follow-up of 36.1 months, a volumetric increase ≥ 50% occurred in 28 patients (35.0%) and a suspicious lymph node in 3 patients (3.8%). Twenty-four patients underwent an FNAB (30.0%) after at least a 1 year follow-up of which 45.8% were malignant, 8.3% benign, 33.3% undetermined and 8.3% nondiagnostic. Sixteen patients (20.0%) underwent conversion surgery after a median follow-up of 57.2 months, confirming the diagnosis of papillary carcinoma in 15/16 cases (not described in 1 histology report), all in remission at 6-12 months postoperative follow-up. CONCLUSION Applying ETA and ATA guidelines to avoid FNA of EU-TIRADS 5 sub-centimeter nodules and proceeding to active surveillance of such nodules in selected patients is a safe procedure. Thus, US-FNAB could be postponed until the nodule shows signs of progression or a suspicious lymph node appears, with no added risk for the patient.
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Affiliation(s)
- A Rozenbaum
- Hôpital Universitaire Pitié Salpêtrière, Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Paris, Île-de-France, France
| | - C Buffet
- Hôpital Universitaire Pitié Salpêtrière, Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Paris, Île-de-France, France
| | - C Bigorgne
- Centre de Pathologie et d'Imagerie, Paris, France
| | - B Royer
- Centre de Pathologie et d'Imagerie, Paris, France
| | - A Rouxel
- Centre de Pathologie et d'Imagerie, Paris, France
| | - M Bienvenu
- Centre de Pathologie et d'Imagerie, Paris, France
| | - N Chereau
- Hôpital Universitaire Pitie Salpetrière, Endocrine Surgery, Paris, Île-de-France, France
| | - F Menegaux
- Hôpital Universitaire Pitie Salpetrière, Endocrine Surgery, Paris, Île-de-France, France
| | - L Leenhardt
- Hôpital Universitaire Pitié Salpêtrière, Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Paris, Île-de-France, France
| | - G Russ
- Hôpital Universitaire Pitié Salpêtrière, Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Paris, Île-de-France, France
- Centre de Pathologie et d'Imagerie, Paris, France
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Saïe C, Wassermann J, Mathy E, Chereau N, Leenhardt L, Tezenas du Montcel S, Buffet C. Impact of age on survival in radioiodine refractory differentiated thyroid cancer patients. Eur J Endocrinol 2021; 184:667-676. [PMID: 33667193 DOI: 10.1530/eje-20-1073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age. METHODS This single-center, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cutoff (45, 55, 65, 75 years). Secondary endpoints were progression free survival (PFS) and prognostic factors in patients under and over 65 years. RESULTS Median OS after RAIR diagnosis was 8.2 years (95% IC: 5.3-9.6). There was no difference according to age with a 65 (P = 0.47) and 55 years old cutoff (P = 0.28). Median OS improved significantly before 45 years old (P = 0.0043). After 75 years old, median OS significantly decreased (P = 0.0008). Median PFS was 2.1 years (95% CI: 0.8-3) in patients < 65 years old, and 1 year in patients ≥ 65 years old (95% CI: 0.8-1.55) with no statistical difference (P = 0.22). There was no impact of age on PFS with any cutoff. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65 years old, an interval of less than 3 years between the initial diagnosis and the diagnosis of RAIR metastatic disease was predictive of poor survival. In patients > 65 years old, the presence of a mediastinum metastasis was a significant factor for mortality (HR: 4.55, 95% CI: 2.27-9.09). CONCLUSION In RAIR-DTC patients, a cut-off age of 65 years old was not a significant predictive factor of survival. Forty-five and 75-years-old cutoff were predictive for OS but not PFS.
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Affiliation(s)
- C Saïe
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - J Wassermann
- Oncology Department, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
| | - E Mathy
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - N Chereau
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
- Department of Surgery, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - L Leenhardt
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
| | - S Tezenas du Montcel
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, Ile de France, France
| | - C Buffet
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
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Saïe C, Ghander C, Saheb S, Jublanc C, Lemesle D, Lussey-Lepoutre C, Leenhardt L, Menegaux F, Tresallet C, Buffet C. Therapeutic Plasma Exchange in Refractory Hyperthyroidism. Eur Thyroid J 2021; 10:86-92. [PMID: 33777824 PMCID: PMC7983568 DOI: 10.1159/000507019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/05/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Hyperthyroid patients who are unresponsive to medical treatment remain a challenging clinical problem. OBJECTIVE The goal of our study was to evaluate the use of therapeutic plasma exchange (TPE) in hyperthyroid patients and their outcome after TPE. METHOD We retrospectively reviewed 22 patients who underwent TPE for refractory thyrotoxicosis in our institution: 13 with Graves' disease, 7 with amiodarone-induced thyrotoxicosis (AIT), 1 with toxic goiter, and 1 pregnant patient with familial nonautoimmune thyrotoxicosis. RESULTS Before TPE, all patients had severe hyperthyroidism, and antithyroid drugs were either contraindicated or not sufficiently effective to restore euthyroidism promptly. After all the TPEs, free T4 (fT4) decreased significantly by 48% (p = 0.001) and fT3 by 52% (p = 0.0001). The median number of TPE sessions per patient was 4 (range: 1-10). There were no complications during the 91 TPE sessions. Total thyroidectomy with no severe side effects was performed on 16/22 patients and 1 other patient was treated with radioactive iodine. One patient died from severe thyrotoxicosis during medical care. The remaining 4 patients were followed up without any radical treatment. For all 7 patients with AIT, iterative TPE led to a significant clinical improvement, and amiodarone was continued for 1 patient. Available treatments were continued between TPE sessions (cholestyramine for 13 patients [60%] and glucocorticoids for 16 patients [73%]). CONCLUSION TPE allowed a safe decrease of 50% in thyroid hormone levels, and it should be considered for refractory hyperthyroid patients when medical treatments are contraindicated or have failed to restore euthyroidism, irrespective of the etiology of the thyrotoxicosis.
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Affiliation(s)
- Clotilde Saïe
- Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Cécile Ghander
- Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Samir Saheb
- Apheresis Unit, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Christel Jublanc
- Department of Endocrinology, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Denis Lemesle
- Department of Anaesthesia, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Charlotte Lussey-Lepoutre
- Nuclear Medicine Department, Pitié-Salpêtrière Hospital APHP, Sorbonne Université, Inserm U970, Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | - Fabrice Menegaux
- Department of Surgery, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
| | | | - Camille Buffet
- Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France
- *Camille Buffet, Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Pitié Salpêtrière Hospital, 47–83 Boulevard de l'Hôpital, FR–75013 Paris (France),
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Bardet S, Goardon N, Lequesne J, Vaur D, Ciappuccini R, Leconte A, Monpeyssen H, Saguet-Rysanek V, Clarisse B, Lasne-Cardon A, Ménégaux F, Leenhardt L, Buffet C. Diagnostic and prognostic value of a 7-panel mutation testing in thyroid nodules with indeterminate cytology: the SWEETMAC study. Endocrine 2021; 71:407-417. [PMID: 32638211 PMCID: PMC7881964 DOI: 10.1007/s12020-020-02411-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this prospective study (ClinicalTrials.gov: NCT01880203) was to evaluate the diagnostic and prognostic value of a 7-panel mutation testing in the aspirates of thyroid nodules with indeterminate cytology (IC). METHODS Eligible patients had a thyroid nodule ≥15 mm with IC (Bethesda III-V) for which surgery had been recommended. Detection of BRAF and RAS mutations was performed using pyrosequencing and RET/PTC and PAX8/PPARγ rearrangements using Real-Time quantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS Among 131 nodules with IC, 21 (16%) were malignant including 20 differentiated cancers and one thyroid lymphoma. Molecular abnormalities were identified in 15 nodules with IC corresponding to 10 malignant and 5 benign tumours. BRAF mutation was detected in 4 nodules all corresponding to classic PTC, and PAX8/PPARγ rearrangement in 2 HCC. In contrast, RAS mutation was identified in eight nodules, of which four were malignant, and one RET/PTC3 rearrangement in a follicular adenoma. This data resulted in an accuracy of 88%, sensitivity of 48%, specificity of 95%, positive-predictive value of 67%, and negative-predictive value of 91%. After a 56 month's follow-up, the proportion of excellent response was similar in patients with molecular alterations (67%) and those without (60%). CONCLUSIONS By increasing the overall risk of cancer from 16 to 67% in mutated nodules and by diminishing it to 9% in wild-type, this study confirms the relevance of the 7-panel mutation testing in the diagnostic of nodules with IC. Genetic testing, however, did not predict outcome in the cancer patient subgroup.
