Recurrent differentiated thyroid carcinoma: Biological implications of age, method of detection, and site and extent of recurrence Journal Article


Authors: Stojadinovic, A.; Shoup, M.; Nissan, A.; Ghossein, R. A.; Shah, J. P.; Brennan, M. F.; Shaha, A. R.
Article Title: Recurrent differentiated thyroid carcinoma: Biological implications of age, method of detection, and site and extent of recurrence
Abstract: Background: We identified factors predictive of outcome for recurrent differentiated thyroid carcinoma (DTC). Methods: Fifty-seven patients with local (LR), regional (RRec), and/or distant recurrence (DR) of 431 recurrent DTCs were studied. Disease-specific survival (DSS) rate was estimated with the Kaplan-Meier method. Univariate and multivariate comparisons were conducted by log-rank and Cox regression analysis. Results: The median follow-up was 13 years. Distribution of the first relapse was LR only (35%), LR and RRec (23%), LR and DR (30%), and LR, RRec, and DR (12%). Factors predictive of resectability were a long (≥5-year) disease-free interval (DFI) and subclinical and thyroid remnant recurrence. Only 26% of symptomatic and 45% of thyroid bed LR, and 43% with DFI <5 years, could be resected completely. No isolated thyroid remnant and 75% of thyroid bed LR resulted in tumor-related mortality. Age <45 years, subclinical recurrence, isolated LR, and the ability to render the patient disease free independently predicted DSS. Fifteen-year DSS for LR only; LR and RRec; LR and DR; and LR, RRec, and DR were 49%, 28%, 15%, and 0%, respectively. Conclusions: Isolated thyroid remnant recurrence defines a benign phenotype. Age, method of detection, site and extent of recurrence, and the ability to render the patient disease free predict outcome for recurrent DTC. Multimodality long-term follow-up is warranted to detect recurrence at a subclinical potentially curative stage.
Keywords: adolescent; adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; recurrent cancer; follow up; follow-up studies; cancer diagnosis; phenotype; neoplasm recurrence, local; proportional hazards models; carcinoma, papillary; recurrence; prediction; cancer mortality; age; carcinoma; outcome; outcomes research; thyroid carcinoma; thyroid neoplasms; kaplan meier method; regression analysis; thyroid; humans; human; male; female; article
Journal Title: Annals of Surgical Oncology
Volume: 9
Issue: 8
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2002-10-01
Start Page: 789
End Page: 798
Language: English
DOI: 10.1245/aso.2002.02.001
PUBMED: 12374663
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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  1. Murray F Brennan
    1059 Brennan
  2. Ronald A Ghossein
    483 Ghossein
  3. Ashok R Shaha
    698 Shaha
  4. Margaret Shoup
    20 Shoup
  5. Aviram Nissan
    20 Nissan
  6. Jatin P Shah
    721 Shah