Houtsma, Cecilia (2022) Early clinical identification of radioactive iodine refractory status in patients with differentiated thyroid carcinoma. thesis, Medicine.
Full text available on request.Abstract
Introduction Thyroid cancer is the most common endocrine malignancy, of which 90% is differentiated thyroid cancer (DTC). Treatment consists of a total-thyroidectomy followed by radioactive iodine (RAI) ablation therapy. Usually, DTC has a good prognosis with 70-95% 10-year survival rates. From all DTC patients 10-15% will develop metastatic disease, of which 60-70% will become refractory to RAI treatment (RAI-R). These patients suffer from unnecessary side effects of RAI therapy while not benefiting from this treatment once their disease has become RAI-R. Also, RAI-R patients have decreased 10-year survival rates of 10%. Due to a lack of consistency in diagnostic criteria for RAI-R patients, diagnosing RAI-R disease in daily practice is very difficult. Therefore, in this research clinical characteristics associated with RAI-R disease will be investigated, aiming to make earlier diagnosis possible. Method A retrospective single-center cohort study was performed at the University Medical Center Groningen. Multivariate Cox-regression analysis was used for identifying clinical characteristics associated with RAI-R disease. RAI-R diagnostic criteria were composed combining diagnostic criteria from the American thyroid association and European thyroid association. Results In this study 200 patients were included. Several clinical characteristics associated with RAI-R disease were investigated. Significant differences were found with age >55-year, gross residual disease, extrathyroidal extension, T3-stage, T4a-stage, T4b-stage, M1-stage, venous lymph node invasion, and extranodal spread. Conclusion Several clinical characteristics could be identified that are associated with developing RAI-R over time. Therefore, clinicians treating DTC patients especially with these characteristics should be aware that RAI-R disease can develop during follow-up.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Kruijff, Prof. dr. Schelto and Brouwers, Adrienne |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jun 2023 11:35 |
| Last Modified: | 06 Jun 2023 11:35 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3549 |
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