Document Detail


Is adjuvant therapy useful in patients with papillary carcinoma smaller than 2 cm?
MedLine Citation:
PMID:  18001178     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate tumor recurrence after total thyroidectomy in patients with single papillary carcinoma with size <or= 2 cm and restricted to the thyroid, we studied 136 consecutive patients divided into two groups according to postoperative management: no ablative therapy (n = 42) (group 1) and ablation with 1.1 GBq (n = 36) or 3.7 GBq (131)I (n = 58) (group 2). None of the patients were submitted to central-compartment (VI level) neck dissection. Thyroid-stimulating hormone (TSH) levels were > 0.5 mIU/L in >or=50% of the measurements in all patients. Complete remission (stimulated thyroglobulin (Tg) <or= 1 ng/mL, undetectable antithyroglobulin antibodies (TgAb), and negative imaging methods) was observed in 83% of the patients in group 1 and in 89% in group 2 (p = 0.4), and none of the patients presented apparent disease during follow-up (mean: 6 years). Posttherapy whole-body scanning was available in 74 patients, and none of them showed ectopic uptake. TgAb were still present in 7.1% of the patients in group 1 and in 8.5% in group 2 (p > 0.05). Six patients who still had stimulated Tg > 1 ng/mL (<5 ng/mL) showed a >50% decrease in comparison with Tg measured 12-24 months earlier. In conclusion, we suggest a more conservative approach with respect to central-compartment neck dissection, postoperative (131)I, and suppressive therapy in patients with small tumors restricted to the thyroid.
Authors:
Pedro W S Rosário; Michelle A R Borges; Maristane M A Valadão; Flávio P J Vasconcelos; Leonardo L Rezende; Eduardo L Padrão; Alvaro L Barroso; Saulo Purisch
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  17     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1225-8     Citation Subset:  IM    
Affiliation:
Department of Thyroid, Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Carcinoma, Papillary / pathology,  radiotherapy*,  surgery*
Combined Modality Therapy
Female
Humans
Iodine Radioisotopes / therapeutic use
Male
Middle Aged
Neoplasm Recurrence, Local / prevention & control
Radiotherapy, Adjuvant
Thyroid Gland / pathology
Thyroid Neoplasms / pathology,  radiotherapy*,  surgery*
Thyroidectomy
Treatment Outcome
Whole Body Imaging
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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