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Only a Rapid Complete Biochemical Remission After 131I-Therapy is Associated with an Unimpaired Life Expectancy in Differentiated Thyroid Cancer.

Only a Rapid Complete Biochemical Remission After 131I-Therapy is Associated with an Unimpaired Life Expectancy in Differentiated Thyroid Cancer.
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Verburg FA, Mäder U, Grelle I, Giovanella L, Reiners C, Hänscheid H,


Verburg FA, Mäder U, Grelle I, Giovanella L, Reiners C, Hänscheid H, (click to view)

Verburg FA, Mäder U, Grelle I, Giovanella L, Reiners C, Hänscheid H,

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Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme 2017 11 1449(11) 860-868 doi 10.1055/s-0043-119462

Abstract

The objective of the work was to investigate the relationship between thyroglobulin doubling time (TgDT) as a marker of speed of response to (131)I-therapy and the differentiated thyroid cancer (DTC) recurrence rate, DTC specific mortality rate, and relative survival rate in a DTC population followed over a long period of time after (131)I-therapy. From our database, data of 1354 patients were reviewed. TgDT could be calculated in 174 patients, however, 376 patients did not have sufficient Tg values available for TgDT calculation and 804 patients reached biochemical remission before a sufficient number of Tg measurements for TgDT calculation was acquired. Main outcome measures were recurrence-free, DTC specific, and relative survival rates. In patients<45 years, TgDT in multivariate analysis was identified as the solitary significant determinant of DTC specific and relative survival. In patients≥45 years of age at diagnosis, TgDT is an independent, but not the only determinant of recurrence free, DTC specific, and relative survival. Importantly, in this age group life expectancy is normal in patients reaching rapid biochemical remission (i. e., before TgDT can be calculated); it was reduced in patients with a negative TgDT, which normally is deemed a marker of response to therapy. Only DTC patients with a rapid biochemical remission have a very good prognosis with a normal life expectancy. If no rapid biochemical remission occurs, both biochemically progressive disease and a slower biochemical remission of disease are associated with a reduced prognosis, especially in older DTC patients.

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