Does the presence of regional lymph node metastases have any impact on the complete remission rate in patients with distant metastases of papillary thyroid carcinoma (PTC), treated by radioiodine therapy?

Abstract

Introduction: The presence of regional nodal and/or distant metastases has an influence on the results of treatment in patients with differentiated thyroid carcinoma (DTC). The aim of the study was to evaluate the frequency of complete remission in patients with DTC depending on the presence of lymph nodes and/or distant metastases.
Material and methods: A total of 102 patients (82 females, 20 males) aged 20-86 with N1 or M1 (according to TNM staging) after thyroidectomy and 131I therapy were chosen from among the 625 patients with DTC who were treated in our Department. The patients were divided in 3 groups: group I - TxN1M0, group II - TxN0M1, and group III - TxN1M1. The documentation was analyzed by classifying the complete remission patients as being those without the presence of radioiodine uptake in the neck or pathological lesions in the whole body 131I scintigraphy scan after six months of ablation therapy, with negative serum thyroglobulin in the absence of anti-thyroglobulin antibodies, and with normal ultrasound image of the neck. We compared the frequency of complete remission in three groups of patients.
Results: We recognized complete remission in 57 patients (82.6%) in group I (TxN1M0), 4 patients (28.6%) in group II (TxN0M1) and 6 patients (31.6%) in group III (TxN1M1).
Conclusions:
1. The highest percentage of complete remission was observed in patients with lymph nodes but without distant metastases (group I).
2. In the case of the presence of distant metastases there was no statistically significant difference in the percentage of complete remission between patients with or without the presence of metastases in lymph nodes.
(Pol J Endocrinol 2010; 61 (5): 443-445)