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Affiliation(s)
- Stéphane Bardet
- Department of Nuclear Medicine and Thyroid Unit, Centre François Baclesse, Caen, France.
| | - Nicolas Goardon
- Department of Molecular Biology, Centre François Baclesse, Caen, France
| | - Justine Lequesne
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | - Dominique Vaur
- Department of Molecular Biology, Centre François Baclesse, Caen, France
| | - Renaud Ciappuccini
- Department of Nuclear Medicine and Thyroid Unit, Centre François Baclesse, Caen, France
| | - Alexandra Leconte
- Department of Clinical Research, Centre François Baclesse, Caen, France
| | | | | | | | | | - Fabrice Ménégaux
- Department of Endocrine Surgery, Pitié Salpêtrière Hospital, IUC, University Paris VI, Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Pitié Salpêtrière Hospital, IUC Sorbonne University, Paris, France
| | - Camille Buffet
- Thyroid and Endocrine Tumors Unit, Institute of Endocrinology, Pitié Salpêtrière Hospital, IUC Sorbonne University, Paris, France
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Deandrea M, Trimboli P, Mormile A, Cont AT, Milan L, Buffet C, Giovanella L, Limone PP, Poirée S, Leenhardt L, Russ G. Determining an energy threshold for optimal volume reduction of benign thyroid nodules treated by radiofrequency ablation. Eur Radiol 2021; 31:5189-5197. [PMID: 33409792 DOI: 10.1007/s00330-020-07532-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/08/2020] [Accepted: 11/17/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Radiofrequency ablation (RFA) is effective in reducing the volume of benign thyroid nodules. However, what parameters can influence the response to RFA is still unclear. The present study aimed to (1) investigate which ultrasound and technical parameters are potential determinants of the volumetric reduction; (2) develop a dose-response model, and (3) analyze the effects of RFA on ultrasound features. METHODS In this retrospective study, three institutions treated patients with benign thyroid nodules according to the same protocol. The technical parameters were power and energy. The 1-year volume reduction ratio (VRR) was the reference standard of the response. The correlations of different parameters with VRR were analyzed and the association between several parameters and a VRR above 50% studied by uni- and multivariate analyses. The probit regression estimated the probability to achieve an effective response. RESULTS One hundred fifteen patients were enrolled. The median power was 50 W and median total delivered energy 27,531 J. At 1-year follow-up, the median VRR was 64.0% and 87 (75.7%) nodules showed a VRR above 50%. Among all parameters, only baseline volume, total energy, and energy per volume were independently associated to a VRR > 50% (p = 0.001, p = 0.0178, p < 0.001 respectively). The probit regression analysis demonstrated that delivering 756 J/ml and 2670 J/ml gave a probability of VRR > 50% in 50% and 99% of patients, respectively. CONCLUSIONS Considering the baseline nodular volume and delivering the adequate energy per volume allow optimizing technical and clinical success. KEY POINTS • The effectiveness of radiofrequency ablation in treating benign thyroid nodules is negatively correlated to the volume of the nodule and positively correlated to the energy delivered per volume. • When planning the treatment, the total energy to deliver can be calculated by using a simple formula: nodular volume × 2670 J.
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Affiliation(s)
- Maurilio Deandrea
- Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, A.O. Ordine Mauriziano, Turin, Italy
| | - Pierpaolo Trimboli
- Clinic for Nuclear Medicine and Competence Centre for Thyroid Disease, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona and Lugano, Switzerland.,Clinic for Endocrinology, Ente Ospedaliero Cantonale, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Alberto Mormile
- Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, A.O. Ordine Mauriziano, Turin, Italy
| | - Alice Tomasi Cont
- Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, A.O. Ordine Mauriziano, Turin, Italy
| | - Lisa Milan
- Clinic for Nuclear Medicine and Competence Centre for Thyroid Disease, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona and Lugano, Switzerland
| | - Camille Buffet
- Thyroid and Endocrine Tumors Unit, La Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | - Luca Giovanella
- Clinic for Nuclear Medicine and Competence Centre for Thyroid Disease, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona and Lugano, Switzerland.,Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurich, Switzerland
| | - Paolo Piero Limone
- Endocrinology, Diabetes and Metabolism Department and Center for Thyroid Diseases, A.O. Ordine Mauriziano, Turin, Italy
| | - Sylvain Poirée
- Thyroid and Endocrine Tumors Unit, La Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, La Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | - Gilles Russ
- Thyroid and Endocrine Tumors Unit, La Pitie-Salpetriere Hospital, Sorbonne University, Paris, France.
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Buffet C, Wassermann J, Hecht F, Leenhardt L, Dupuy C, Groussin L, Lussey-Lepoutre C. Redifferentiation of radioiodine-refractory thyroid cancers. Endocr Relat Cancer 2020; 27:R113-R132. [PMID: 32191916 DOI: 10.1530/erc-19-0491] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 11/08/2022]
Abstract
The management of radioiodine refractory thyroid cancers (RAIR TC) is challenging for the clinician. Tyrosine kinase inhibitors classically prescribed in this setting can fail due to primary or acquired resistance or the necessity of drug withdrawal because of serious or moderate but chronic and deleterious adverse effects. Thus, the concept of redifferentiation strategy, which involves treating patients with one or more drugs capable of restoring radioiodine sensitivity for RAIR TC, has emerged. The area of redifferentiation strategy leads to the creation of new definitions of RAIR TC including persistent non radioiodine-avid patients and 'true' RAIR TC patients. The latter group presents a restored or increased radioiodine uptake in metastatic lesions but with no radiological response on conventional imaging, that is, progression of a metastatic disease, thus proving that they are 'truly' resistant to the radiation delivered by radioiodine. Unlike these patients, metastatic TC patients with restored radioiodine uptake offer the hope of prolonged remission or even cure of the disease as for radioiodine-avid metastatic TC. Here, we review the different redifferentiation strategies based on the underlying molecular mechanism leading to the sodium iodide symporter (NIS) and radioiodine uptake reinduction, that is, by modulating signaling pathways, NIS transcription, NIS trafficking to the plasma membrane, NIS post-transcriptional regulation, by gene therapy and other potential strategies. We discuss clinical trials and promising preclinical data of potential future targets.
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Affiliation(s)
- Camille Buffet
- Sorbonne Université, Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Johanna Wassermann
- Sorbonne Université, Service d'Oncologie, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Fabio Hecht
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil
| | - Laurence Leenhardt
- Sorbonne Université, Unité Thyroïde-Tumeurs endocrine, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Corinne Dupuy
- UMR 8200 CNRS, Villejuif, France
- Université Paris-Saclay et Gustave Roussy, Villejuif, France
| | - Lionel Groussin
- INSERM Unité 1016, CNRS, UMR 8104, Institut Cochin, Paris, France
- Université de Paris, Paris, France
- Department of Endocrinology, APHP, Cochin Hospital, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université Service de Médecine Nucléaire, Groupe de Recherche Clinique n°16 Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France
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Mohr A, Trésallet C, Monot N, Bauvois A, Abiven D, Atif M, Claër L, Malhotra R, Mayer G, Balderas R, Vaarala O, Deniziaut G, Brocheriou I, Buffet C, Leenhardt L, Gorochov G, Miyara M. Tissue Infiltrating LTi-Like Group 3 Innate Lymphoid Cells and T Follicular Helper Cells in Graves' and Hashimoto's Thyroiditis. Front Immunol 2020; 11:601. [PMID: 32328068 PMCID: PMC7160246 DOI: 10.3389/fimmu.2020.00601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Hashimoto's thyroiditis (HT) and Graves' disease (GD) are autoimmune thyroid disorders (AITDs). These conditions have been associated to abnormalities in circulating regulatory T cells (Tregs). We postulated that immune perturbations could be more pronounced at the thyroid tissue level. Methods: The phenotype of PBMCs and immune cells infiltrating thyroid tissue from 19 patients with HT, 21 patients with GD, and 30 controls has been analyzed by flow cytometry. Results: We report that blood and thyroid Treg cell subsets are similarly represented in all AITDs patients and controls. Increased Lymphoid tissue inducer (LTi)-like ILC3 and CXCR5+ PD-1hi CD4+ T follicular helper cells (Tfh) tissue-infiltrating cells, together with the prevalence of tertiary lymphoid structures (TLS) and germinal centers (GCs) represented a typical immune signature in all HT and 60% of GD patients. In the remaining group of GD patients, the absence of the aforementioned abnormalities was associated with a higher prevalence of ophthalmopathy. Conclusion: Tissue infiltrating Lymphoid Tissue inducer—like group 3 Innate Lymphoid cells and T follicular helper cells are increased in most thyroid autoimmune disease.
