open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15
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Relapse of differentiated thyroid carcinoma in low-risk patients

Jolanta Krajewska, Agnieszka Czarniecka, Michał Jarząb, Aleksandra Kukulska, Daria Hankiewicz-Junak, Kornelia Hasse-Lazar, Elżbieta Gubała, Zbigniew Puch, Ewa Paliczka, Józef Roskosz
Endokrynologia Polska 2006;57(4):386-391.

open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15

Abstract

Introduction: The low incidence of relapse in differentiated thyroid carcinoma (DTC), primarily treated by total thyroidectomy and 131I ablation, stimulates the search for optimal follow-up algorithms which do not include too many tests but are not connected with a risk of missing early recurrence. The aim of the study was to analyze the impact of the routine follow up examinations for early detection of DTC recurrence in low risk DTC patients.
Material and methods: The group consisted of 617 DTC patients diagnosed in 1995-1996. In 513 (83%) total thyroidectomy was performed. 449 (73%) received ablative 131I therapy. After primary approach complete remission (CR) was stated in 453 (73%), persistent disease in 116 (19%), asymptomatic hyperthyroglobulinaemia in 14 (2%). Patients with CR constituted the low risk group analyzed in this study. The median follow up was 4.16 yrs.
Results: Recurrent disease appeared in 28 (6%) patients (23 locoregional, 9 distant metastases, both in 4). Serum Tg (thyroglobulin) level at the moment of relapse diagnosis was detectable in 44% while neck sonography was the first examination to detect recurrence in 56% of cases.
Conclusion: In the selected group of DTC patients treated by radical primary approach and showing a low risk of recurrence only half of all relapse cases are diagnosed by the rise of serum Tg level. Regular sonography contributes to the second half of diagnoses. Thus, a special weight should be put on neck sonography as the important element of regular follow up in low risk DTC patients.

Abstract

Introduction: The low incidence of relapse in differentiated thyroid carcinoma (DTC), primarily treated by total thyroidectomy and 131I ablation, stimulates the search for optimal follow-up algorithms which do not include too many tests but are not connected with a risk of missing early recurrence. The aim of the study was to analyze the impact of the routine follow up examinations for early detection of DTC recurrence in low risk DTC patients.
Material and methods: The group consisted of 617 DTC patients diagnosed in 1995-1996. In 513 (83%) total thyroidectomy was performed. 449 (73%) received ablative 131I therapy. After primary approach complete remission (CR) was stated in 453 (73%), persistent disease in 116 (19%), asymptomatic hyperthyroglobulinaemia in 14 (2%). Patients with CR constituted the low risk group analyzed in this study. The median follow up was 4.16 yrs.
Results: Recurrent disease appeared in 28 (6%) patients (23 locoregional, 9 distant metastases, both in 4). Serum Tg (thyroglobulin) level at the moment of relapse diagnosis was detectable in 44% while neck sonography was the first examination to detect recurrence in 56% of cases.
Conclusion: In the selected group of DTC patients treated by radical primary approach and showing a low risk of recurrence only half of all relapse cases are diagnosed by the rise of serum Tg level. Regular sonography contributes to the second half of diagnoses. Thus, a special weight should be put on neck sonography as the important element of regular follow up in low risk DTC patients.
Get Citation

Keywords

differentiated thyroid cancer; thyroglobulin; neck USG; 131I scintigraphy

About this article
Title

Relapse of differentiated thyroid carcinoma in low-risk patients

Journal

Endokrynologia Polska

Issue

Vol 57, No 4 (2006)

Pages

386-391

Published online

2006-07-07

Bibliographic record

Endokrynologia Polska 2006;57(4):386-391.

Keywords

differentiated thyroid cancer
thyroglobulin
neck USG
131I scintigraphy

Authors

Jolanta Krajewska
Agnieszka Czarniecka
Michał Jarząb
Aleksandra Kukulska
Daria Hankiewicz-Junak
Kornelia Hasse-Lazar
Elżbieta Gubała
Zbigniew Puch
Ewa Paliczka
Józef Roskosz

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