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Horm Metab Res 2017; 49(11): 860-868
DOI: 10.1055/s-0043-119462
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

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

Frederik A. Verburg
1   Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany
2   University Hospital Marburg, Department of Nuclear Medicine, Marburg, Germany
,
Uwe Mäder
3   Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
,
Inge Grelle
1   Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany
,
Luca Giovanella
4   Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona, Switzerland
,
Christoph Reiners
1   Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany
,
Heribert Hänscheid
1   Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany
› Author Affiliations
Further Information

Publication History

received 12 December 2016

accepted 05 September 2017

Publication Date:
14 November 2017 (online)

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Abstract

The objective of the work was to investigate the relationship between thyroglobulin doubling time (TgDT) as a marker of speed of response to 131I-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 131I-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.

Key words

differentiated thyroid carcinoma - thyroglobulin - thyroglobulin doubling time - prognosis - life expectancy
 

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