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Affiliation(s)
- Audrey Mohr
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Christophe Trésallet
- Service de Chirurgie Digestive, Bariatrique et Endocrinienne, Hôpital Avicenne, Bobigny, France.,Université Paris Nord Seine St Denis Paris 13, Laboratoire d'imagerie Biomédicale (LIB) INSERM CNRS U678, CHU Pitié-Salpêtriẽre, Paris, France
| | - Natacha Monot
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Adeline Bauvois
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Delphine Abiven
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Muhammad Atif
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Laetitia Claër
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Rajneesh Malhotra
- Translational Science and Experimental Medicine, Early RIA, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Gaëll Mayer
- Clinical Development-Respiratory Inhalation and Oral Development, Global Medicines Development, AstraZeneca, Gothenburg, Sweden
| | | | - Outi Vaarala
- Respiratory, Inflammation, and Autoimmunity, Medimmune, Gaithersburg, MD, United States
| | - Gabrielle Deniziaut
- Sorbonne Université, Service d'Anatomie Pathologique, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Isabelle Brocheriou
- Sorbonne Université, Service d'Anatomie Pathologique, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Camille Buffet
- Sorbonne Université, Unité Thyroïde Tumeurs Endocrines, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, Unité Thyroïde Tumeurs Endocrines, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Guy Gorochov
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Makoto Miyara
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
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Bourcigaux N, Rubino C, Berthaud I, Toubert ME, Donadille B, Leenhardt L, Petrot-Keller I, Brailly-Tabard S, Fromigué J, de Vathaire F, Simon T, Siffroi JP, Schlumberger M, Bouchard P, Christin-Maitre S. Impact on testicular function of a single ablative activity of 3.7 GBq radioactive iodine for differentiated thyroid carcinoma. Hum Reprod 2020; 33:1408-1416. [PMID: 29912343 DOI: 10.1093/humrep/dey222] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/06/2018] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
STUDY QUESTION What are the consequences of radioactive iodine (RAI) therapy for testicular function? SUMMARY ANSWER A single activity of 3.7 GBq RAI for differentiated thyroid carcinoma (DTC) treatment in young men transiently altered Sertoli cell function and induced sperm chromosomal abnormalities. WHAT IS KNOWN ALREADY Few studies, mainly retrospective, have reported the potential impacts of RAI on endocrine and exocrine testicular function. STUDY DESIGN, SIZE, DURATION A longitudinal prospective multi-center study on testicular function performed in DTC patients before a single 131I ablative activity of 3.7 GBq (V0) and at 3 months (V3) and 13 months (V13) after treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS Forty male patients, aged 18-55 years, with DTC participated. Hormonal analysis included FSH, LH, testosterone and inhibin B serum levels at V0, V3 and V13. Furthermore, sperm parameters, DNA fragmentation and sperm chromosomal abnormalities were evaluated at each time points. The differences in all parameters, between V0-V3, V0-V13 and V3-V13, were analyzed, using a Wilcoxon test. MAIN RESULTS AND THE ROLE OF CHANCE Prior to RAI administration, all patients had normal gonadal function. At V3, a statistically significant increase in FSH levels and a decrease in inhibin B levels were observed and sperm concentration, as well as the percentage of morphologically normal spermatozoa, were significantly decreased (P < 0.0001). These modifications were transient as both sperm concentration and normal morphology rate returned to baseline values at V13. However, at this later time point, FSH and inhibin B levels were still impacted by RAI administration but remained in the normal range. Although no DNA fragmentation was observed at V3 nor V13, our study revealed a statistically significant increase in the number of sperm chromosomal abnormalities both at V3 (P < 0.001) and V13 (P = 0.01). LIMITATIONS, REASONS FOR CAUTION Among the 40 patients included in the study, only 24 had all the parameters available at all visits. WIDER IMPLICATIONS OF THE FINDINGS Prospective studies with longer term follow up would be helpful to determine whether the chromosome abnormalities persist. These studies would be required before sperm banking should be suggested for all patients. However, sperm preservation for DTC patients who require cumulative radioiodine activities higher than 3.7 GBq should be proposed. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Programme Hospitalier de Recherche Clinique, AP-HP (No. P040419). The authors report no conflict of interest in this work. TRIAL REGISTRATION NUMBER NCT01150318.
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Affiliation(s)
- N Bourcigaux
- Department of Endocrinology, St Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Rubino
- Radiation Epidemiology Group and Center for Research in Epidemiology and Population Health (CESP), Inserm, U1018, Institute Gustave Roussy, Villejuif, France
- University of Paris-Sud, Villejuif, France
| | - I Berthaud
- Department of Reproduction Biology CECOS, Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - M E Toubert
- Department of Nuclear Medicine, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - B Donadille
- Department of Endocrinology, St Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - L Leenhardt
- Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - I Petrot-Keller
- Department of Nuclear Medicine, St Antoine Hospital, Assistance Publique Hôpitaux de Paris, France
| | - S Brailly-Tabard
- Department of Molecular Genetics, Pharmacogenetics and Hormonology, Kremlin-Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Inserm, U1185, Le Kremlin-Bicêtre, France
| | - J Fromigué
- Department of Endocrinology, St Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - F de Vathaire
- Radiation Epidemiology Group and Center for Research in Epidemiology and Population Health (CESP), Inserm, U1018, Institute Gustave Roussy, Villejuif, France
- University of Paris-Sud, Villejuif, France
| | - T Simon
- Clinical Research Unit (GH HUEP), St Antoine Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - J P Siffroi
- Department of Medical Genetics, Pediatrics Hospital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, France
- Inserm, UMR-S933, Paris, France
- Sorbonne Université, Paris, France
| | - M Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Institute Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - P Bouchard
- Department of Gynecology, Hospital Foch, Suresnes, France
| | - S Christin-Maitre
- Department of Endocrinology, St Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Inserm, UMR-S933, Paris, France
- Sorbonne Université, Paris, France
