Papillary thyroid cancer: Time course of recurrences during postsurgery surveillance

Cosimo Durante, Teresa Montesano, Massimo Torlontano, Marco Attard, Fabio Monzani, Salvatore Tumino, Giuseppe Costante, Domenico Meringolo, Rocco Bruno, Fabiana Trulli, Michela Massa, Adele Maniglia, D'Apollo Rosaria D'Apollo, Laura Giacomelli, Giuseppe Ronga, Sebastiano Filetti

Research output: Contribution to journalArticle

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Abstract

Context: The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largelyonthe study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20% and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly. Objectives: The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort. Patients and Design: We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography. Results: At the initial posttreatment (≤12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4%) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation. Conclusion: In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients.

Original languageEnglish
Pages (from-to)636-642
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number2
DOIs
Publication statusPublished - Feb 2013

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Recurrence
Ablation
Ultrasonography
Thyroglobulin
Surgery
Assays
Thyroid Gland
Papillary Thyroid cancer
Tissue
Monitoring
Thyroid Diseases
Thyroidectomy
Rare Diseases
Postoperative Period
Costs
Neck
Therapeutics
Lymph Nodes
Costs and Cost Analysis
Serum

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Papillary thyroid cancer : Time course of recurrences during postsurgery surveillance. / Durante, Cosimo; Montesano, Teresa; Torlontano, Massimo; Attard, Marco; Monzani, Fabio; Tumino, Salvatore; Costante, Giuseppe; Meringolo, Domenico; Bruno, Rocco; Trulli, Fabiana; Massa, Michela; Maniglia, Adele; Rosaria D'Apollo, D'Apollo; Giacomelli, Laura; Ronga, Giuseppe; Filetti, Sebastiano.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 98, No. 2, 02.2013, p. 636-642.

Research output: Contribution to journalArticle

Durante, C, Montesano, T, Torlontano, M, Attard, M, Monzani, F, Tumino, S, Costante, G, Meringolo, D, Bruno, R, Trulli, F, Massa, M, Maniglia, A, Rosaria D'Apollo, DA, Giacomelli, L, Ronga, G & Filetti, S 2013, 'Papillary thyroid cancer: Time course of recurrences during postsurgery surveillance', Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 2, pp. 636-642. https://doi.org/10.1210/jc.2012-3401
Durante, Cosimo ; Montesano, Teresa ; Torlontano, Massimo ; Attard, Marco ; Monzani, Fabio ; Tumino, Salvatore ; Costante, Giuseppe ; Meringolo, Domenico ; Bruno, Rocco ; Trulli, Fabiana ; Massa, Michela ; Maniglia, Adele ; Rosaria D'Apollo, D'Apollo ; Giacomelli, Laura ; Ronga, Giuseppe ; Filetti, Sebastiano. / Papillary thyroid cancer : Time course of recurrences during postsurgery surveillance. In: Journal of Clinical Endocrinology and Metabolism. 2013 ; Vol. 98, No. 2. pp. 636-642.
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abstract = "Context: The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largelyonthe study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20{\%} and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly. Objectives: The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort. Patients and Design: We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography. Results: At the initial posttreatment (≤12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4{\%}) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation. Conclusion: In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients.",
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AU - Tumino, Salvatore

AU - Costante, Giuseppe

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AU - Massa, Michela

AU - Maniglia, Adele

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AU - Giacomelli, Laura

AU - Ronga, Giuseppe

AU - Filetti, Sebastiano

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N2 - Context: The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largelyonthe study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20% and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly. Objectives: The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort. Patients and Design: We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography. Results: At the initial posttreatment (≤12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4%) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation. Conclusion: In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients.

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