Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma
| العنوان: | Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma |
|---|---|
| المؤلفون: | Davor Kust, Zvonko Kusić, Marin Prpić, Ante Bolanča, Tomislav Jukić, Ivan Kruljac, Nina Dabelić, Lora Stanka Kirigin |
| المصدر: | Endocrine. 52:602-608 |
| بيانات النشر: | Springer Science and Business Media LLC, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Radioactive iodine, Radioiodine ablation, Thyroglobulin, Anti-Tg antibody, 030209 endocrinology & metabolism, Adenocarcinoma, Scintigraphy, Gastroenterology, Iodine Radioisotopes, Thyroid carcinoma, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Internal medicine, Humans, Medicine, Thyroid Neoplasms, Lymph node, Autoantibodies, Retrospective Studies, Predictive marker, medicine.diagnostic_test, business.industry, Thyroidectomy, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Combined Modality Therapy, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, business, Nuclear medicine |
| الوصف: | The aim of this study was to evaluate the efficacy of different radioactive iodine (I- 131) activities used for re-ablation, to compare various combinations of treatment activities, and to identify predictors of re- ablation failure in low- and intermediate-risk differentiated thyroid carcinoma (DTC) patients. The study included 128 consecutive low- and intermediate-risk patients with DTC with ablation failure after total thyroidectomy. Patient characteristics, T status, tumor size, lymph node involvement, postoperative remnant size on whole-body scintigraphy, serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH), anti-Tg antibody (TgAb), and Tg/TSH ratio were analyzed as potential predictors of the re-ablation success. Re-ablation was successful in 113 out of 128 patients (88.3 %). Mean first I-131 activity was 2868 ± 914 MBq (77.5 ± 24.7 mCi) and mean second I-131 activity 3004 ± 699 MBq (81.2 ± 18.9 mCi). There was no association between the first, second, and cumulative activity with re-ablation treatment outcome. Treatment failure was associated with higher Tg levels prior to re-ablation (Tg2) (OR 1.16, 95 % CI 1.05–1.29, P = 0.003) and N1a status (OR 3.89, 95 % CI 1.13–13.41, P = 0.032). After excluding patients with positive-to-negative TgAb conversion, Tg2 level of 3.7 ng/mL predicted treatment failure with a sensitivity of 75.0 %, specificity of 80.5 %, and a negative predictive value of 97.1 %. Patients with positive-to-negative TgAb conversion had higher failure rates (OR 2.96, 95 % CI 0.94– 9.29). Re-ablation success was high in all subgroups of patients and I-131 activity did not influence treatment outcome. Tg may serve as a good predictor of re-ablation failure. Patients with positive-to-negative TgAb conversion represent a specific group, in whom Tg level should not be used as a predictive marker of treatment outcome. |
| وصف الملف: | application/pdf |
| تدمد: | 1559-0100 1355-008X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a05923105672281c9ab7ce4efe218903Test https://doi.org/10.1007/s12020-015-0846-9Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a05923105672281c9ab7ce4efe218903 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15590100 1355008X |
|---|