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Wassermann J, Mathy E, Lescaille G, Slim M, Buffet C, Saie C, Braik-Djellas Y, Simon JM, Ménégaux F, Tresallet C, Chami L, Lussey-Lepoutre C, Hervé G, Bernier MO, Spano JP, Leenhardt L. Safety of denosumab in patients with refractory differentiated thyroid cancer and advanced medullary thyroid cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e17578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17578 Background: Few data exist regarding the use of denosumab in patients with bone metastases from radioactive iodine (RAI) refractory differentiated thyroid cancer (DTC) and advanced medullary thyroid cancer (MTC). We aimed to describe adverse events of specific interest - osteonecrosis of the jaw (ONJ) and severe hypocalcemia - in this rare setting. Methods: We retrospectively reviewed the charts of all the patients treated with denosumab for bone metastases from RAI-refractory DTC and advanced MTC in our institution. All patients had a calcium measurement and a clinical and radiological dental screening before denosumab initiation. All patients without hypercalcemia received a calcium supplementation. We assessed associations between ONJ or severe hypocalcemia ( < 1.75mmol/L) and suspected risk factors by Fisher exact tests. Results: Between 2014 and 2018, 23 patients were treated with denosumab. Two-thirds of patients were male (n = 16), median age was 69 years (range 43-87). Histology was DTC and MTC in 19 (83%) and 4 (17%) patients, respectively. DTC patients had received a median cumulated dose (CD) of 300 mCi of RAI (range 100-700). Ten patients (43%) had at least one cervical surgery for recurrence or persistence, and 6 (26%) had cervical radiotherapy. Four patients had hypoparathyroidism before denosumab initiation. Two-thirds of patients ( n =15) received a tyrosine kinase inhibitor (TKI) in association with denosumab. The median duration of denosumab was 20 months (range 1-47). ONJ occurred in 6 patients (26%) and severe hypocalcemia in 3 patients (13%). Conclusions: Patients with RAI-refractory DTC and advanced MTC are at high risk of ONJ and severe hypocalcemia under denosumab treatment. Benefit/risk ratio should be highly weighted particularly when treatment is prolonged. Patients should be closely monitored for the risk of ONJ and hypocalcemia. [Table: see text]
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Affiliation(s)
- Johanna Wassermann
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Elise Mathy
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Geraldine Lescaille
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Marine Slim
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Camille Buffet
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Clotilde Saie
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Yasmin Braik-Djellas
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Jean-Marc Simon
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Fabrice Ménégaux
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Christophe Tresallet
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Linda Chami
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | | | - Geneviève Hervé
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Marie-Odile Bernier
- Institute for Radiological Protection and Nuclear Safety, Fontenay-Aux-Roses, France
| | - Jean-Philippe Spano
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
| | - Laurence Leenhardt
- Pitié-Salpêtrière Hospital, Sorbonne University, Cancer University Institute, Paris, France
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Leenhardt L, Leboulleux S, Bournaud C, Zerdoud S, Schvartz C, Ciappuccini R, Kelly A, Morel O, Dygai-Cochet I, Rusu D, Chougnet CN, Lion G, Eberlé-Pouzeratte MC, Catargi B, Kabir-Ahmadi M, Le Peillet Feuillet E, Taïeb D. Recombinant Thyrotropin vs Levothyroxine Withdrawal in 131I Therapy of N1 Thyroid Cancer: A Large Matched Cohort Study (ThyrNod). J Clin Endocrinol Metab 2019; 104:1020-1028. [PMID: 30398518 DOI: 10.1210/jc.2018-01589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Recombinant human thyrotropin (rhTSH) has been shown to be an effective stimulation method for radioactive iodine (RAI) therapy in differentiated thyroid cancer, including in those with nodal metastases (N1 DTC). OBJECTIVES To demonstrate the noninferiority of rhTSH vs thyroid hormone withdrawal (THW) in preparation to RAI regarding disease status at the first evaluation in the real-life setting in patients with N1 DTC. DESIGN This was a French multicenter retrospective study. Groups were matched according to age (<45/≥45 years), number of N1 nodes (≤5/>5 lymph nodes), and stage (pT1-T2/pT3). RESULTS The cohort consisted of 404 patients pT1-T3/N1/M0 DTC treated with rhTSH (n = 205) or THW (n = 199). Pathological characteristics and initially administrated RAI activities (3.27 ± 1.00 GBq) were similar between the two groups. At first evaluation (6 to 18 months post-RAI), disease-free status was defined by thyroglobulin levels below threshold and a normal ultrasound. Disease-free rate was not inferior in the rhTSH group (75.1%) compared with the THW group (71.9%). The observed difference between the success rates was 3.3% (-6.6 to 13.0); rhTSH was therefore considered noninferior to THW because the upper limit of this interval was <15%. At the last evaluation (29.7 ± 20.7 months for rhTSH; 36.7 ± 23.8 months for THW), 83.5% (rhTSH) and 81.5% (THW) of patients achieved a complete response. This result was not influenced by any of the known prognostic factors. CONCLUSIONS A preparation for initial RAI treatment with rhTSH was noninferior to that with THW in our series of pT1-T3/N1/M0-DTC on disease-free status outcomes at the first evaluation and after 3 years.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Daniela Rusu
- René Gauducheau Centre, Saint Herblain Cedex, France
| | | | - Georges Lion
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | | | | | | | | | - David Taïeb
- Aix-Marseille University, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille, France
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Guenego A, Mesrine S, Dartois L, Leenhardt L, Clavel-Chapelon F, Kvaskoff M, Boutron-Ruault MC, Bonnet F. Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort. Clin Endocrinol (Oxf) 2019; 90:360-368. [PMID: 30390407 DOI: 10.1111/cen.13899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Thyroid cancers are threefold more frequent in women than in men. A role of reproductive or hormonal factors has been suggested but with contradictory results. We investigated potential associations between history of hysterectomy, with or without oophorectomy, and history of benign gynaecological disease (uterine fibroids, endometriosis) and the incidence of differentiated thyroid cancer, in a large French prospective cohort. METHODS A total of 89 340 women from the E3N cohort were followed up between 1990 and 2012. Gynaecological diseases treated by surgery were self-reported. Thyroid cancers were validated by histological reports. Time-dependent covariates included smoking status, BMI and history of benign thyroid disease. Cox proportional hazard models with age as timescale were used to estimate Hazard Ratios (HR) and 95% confidence intervals (CI). RESULTS A total of 412 cases of thyroid cancer were diagnosed during follow-up. A history of hysterectomy was associated with an increased risk of differentiated thyroid cancer (adjusted HR=2.05; 95%CI: 1.65-2.55). The association was not altered after further adjustment for reproductive factors. Endometriosis, uterine polyps, ovarian cysts and oophorectomy without hysterectomy were not associated with the risk of thyroid cancer. A history of fibroids was also significantly related to the risk of thyroid cancer over the follow-up period (adjusted HR=1.91; 95%CI: 1.50-2.44) and the increased risk persisted after adjustment for history of hysterectomy. CONCLUSIONS Women who had either a history of fibroids or hysterectomy had an increased risk of differentiated thyroid cancer. These findings suggest shared biological mechanisms between fibroids and thyroid cancer, which deserve to be further dissected.
