The Frequency of Differentiated Thyroid Cancer Recurrence in 2302 Patients With Excellent Response to Primary Therapy
Authors' conclusion
True recurrence is rare in DTC patients. PTC patients with ExR to primary therapy and N0/Nx can be dismissed from oncological follow-up. Despite ExR to primary therapy, DTC patients with N1, and PDTC, OTC, FTC should remain under oncological follow-up.
Study context
- Population
- Consecutive differentiated thyroid cancer (DTC) patients with excellent response (excellent responses (ExR)) to primary therapy, treated during 24 years at a single center
- Participants
- 2,302 patients
- Outcome
- Frequency of true recurrence (percentage of recurrence and cumulative recurrence rate)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Recurrence in DTC with ExR
- Recurrence
- 32 (1.4%)
- Cumulative recurrence rate (CRR) at 5 years
- 1.2%
- CRR at 10 years
- 1.9%
- CRR at 15 years
- 2.5%
- CRR at 20 years
- 2.9%
- CRR at 24 years
- 2.9%
Observational data: associations, not effects.
Further findings
Risk factors for recurrence in PTC
- Younger age
- P = 0.0182
- Larger tumor size
- P = 0.0013
- Lymph node metastases
- P = 0.0013
- Incomplete resection
- P = 0.0446
- Higher ATA risk
- P = 0.0002
- More frequently treated with 131I
- P = 0.0203
CRR by histological type
- CRRs highest for poorly differentiated thyroid cancer (PDTC), lower for oncocytic (OTC) and follicular thyroid cancer (FTC), lowest for PTC
- Most recurrences occurred within the first 5 years
Methods for detecting recurrence
- Most effective for local recurrence: US with fine needle aspiration cytology; for distant metastases: 18F-FDG PET
Original publication
The Frequency of Differentiated Thyroid Cancer Recurrence in 2302 Patients With Excellent Response to Primary Therapy. J Clin Endocrinol Metab. Published 28 September 2023. doi:10.
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