Initial clinical and treatment patterns of advanced differentiated thyroid cancer: ERUDIT study
Por:
Casas J.A.V., Sambo M., López C.L., Durán-Poveda M., García J.R.-V., Santos R.J., Llanos M., Navarro-González E., Aller J., Pubul V., Guadalix S., Crespo G., González C., Zafón C., Navarro M., Santamaría-Sandi J., Segura Á., Gajate P., Gómez-Balaguer M., Valdivia J., Puig-Domingo M., Galofré J.C., Castelo B., Villanueva M.J., Argüelles I., Orcajo-Rincón L.
Publicada:
1 ene 2022
Resumen:
Background: Up to 30% of differentiated thyroid cancer (DTC) will develop advanced-stage disease (aDTC) with reduced overall survival (OS). Objective: The aim of this study is to characterize initial diagnosis of aDTC, its therapeutic management, and prognosis in Spain and Portugal. Methods: A 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. Results: Two 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). Conclusion: Identification 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. © 2022 S. Karger AG. All rights reserved.
Filiaciones:
Casas J.A.V.:
Department of Nuclear Medicine (UGC), Maimónides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
Sambo M.:
Department of Endocrinology, Gregorio Marañón University Hospital, Madrid, Spain
López C.L.:
Department of Medical Oncology, Marqués de Valdecilla University Hospital, IDIVAL, Santander, Spain
Durán-Poveda M.:
Department of General and Digestive Surgery, Rey Juan Carlos University Hospital, Madrid, Spain
García J.R.-V.:
Oncology Business Group, EISAI Farmacéutica SA, Madrid, Spain
Santos R.J.:
Department of Endocrinology, Francisco Gentil Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
Llanos M.:
Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
Navarro-González E.:
Department of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
Aller J.:
Department of Endocrinology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
Pubul V.:
Department of Nuclear Medicine, University Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
Guadalix S.:
Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Madrid, Spain
Crespo G.:
Department of Medical Oncology, Burgos University Hospital, Burgos, Spain
González C.:
Department of Endocrinology, Santa Creu i Sant Pau University Hospital, CIBER-BBN, Barcelona, Spain
Zafón C.:
Department of Endocrinology and Nutrition, Vall Hebron University Hospital, Autonomous University of Barcelona (UAB), Barcelona, Spain
Navarro M.:
Department of Medical Oncology, University Hospital of Salamanca, Salamanca, Spain
Santamaría-Sandi J.:
Department of Endocrinology, Cruces University Hospital, Vizcaya, Spain
Segura Á.:
Medical Oncology Unit, La Fe University Hospital, Valencia, Spain
Gajate P.:
Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain
Gómez-Balaguer M.:
Department of Endocrinology, Doctor Peset University Hospital, Valencia, Spain
Valdivia J.:
Department of Oncology, University Hospital Centre Virgen de las Nieves, Granada, Spain
Puig-Domingo M.:
Endocrine and Nutrition Service, Health Sciences Research Institute, University Hospital Germans Trias i Pujol, Badalona, Spain
Galofré J.C.:
Department of Endocrinology, Clínica Universidad de Navarra, University of Navarra, Portugal
Castelo B.:
Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
Villanueva M.J.:
Department of Medical Oncology, Alvaro Cunqueiro University Hospital Complex, University of Vigo, Vigo, Spain
Argüelles I.:
Department of Endocrinology and Nutrition, Son Espases University Hospital, Palma de Mallorca, Spain
Orcajo-Rincón L.:
Oncology Business Group, EISAI Farmacéutica SA, Madrid, Spain
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