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Affiliation(s)
- Agathe Guenego
- Service d'Endocrinologie, CHU de Rennes, Rennes, France
- Univ Rennes1, Rennes, France
| | - Sylvie Mesrine
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laureen Dartois
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Institut of Endocrinology, Pitié Salpêtrière Hospital, Paris, France
| | - Françoise Clavel-Chapelon
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Fabrice Bonnet
- Service d'Endocrinologie, CHU de Rennes, Rennes, France
- Univ Rennes1, Rennes, France
- Inserm U1018, CESP, Health Across Generations Team, Université Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, France
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Chereau N, Greilsamer T, Mirallié E, Sadowski SM, Pusztaszeri M, Triponez F, Baud G, Pattou F, Christou N, Mathonnet M, Brunaud L, Santucci N, Goudet P, Guérin C, Sebag F, Donatini G, Kraimps JL, Tissier F, Lussey-Lepoutre C, Leenhardt L, Menegaux F. NIFT-P: Are they indolent tumors? Results of a multi-institutional study. Surgery 2019; 165:12-16. [DOI: 10.1016/j.surg.2018.04.089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/03/2018] [Accepted: 04/09/2018] [Indexed: 11/26/2022]
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Luster M, Aktolun C, Amendoeira I, Barczyński M, Bible KC, Duntas LH, Elisei R, Handkiewicz-Junak D, Hoffmann M, Jarząb B, Leenhardt L, Musholt TJ, Newbold K, Nixon IJ, Smit J, Sobrinho-Simões M, Sosa JA, Tuttle RM, Verburg FA, Wartofsky L, Führer D. European Perspective on 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: Proceedings of an Interactive International Symposium. Thyroid 2019; 29:7-26. [PMID: 30484394 DOI: 10.1089/thy.2017.0129] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The American Thyroid Association (ATA) management guidelines for patients with thyroid nodules and differentiated thyroid cancer (DTC) are highly influential practice recommendations. The latest revision appeared in 2015 ("ATA 2015"). These guidelines were developed predominantly by North American experts. European experts frequently have different perspectives, given epidemiological, technological/methodological, practice organization, and medicolegal differences between the respective regions. SUMMARY Divergent viewpoints were the focus of an invited symposium organized by the European Association of Nuclear Medicine involving 17 European thyroidologists, four ATA Guidelines Taskforce members, and an audience of 200 international experts. The group discussed the preoperative assessment of thyroid nodules, surgery and the role of pathology, radioiodine (RAI) therapy (RAIT), the assessment of initial therapy and dynamic risk stratification, and the treatment of persistent disease, recurrences, and advanced thyroid cancer. The dialogue resulted in this position paper contrasting European and ATA 2015 perspectives on key issues. One difference pertains to the permissiveness of ATA 2015 regarding lobectomy for primary tumors ≤4 cm. European panelists cited preclusion of RAIT, potential need for completion thyroidectomy, frequent inability to avoid chronic thyroid hormone replacement, and limitations of supportive evidence as arguments against widely applying lobectomy. Significant divergence involved ATA 2015's guidance regarding RAIT. European panelists favored wider use of postoperative RAIT than does ATA 2015. Rationales included the modality's association with favorable patient outcomes and generally limited toxicity, and lack of high-quality evidence supporting withholding RAIT. Additionally, European panelists favored recombinant human thyrotropin (rhTSH) in more settings than does ATA 2015, citing avoidance of hypothyroid morbidity and quality-of-life impairment, without apparent sacrifice in oncologic outcomes. Based on clinical evidence plus theoretical advantages, European experts advocated dosimetric versus fixed-activity RAIT approaches for advanced DTC. European panelists noted that the ATA 2015 risk-stratification system requires information sometimes unavailable in everyday practice. ATA 2015 recommendations regarding RAI-refractory DTC should consider potential palliative benefits of RAIT in patients who also have RAI-susceptible lesions. CONCLUSIONS European panelists suggested modifications to approximately one-third of ATA 2015 recommendations. Varying European and ATA 2015 perspectives can stimulate analysis and discussion of the literature and performance of primary research to resolve discrepant recommendations and potentially improve patient outcomes.
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Affiliation(s)
- Markus Luster
- 1 Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Cumali Aktolun
- 2 Department of Nuclear Medicine, School of Medicine, Izmir Ekonomi Universitesi, Izmir, Turkey
| | - Isabel Amendoeira
- 3 University Hospital of São João, Medical Faculty and Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - Marcin Barczyński
- 4 Department of Endocrine Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Keith C Bible
- 5 Division of Medical Oncology, Department of Oncology, The Mayo Clinic, Rochester, Minnesota
| | - Leonidas H Duntas
- 6 Endocrine Unit, Evgenidion Hospital, University of Athens, Athens, Greece
| | - Rossella Elisei
- 7 Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daria Handkiewicz-Junak
- 8 Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Gliwice, Poland
| | - Martha Hoffmann
- 9 Departments of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Radiology Center, Vienna, Austria
| | - Barbara Jarząb
- 8 Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Gliwice, Poland
| | - Laurence Leenhardt
- 10 Thyroid and Endocrine Tumor Unit, Pitié-Salpêtrière Sorbonne University Hospital, Paris, France
| | - Thomas J Musholt
- 11 Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medicine, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kate Newbold
- 12 Thyroid Therapy Unit, The Royal Marsden Hospital, London, United Kingdom
| | - Iain J Nixon
- 13 Department of Ear, Nose, and Throat Surgery, NHS Lothian and University of Edinburgh, Edinburgh, United Kingdom
| | - Johannes Smit
- 14 Department of Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Manuel Sobrinho-Simões
- 3 University Hospital of São João, Medical Faculty and Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - Julie Ann Sosa
- 15 Department of Surgery, University of California at San Francisco-UCSF, San Francisco, California
| | - R Michael Tuttle
- 16 Department of Endocrinology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Frederik A Verburg
- 1 Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Leonard Wartofsky
- 17 Department of Medicine, Washington Hospital Center, Washington, DC
| | - Dagmar Führer
- 18 Department of Endocrinology and Metabolism, Endocrine Tumor Center at WTZ, Essen University Hospital, Essen, Germany
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Goichot B, Leenhardt L, Massart C, Raverot V, Tramalloni J, Iraqi H. Diagnostic procedure in suspected Graves' disease. Ann Endocrinol (Paris) 2018; 79:608-617. [PMID: 30220410 DOI: 10.1016/j.ando.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Diagnostic procedure in suspected Graves' disease has never been studied scientifically and actual practice seems quite variable, notably between countries. Recommendations are few and weak (expert opinion). This article presents the recommendations of an expert consensus meeting organized by the French Society of Endocrinology in 2016. In case of clinically suspected thyrotoxicosis, the first-line biological assessment is of thyroid-stimulating hormone (TSH). Free T4 and possibly free T3 assays assess biological severity and are necessary for treatment efficacy monitoring. Positive diagnosis of Graves' disease after biological confirmation of thyrotoxicosis does not always require complementary etiological examinations if clinical presentation is unambiguous, notably including extra-thyroid signs. Otherwise, first-line anti-TSH-receptor (TSH-R) antibody screening is recommended for its good intrinsic performance (sensitivity and specificity) and ease of access in France. Scintigraphy is reserved to rare cases of Graves' disease with negative antibody findings or when another etiology is suspected. Thyroid ultrasound scan may be contributive, but is not recommended in first line.
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Affiliation(s)
- Bernard Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
| | - Laurence Leenhardt
- Unité thyroïde tumeurs endocrines, institut E3M, hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Catherine Massart
- Service de biochimie-toxicologie, laboratoire d'hormonologie, CHU de Rennes, 35033 Rennes Cedex 09, France
| | - Véronique Raverot
- Service de biochimie et biologie moléculaire, laboratoire d'hormonologie, groupement hospitalier Est, CHU de Lyon, 69500 Bron, France
| | | | - Hinde Iraqi
- Service d'endocrinologie, CHU de Rabat, Rabat, Morocco
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Kahaly GJ, Bartalena L, Hegedüs L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism. Eur Thyroid J 2018; 7:167-186. [PMID: 30283735 PMCID: PMC6140607 DOI: 10.1159/000490384] [Citation(s) in RCA: 397] [Impact Index Per Article: 66.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/24/2018] [Indexed: 12/12/2022] Open
Abstract
Graves' disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate diagnosis/differential diagnosis, prior to stopping antithyroid drug (ATD) treatment and during pregnancy. Graves' hyperthyroidism is treated by decreasing thyroid hormone synthesis with the use of ATD, or by reducing the amount of thyroid tissue with radioactive iodine (RAI) treatment or total thyroidectomy. Patients with newly diagnosed Graves' hyperthyroidism are usually medically treated for 12-18 months with methimazole (MMI) as the preferred drug. In children with GD, a 24- to 36-month course of MMI is recommended. Patients with persistently high TSH-R-Ab at 12-18 months can continue MMI treatment, repeating the TSH-R-Ab measurement after an additional 12 months, or opt for therapy with RAI or thyroidectomy. Women treated with MMI should be switched to propylthiouracil when planning pregnancy and during the first trimester of pregnancy. If a patient relapses after completing a course of ATD, definitive treatment is recommended; however, continued long-term low-dose MMI can be considered. Thyroidectomy should be performed by an experienced high-volume thyroid surgeon. RAI is contraindicated in Graves' patients with active/severe orbitopathy, and steroid prophylaxis is warranted in Graves' patients with mild/active orbitopathy receiving RAI.
