Response to therapy status Is an excellent predictor of pregnancy-associated structural disease progression in patients previously treated for differentiated thyroid cancer Journal Article
| Authors: | Rakhlin, L.; Fish, S.; Tuttle, R. M. |
| Article Title: | Response to therapy status Is an excellent predictor of pregnancy-associated structural disease progression in patients previously treated for differentiated thyroid cancer |
| Abstract: | Background: Pregnancy may be associated with an increased risk of recurrence/progression of differentiated thyroid cancer (DTC). However, it is unclear if the impact of pregnancy would differ based on pre-pregnancy response to therapy status. The objective of this study was to investigate the risk of recurrence/progression of DTC, applying the response to therapy assessments to pre-pregnancy status as recommended by the 2015 American Thyroid Association thyroid cancer guidelines. Methods: This was a retrospective review of 235 women followed at Memorial Sloan Kettering Cancer Center for DTC who had a term pregnancy after initial treatment for DTC between 1997 and 2015. Results: Structural disease recurrence/progression after pregnancy was documented in 5% (11/235) of the patients. When evaluated 3-12 months after delivery, patients who had an excellent, indeterminate, or biochemical incomplete response before pregnancy continued to show no evidence of structurally identifiable disease. Conversely, in women with a structural incomplete response to therapy prior to pregnancy, structural progression (defined as ≥3 mm increase in the size of known disease or identification of new metastatic foci) was identified after delivery in 29% (11/38). However, additional therapy was recommended during the first postpartum years in only 8% (3/38) of those patients who had a structural incomplete response to therapy prior to pregnancy, while the remainder (92%) continued to be followed with observation. Conclusion: None of the patients with an excellent, indeterminate, or biochemical incomplete response to therapy prior to pregnancy developed structurally identifiable disease after a full-term delivery. Even though structural disease progression was seen in almost a third of the patients with known structural disease prior to pregnancy, only a minority of these patients had changes sufficient to warrant additional therapy. These data confirm that pre-pregnancy response to therapy status is an excellent predictor of pregnancy-associated disease progression in women previously treated for DTC. © 2017, Mary Ann Liebert, Inc. |
| Keywords: | pregnancy; response to therapy; differentiated thyroid cancer |
| Journal Title: | Thyroid |
| Volume: | 27 |
| Issue: | 3 |
| ISSN: | 1050-7256 |
| Publisher: | Mary Ann Liebert, Inc |
| Date Published: | 2017-03-01 |
| Start Page: | 396 |
| End Page: | 401 |
| Language: | English |
| DOI: | 10.1089/thy.2016.0501 |
| PROVIDER: | scopus |
| PUBMED: | 27835925 |
| PMCID: | PMC5912718 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 April 2017 -- Source: Scopus |
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