Initial clinical and treatment patterns of advanced differentiated thyroid cancer: ERUDIT study
Por:
Casas, JAV, Sambo, M, Lopez, CL, Duran-Poveda, M, Garcia, JRV, Santos, RJ, Llanos, M, Navarro-Gonzalez, E, Aller, J, Pubul, V, Guadalix, S, Crespo, G, Gonzalez, C, Zafon, C, Navarro, M, Santamaria-Sandi, J, Segura, A, Gajate, P, Gomez-Balaguer, M, Valdivia, J, Puig-Domingo, M, Galofre, JC, Castelo, B, Villanueva, MJ, Argueelles, I and Orcajo-Rincon, L
Publicada:
1 oct 2022
Resumen:
BackgroundUp to 30% of differentiated thyroid cancer (DTC) will develop advanced-stage disease (aDTC) with reduced overall survival (OS).ObjectiveThe aim of this study is to characterize initial diagnosis of aDTC, its therapeutic management, and prognosis in Spain and Portugal.MethodsA multicentre, longitudinal, retrospective study of adult patients diagnosed with aDTC in the Iberian Peninsula was conducted between January 2007 and December 2012. Analyses of baseline characteristics and results of initial treatments, relapse- or progression-free survival ((RP)FS) from first DTC diagnosis, OS, and prognostic factors impacting the evolution of advanced disease were evaluated.ResultsTwo hundred and thirteen patients (median age: 63 years; 57% female) were eligible from 23 hospitals. Advanced disease presented at first diagnosis (de novo aDTC) included 54% of patients, while 46% had relapsed from early disease (recurrent/progressive eDTC). At initial stage, most patients received surgery (98%) and/or radioiodine (RAI) (89%), with no differences seen between median OS (95% CI) (10.4 (7.3-15.3) years) and median disease-specific-survival (95% CI) (11.1 (8.7-16.2) years; log-rank test P = 0.4737). Age at diagnosis being < 55 years was associated with a lower risk of death (Wald chi-square (Wc-s) P < 0.0001), while a poor response to RAI to a higher risk of death ((Wc-s) P < 0.05). In the eDTC cohort, median (RP)FS (95% CI) was of 1.7 (1.0-2.0) years after RAI, with R0/R1 surgeries being the only common significant favourable factor for longer (RP)FS and time to aDTC ((Wc-s) P < 0.05).ConclusionIdentification of early treatment-dependent prognostic factors for an unfavourable course of advanced disease is possible. An intensified therapeutic attitude may reverse this trend and should be considered in poor-performing patients. Prospective studies are required to confirm these findings.
Filiaciones:
Casas, JAV:
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC, Dept Nucl Med UGC, Cordoba, Spain
Sambo, M:
Gregorio Maranon Univ Hosp, Dept Endocrinol, Madrid, Spain
Lopez, CL:
Marques Valdecilla Univ Hosp, Dept Med Oncol, IDIVAL, Santander, Spain
Duran-Poveda, M:
Rey Juan Carlos Univ Hosp, Dept Gen & Digest Surg, Madrid, Spain
Garcia, JRV:
EISAI Farmaceut SA, Oncol Business Grp, Madrid, Spain
Santos, RJ:
Francisco Gentil Portuguese Inst Oncol Lisbon, Dept Endocrinol, Lisbon, Portugal
Llanos, M:
Hosp Univ Canarias, Dept Med Oncol, San Cristobal la Laguna, Santa Cruz de T, Spain
Navarro-Gonzalez, E:
Virgen Rocio Univ Hosp, Dept Endocrinol, Seville, Spain
Aller, J:
Puerta Hierro Majadahonda Univ Hosp, Dept Endocrinol, Madrid, Spain
Pubul, V:
Univ Hosp, Hlth Res Inst St iago Compostela, Dept Nucl Med, Santiago De Compostela, Spain
Guadalix, S:
Hosp Univ 12 Octubre, Dept Endocrinol & Nutr, Madrid, Spain
Crespo, G:
Burgos Univ Hosp, Dept Med Oncol, Burgos, Spain
Gonzalez, C:
Santa Creu & St Pau Univ Hosp, Dept Endocrinol, CIBER BBN, Barcelona, Spain
Zafon, C:
Autonomous Univ Barcelona UAB, Vall Hebron Univ Hosp, Dept Endocrinol & Nutr, Barcelona, Spain
Navarro, M:
Univ Hosp Salamanca, Dept Med Oncol, Salamanca, Spain
Santamaria-Sandi, J:
Cruces Univ Hosp, Dept Endocrinol, Vizcaya, Spain
Segura, A:
La Fe Univ Hosp, Med Oncol Unit, Valencia, Spain
Gajate, P:
Ramon & Cajal Univ Hosp, Dept Med Oncol, Madrid, Spain
Gomez-Balaguer, M:
Doctor Peset Univ Hosp, Dept Endocrinol, Valencia, Spain
Valdivia, J:
Univ Hosp Ctr Virgen Nieves, Dept Oncol, Granada, Spain
:
Univ Hosp Germans Trias i Pujol, Hlth Sci Res Inst, Endocrine & Nutr Serv, Badalona, Spain
Galofre, JC:
Univ Navarra, Clin Univ Navarra, Dept Endocrinol, Lisbon, Spain
Castelo, B:
La Paz Univ Hosp, Dept Med Oncol, Madrid, Spain
Villanueva, MJ:
Univ Vigo, Alvaro Cunqueiro Univ Hosp Complex, Dept Med Oncol, Vigo, Spain
Argueelles, I:
Son Espases Univ Hosp, Dept Endocrinol & Nutr, Palma De Mallorca, Spain
Orcajo-Rincon, L:
EISAI Farmaceut SA, Oncol Business Grp, Madrid, Spain
Green Published, gold
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