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Affiliation(s)
- George J. Kahaly
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
- *Prof. George J. Kahaly, JGU Medical Center, DE-55101 Mainz (Germany), E-Mail
| | - Luigi Bartalena
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Lazlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Kris Poppe
- Endocrine Unit, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Simon H. Pearce
- Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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Chaigneau E, Russ G, Royer B, Bigorgne C, Bienvenu-Perrard M, Rouxel A, Leenhardt L, Belin L, Buffet C. TIRADS score is of limited clinical value for risk stratification of indeterminate cytological results. Eur J Endocrinol 2018; 179:13-20. [PMID: 29703794 DOI: 10.1530/eje-18-0078] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/27/2018] [Indexed: 02/05/2023]
Abstract
CONTEXT Thyroid nodules with cytological indeterminate results represent a daily and recurrent issue for patient management. OBJECTIVE The primary aim of our study was to determine if TIRADS (Thyroid Imaging Reporting and Data System) could be used to stratify the malignancy risk of these nodules and to help in their clinical management. Secondary objective was to estimate if this risk stratification would change after reclassification of encapsulated non-invasive follicular variant of papillary carcinomas (FVPTC) as non-invasive follicular thyroid neoplasm (NIFTP). PATIENTS AND METHODS Single-center retrospective study of a cohort of 602 patients who were referred for ultrasound-guided fine-needle aspiration from January 2010 to December 2016 with an indeterminate cytological result and in whom histological results after surgery were available. TIRADS score was prospectively determined for all patients included. Nodules that had been classified as FVPTC were submitted to a rereading of histological report and reclassified as NIFTP when judged relevant. A table of malignancy risk crossing Bethesda and TIRADS results was built before and after this reclassification. RESULTS The study included 602 cytologically indeterminate nodules. TIRADS score was positively correlated with the malignancy rate (P < 0.0001). Risk stratification with TIRADS was significant only in Bethesda V nodules (P = 0.0004). However, the risk of malignancy in this Bethesda V category was always above 45%, whatever the TIRADS score. CONCLUSION For a clinician facing an indeterminate cytological result for a thyroid nodule, return to TIRADS score is of limited value in most conditions to rule in or rule out malignancy and to guide subsequent management of patients.
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Affiliation(s)
- E Chaigneau
- Department of Endocrinology and Cardiovascular Prevention, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
| | - G Russ
- Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
| | - B Royer
- Centre of Pathology and Radiology, Paris, France
| | - C Bigorgne
- Centre of Pathology and Radiology, Paris, France
| | | | - A Rouxel
- Centre of Pathology and Radiology, Paris, France
| | - L Leenhardt
- Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
| | - L Belin
- Department of Biostatistics, Public Health, and Medical Information, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
| | - C Buffet
- Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
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Hindié E, Récher C, Zerdoud S, Leenhardt L, Avram AM. Risk of Hematologic Malignancies After Radioactive Iodine Treatment of Thyroid Cancer: An Unjustified Warning. J Clin Oncol 2018; 36:1881-1882. [PMID: 29723097 DOI: 10.1200/jco.2018.78.1096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Elif Hindié
- Elif Hindié, Bordeaux University Hospitals, Hôpital Haut-Lévêque, Pessac, France; Christian Récher and Slimane Zerdoud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Laurence Leenhardt, Pitié Salpêtrière University Hospital, Paris, France; and Anca M. Avram, University of Michigan, Ann Arbor, MI
| | - Christian Récher
- Elif Hindié, Bordeaux University Hospitals, Hôpital Haut-Lévêque, Pessac, France; Christian Récher and Slimane Zerdoud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Laurence Leenhardt, Pitié Salpêtrière University Hospital, Paris, France; and Anca M. Avram, University of Michigan, Ann Arbor, MI
| | - Slimane Zerdoud
- Elif Hindié, Bordeaux University Hospitals, Hôpital Haut-Lévêque, Pessac, France; Christian Récher and Slimane Zerdoud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Laurence Leenhardt, Pitié Salpêtrière University Hospital, Paris, France; and Anca M. Avram, University of Michigan, Ann Arbor, MI
| | - Laurence Leenhardt
- Elif Hindié, Bordeaux University Hospitals, Hôpital Haut-Lévêque, Pessac, France; Christian Récher and Slimane Zerdoud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Laurence Leenhardt, Pitié Salpêtrière University Hospital, Paris, France; and Anca M. Avram, University of Michigan, Ann Arbor, MI
| | - Anca M Avram
- Elif Hindié, Bordeaux University Hospitals, Hôpital Haut-Lévêque, Pessac, France; Christian Récher and Slimane Zerdoud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Laurence Leenhardt, Pitié Salpêtrière University Hospital, Paris, France; and Anca M. Avram, University of Michigan, Ann Arbor, MI
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Du Pasquier-Fediaevsky L, Andrei S, Berche M, Leenhardt L, Héron E, Rivière S. Low-Dose Rituximab for Active Moderate to Severe Graves' Orbitopathy Resistant to Conventional Treatment. Ocul Immunol Inflamm 2018; 27:844-850. [PMID: 29652204 DOI: 10.1080/09273948.2018.1453078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Purpose: To report low-dose rituximab effect in Graves' orbitopathy (GO) resistant to conventional treatment. Methods: Retrospective analysis of medical records, filled in according to the European Group on Graves' Orbitopathy (EUGOGO) standards, of patients with active moderate-to-severe GO who received low-dose rituximab after failure of conventional treatment. Efficacy was defined by a decrease of the clinical activity score of 2 points or <4/10. Results: Among 219 patients treated between 2012 and 2016 by pulse methylprednisolone, possibly followed by oral steroids and/or orbital radiotherapy, 15 (6.8%) finally received 100 mg rituximab doses (cumulative dose, 100-400 mg) owing to persistent active disease. Rituximab showed efficacy within 2 months in 13 of 15 (87%), stable at 1 year. No significant effect was observed on proptosis, lid fissure width, and eye motility. Conclusion: Low-dose rituximab showed sustained anti-inflammatory effect in most patients with active GO resistant to conventional treatment.
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Affiliation(s)
| | - Stefan Andrei
- a Department of Internal Medicine, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts , Paris Cedex 12 , France
| | - Michel Berche
- b Department of Ophthalmology 4, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts , Paris Cedex 12 , France
| | - Laurence Leenhardt
- c Institut E3M, Centre Hospitalier Universitaire Pitié-Salpétrière , Paris Cedex 13 , France
| | - Emmanuel Héron
- a Department of Internal Medicine, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts , Paris Cedex 12 , France
| | - Sébastien Rivière
- d Department of Internal Medicine, Centre Hospitalier Universitaire Saint-Antoine , Paris Cedex 12 , France
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Bardet S, Ciappuccini R, Pellot-Barakat C, Monpeyssen H, Michels JJ, Tissier F, Blanchard D, Menegaux F, de Raucourt D, Lefort M, Reznik Y, Rouxel A, Heutte N, Brenac F, Leconte A, Buffet C, Clarisse B, Leenhardt L. Shear Wave Elastography in Thyroid Nodules with Indeterminate Cytology: Results of a Prospective Bicentric Study. Thyroid 2017; 27:1441-1449. [PMID: 28982296 DOI: 10.1089/thy.2017.0293] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The clinical management of thyroid nodules with indeterminate cytology (IC) remains challenging. The role of shear wave elastography (SWE) in this setting is controversial. The aim of the study was to assess the performances of SWE in terms of prediction of malignancy, reproducibility, and combined analysis with ultrasound (US) examination in thyroid nodules with IC. METHODS This prospective study was conducted in two referral centers. Eligible patients had a thyroid nodule ≥15 mm with IC (Bethesda class III-V) for which surgery had been recommended. Patients underwent a standardized US evaluation combined with a SWE exam followed by surgery. SWE parameters included mean (meanEI; kPa) and max (maxEI) elasticity values, and ratio (meanEI nodule/parenchyma). RESULTS One hundred and thirty-one nodules (median size 30 mm) in 131 patients were studied. IC was class III in 28%, class IV in 64%, and class V in 8% of cases. After surgery, 21 (16%) nodules were malignant, including nine papillary thyroid cancers (PTC), six follicular thyroid cancers, five poorly differentiated carcinomas, and one large B-cell lymphoma. SWE parameters were similar in benign and malignant nodules, including meanEI (20.2 vs. 19.6 kPa), maxEI (34.3 vs. 32.5 kPa), and ratio (1.57 vs. 1.38). In malignant nodules, meanEI, maxEI, and ratio were higher in the classic PTC variants (n = 4) than in the other PTC variants (n = 5; p < 0.02) and in non-PTC tumors (n = 12; p < 0.005). Intra- and inter-observer coefficients of variations for meanEI in nodules were 23% and 26%, respectively. The French Thyroid Imaging Reporting and Data System score, the American Thyroid Association US classification, and the EU-Thyroid Imaging Reporting and Data System were not associated with malignancy. CONCLUSIONS Despite high elasticity values in classic PTC variants, conventional SWE indexes failed to discriminate between benign and malignant tumors in thyroid nodules with IC.
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Affiliation(s)
- Stéphane Bardet
- 1 Department of Nuclear Medicine and Thyroid Unit, Centre François Baclesse , Caen, France
| | - Renaud Ciappuccini
- 1 Department of Nuclear Medicine and Thyroid Unit, Centre François Baclesse , Caen, France
| | - Claire Pellot-Barakat
- 2 In Vivo Molecular Imaging, IMIV Laboratory, Inserm, CEA, CNRS, University Paris-Sud, University Paris Saclay , Orsay, France
| | | | | | | | - David Blanchard
- 6 Department of Head and Neck Surgery, Centre François Baclesse , Caen, France
| | - Fabrice Menegaux
- 7 Department of Endocrine Surgery, University Paris VI , Paris, France
| | | | - Muriel Lefort
- 8 Biomedical Imaging laboratory, LIB, UPMC Univ Paris 06, Inserm, CNRS, Sorbonne Universités , Paris, France
| | - Yves Reznik
- 9 Department of Endocrinology, University Hospital , Caen, France
| | - Agnès Rouxel
- 10 Department of Thyroid and Endocrine Tumors Unit, Institute of Endocrinology; Pitié Salpêtrière Hospital, IUC, University Paris VI , Paris, France
| | - Natacha Heutte
- 11 Department of Clinical Research, Centre François Baclesse , Caen, France
| | | | - Alexandra Leconte
- 11 Department of Clinical Research, Centre François Baclesse , Caen, France
| | - Camille Buffet
- 10 Department of Thyroid and Endocrine Tumors Unit, Institute of Endocrinology; Pitié Salpêtrière Hospital, IUC, University Paris VI , Paris, France
| | - Bénédicte Clarisse
- 11 Department of Clinical Research, Centre François Baclesse , Caen, France
| | - Laurence Leenhardt
- 10 Department of Thyroid and Endocrine Tumors Unit, Institute of Endocrinology; Pitié Salpêtrière Hospital, IUC, University Paris VI , Paris, France
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Zerdoud S, Leboulleux S, Clerc J, Leenhardt L, Bournaud C, Al Ghuzlan A, Keller I, Bardet S, Giraudet AL, Groussin L, Sebag F, Garrel R, Lamy PJ, Toubert ME, Mirallié É, Hindié E, Taïeb D. Traitement par iode 131 des cancers thyroïdiens différenciés : recommandations 2017 des sociétés françaises SFMN/SFE/SFP/SFBC/AFCE/SFORL. Médecine Nucléaire 2017. [DOI: 10.1016/j.mednuc.2017.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Smit J, Brose M, Pitoia F, Lin CC, Sugitani I, Alevizaki M, Godbert Y, Aller J, Peeters R, Pazaitou-Panayiotou K, Leenhardt L, Fellous M, De Sanctis Y, Schlumberger M. Interim baseline characteristics from RIFTOS MKI, a global non-interventional study assessing the use of multikinase inhibitors (MKIs) in the treatment of patients with asymptomatic radioactive iodine-refractory differentiated thyroid cancer (RAI-R DTC): A European subgroup analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J 2017; 6:225-237. [PMID: 29167761 PMCID: PMC5652895 DOI: 10.1159/000478927] [Citation(s) in RCA: 619] [Impact Index Per Article: 88.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/17/2017] [Indexed: 01/04/2023] Open
Abstract
Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules. Based on a review of the literature and on the American Association of Clinical Endocrinologists, American Thyroid Association, and Korean guidelines, the panel created the novel European Thyroid Imaging and Reporting Data System, called EU-TIRADS. This comprises a thyroid US lexicon; a standardized report; definitions of benign and low-, intermediate-, and high-risk nodules, with the estimated risks of malignancy in each category; and indications for FNA. Illustrated by numerous US images, the EU-TIRADS aims to serve physicians in their clinical practice, to enhance the interobserver reproducibility of descriptions, and to simplify communication of the results.
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Affiliation(s)
- Gilles Russ
- Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
| | - Steen J. Bonnema
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Murat Faik Erdogan
- Department of Endocrinology and Metabolism, University of Ankara School of Medicine, İbni Sina Hastanesi, Ankara, Turkey
| | - Cosimo Durante
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Rose Ngu
- Head Neck and Thyroid Imaging, Department of Radiology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Laurence Leenhardt
- Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, Paris, France
- *Laurence Leenhardt, MD, PhD, Thyroid and Endocrine Tumors Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 83 Bd de l'Hôpital, FR–75651 Paris Cedex 13 (France), E-Mail
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Zerdoud S, Giraudet AL, Leboulleux S, Leenhardt L, Bardet S, Clerc J, Toubert ME, Al Ghuzlan A, Lamy PJ, Bournaud C, Keller I, Sebag F, Garrel R, Mirallié E, Groussin L, Hindié E, Taïeb D. Radioactive iodine therapy, molecular imaging and serum biomarkers for differentiated thyroid cancer: 2017 guidelines of the French Societies of Nuclear Medicine, Endocrinology, Pathology, Biology, Endocrine Surgery and Head and Neck Surgery. Ann Endocrinol (Paris) 2017; 78:162-175. [PMID: 28578852 DOI: 10.1016/j.ando.2017.04.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Slimane Zerdoud
- Service de médecine nucléaire, institut universitaire du cancer Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Anne-Laure Giraudet
- Médecine nucleaire, centre LUMEN, curiethérapie, thyroïde, tumeurs endocrines, centre de lutte contre le cancer Léon-Berard, 28, rue Laennec, 69008 Lyon, France
| | - Sophie Leboulleux
- Service de médecine nucléaire et cancérologie endocrinienne Gustave-Roussy, université Paris Saclay, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Laurence Leenhardt
- Unité thyroïde tumeurs endocrines, institut E3M, hôpital La Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - Stéphane Bardet
- Service de médecine nucléaire et UCP thyroïde, centre François-Baclesse, 3, avenue Général-Harris, 14076 Caen cedex 05, France
| | - Jérôme Clerc
- Service de médecine nucléaire, groupe hospitalier Paris Centre, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - Marie-Elisabeth Toubert
- Service de médecine nucléaire, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Abir Al Ghuzlan
- Département de biologie et de pathologie médicales Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif, France
| | - Pierre-Jean Lamy
- Laboratoire d'oncologie moléculaire, institut médical d'analyse génomique, Labosud, 141, avenue Paul-Bringuier, 34080 Montpellier, France; Unité de recherche clinique, clinique Beau-Soleil, 119, avenue de Lodeve, 34070 Montpellier, France
| | - Claire Bournaud
- Service de médecine nucléaire, hospices civils de Lyon, groupement hospitalier Est, 28, avenue Doyen-Lépine, 69677 Bron cedex, France
| | - Isabelle Keller
- Service de médecine nucléaire, hôpitaux universitaires Est Parisien, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Frédéric Sebag
- Service de chirurgie endocrinienne, université Aix-Marseille, CHU de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Renaud Garrel
- Département ORL et chirurgie cervico faciale, pole neuroscience tête et cou, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, rue Fliche, 34295 Montpellier, France
| | - Eric Mirallié
- Service de chirurgie endocrinienne et digestive, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - Lionel Groussin
- Service d'endocrinologie et maladies métaboliques, hôpital Cochin, AP-HP, 123, boulevard du Port-Royal, 75014 Paris, France
| | - Elif Hindié
- Service de médecine nucléaire, hôpital Haut-Lévêque, université de Bordeaux, CHU de Bordeaux, avenue Magellan, 33604 Pessac, France.
| | - David Taïeb
- Service central de biophysique et de médecine nucléaire, université Aix-Marseille, CHU de la Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France.
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Tavarelli M, Sarfati J, Chereau N, Tissier F, Golmard JL, Ghander C, Lussey-Lepoutre C, Trésallet C, Menegaux F, Leenhardt L, Buffet C. Heterogeneous Prognoses for pT3 Papillary Thyroid Carcinomas and Impact of Delayed Risk Stratification. Thyroid 2017; 27:778-786. [PMID: 28351220 DOI: 10.1089/thy.2016.0512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Papillary thyroid carcinomas (PTC) in the pT3 category constitute a heterogeneous group of tumors with a variable risk of recurrence. The objectives of this study were (i) to estimate disease-free survival (DFS) and identify prognostic factors associated with recurrence in a cohort of pT3 PTC, and (ii) to evaluate the concept of delayed risk stratification in a cohort of pT3 tumors. METHODS A total of 560 patients with pT3 PTC, treated and followed at the authors' institution, were studied. They were divided into three groups: group 1, pT3 ≤10 mm; group 2, pT3 >10 mm with extrathyroidal invasion (ETI); and group 3, pT3 due to a tumor size >4 cm. DFS was estimated using the Kaplan-Meier method, and associated prognostic features were studied in univariate and multivariate Cox model-based analyses in each group. Then, DFS was studied for each group according to the six- to eight-month status (remission or not). RESULTS DFS at 10 years was 75% for the entire cohort and was 89%, 67%, and 82% in groups 1, 2, and 3, respectively (p < 0.0001). Multivariate analysis identified three factors significantly associated with reduced DFS: lymph node (LN) involvement, male sex, and group 2 (>1 cm with ETI). A trend toward a worse prognosis in patients with pT3 N0/Nx PTC >10 mm with ETI was found in comparison with the other pT3 N0/Nx patients. When the six- to eight-month checkup was normal, the DFS at 10 years increased to 98%, 96%, and 91% in groups 1-3, respectively. Furthermore, in this case, initial LN involvement no longer seemed to affect the prognosis in those groups. CONCLUSION PTC ≤10 mm with ETI and large tumors >4 cm without ETI both have a low-recurrence risk when there are no adverse associated prognostic features such as LN involvement. LN involvement, especially in the lateral compartment (N1b), is a strong prognostic factor of recurrence in pT3 PTC. Delayed risk stratification can be applied in pT3 PTC patients. Those cured at the first checkup, including those with limited LN involvement, have excellent outcomes, which should prompt clinicians to adapt subsequent management accordingly.
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Affiliation(s)
- Martina Tavarelli
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Julie Sarfati
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Nathalie Chereau
- 2 Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Frederique Tissier
- 3 Department of Pathology, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Jean Louis Golmard
- 4 Biostatistics Department; Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Cécile Ghander
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Charlotte Lussey-Lepoutre
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Christophe Trésallet
- 2 Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Fabrice Menegaux
- 2 Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Laurence Leenhardt
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
| | - Camille Buffet
- 1 Thyroid and Endocrine Tumors Unit, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Paris VI University , Cancer Institute, Paris, France
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Bergeret-Cassagne H, Lazard DS, Lefort M, Hachi S, Leenhardt L, Menegaux F, Russ G, Trésallet C, Frouin F. Sonographic Dynamic Description of the Laryngeal Tract: Definition of Quantitative Measures to Characterize Vocal Fold Motion and Estimation of Their Normal Values. J Ultrasound Med 2017; 36:1037-1044. [PMID: 28072470 DOI: 10.7863/ultra.16.05014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/01/2016] [Indexed: 06/06/2023]
Abstract
Vocal fold motion was analyzed during free breathing using two-dimensional dynamic ultrasound imaging. Two cadavers were first analyzed to define easily identifiable landmarks. Motion of the laryngeal tract was then analyzed in an axial plane. Left and right arytenoids and thyroid cartilage were defined on images corresponding to abduction and adduction of the laryngeal tract. Associated area measurements were established for 50 healthy subjects. All area indices were significantly larger during abduction than adduction. Symmetry of motion was established by comparing each hemi-larynx, and mobility fractions were defined. Normal values of laryngeal motion during free breathing were thus established.
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Affiliation(s)
- Héloïse Bergeret-Cassagne
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Department of General, Visceral and Endocrine Surgery, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Diane S Lazard
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Department of General, Visceral and Endocrine Surgery, Paris, France
- Institut Arthur Vernes, ENT Surgery, Paris, France
| | - Muriel Lefort
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Siham Hachi
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Laurence Leenhardt
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Thyroid and Endocrine Tumors Department, Paris, France
| | - Fabrice Menegaux
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Department of General, Visceral and Endocrine Surgery, Paris, France
| | - Gilles Russ
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Thyroid and Endocrine Tumors Department, Paris, France
| | - Christophe Trésallet
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, Hôpital Pitié-Salpêtrière, Department of General, Visceral and Endocrine Surgery, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Frédérique Frouin
- Inserm, CEA, Univ Paris-Sud, CNRS, Université Paris-Saclay, Laboratoire Imagerie Moléculaire In Vivo (IMIV), CEA/I2BM/Service Hospitalier Frédéric Joliot, Orsay, France
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50
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Mathonnet M, Cuerq A, Tresallet C, Thalabard JC, Fery-Lemonnier E, Russ G, Leenhardt L, Bigorgne C, Tuppin P, Millat B, Fagot-Campagna A. What is the care pathway of patients who undergo thyroid surgery in France and its potential pitfalls? A national cohort. BMJ Open 2017; 7:e013589. [PMID: 28389487 PMCID: PMC5558818 DOI: 10.1136/bmjopen-2016-013589] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The rate of thyroid cancer is increasing in France, as well as concerns about overdiagnosis and treatment. OBJECTIVES To examine the care pathway of patients who undergo thyroid surgery in France and detect potential pitfalls. DESIGN A large observational study based on medical reimbursements, 2009-2011. SETTING Data from the Sniiram (National Health Insurance Information System). PATIENTS Patients with thyroid surgery in 2010, classified into 4 groups: thyroid cancer, benign nodule, goitre or multiple nodules, other (hyperthyroidism, head-neck cancer). MAIN OUTCOME MEASURES Medical investigations during, prior and after thyroidectomy. RESULTS A total of 35 367 patients underwent surgery (mean age 51 years, 80% women): 17% had a reported diagnosis of thyroid cancer, 20% benign nodule, 38% goitre or multiple nodules and 25% another diagnosis. The ratio of thyroidectomies with cancer over thyroidectomies with benign nodule was 0.8 and varied across regions. In the year preceding surgery, 82% of patients had an investigation by thyroid ultrasonography, 21% thyroid scintigraphy, 34% fine-needle aspiration cytology, 40% serum calcitonin assay and 54% serum calcium assay. In the following year, all patients with total thyroidectomy and 44% of patients with partial thyroidectomy and a diagnosis of benign nodule were taking thyroid hormone therapy. 100 patients had been reoperated for a compressive haematoma and 63 died during the first month, half of whom had been operated for cancer. Mean rates of recurrent laryngeal nerve injury and hypocalcaemia (requiring blood tests plus treatments within 4-12 months) were estimated at 1.5% and 3.4%, respectively, and were higher in the cancer group (2.3% and 5.7%). CONCLUSIONS This almost nationwide study demonstrates the suboptimal management of patients prior to thyroidectomy in France. It suggests overdiagnosis and potential harms to patients, and calls for a review of the relevance of thyroidectomy, particularly with regard to microcancers.
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Affiliation(s)
| | - Anne Cuerq
- Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - Christophe Tresallet
- Department of General, Visceral and Endocrine Surgery, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Gilles Russ
- Department of Thyroid Diseases and Endocrine Tumors, Pitié Salpêtrière Hospital, University Paris VI, Institut E3M, Paris, France
| | - Laurence Leenhardt
- Department of Thyroid Diseases and Endocrine Tumors, Pitié Salpêtrière Hospital, University Paris VI, Institut E3M, Paris, France
| | - Claude Bigorgne
- Department of Pathology, La Pitié Salpétrière Hospital, Paris, France
| | - Philippe Tuppin
- Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | | | - Anne Fagot-Campagna
- Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
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