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Clinical implications of age and excellent response to therapy in patients with high-risk differentiated thyroid carcinoma

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Abstract
Background: Patients with American Thyroid Association (ATA) high-risk differentiated thyroid carcinoma (DTC) have poor clinical outcomes. This study aimed to evaluate the clinical implications of age and response to therapy classification in patients with ATA high-risk DTC.
Design and patients: This study included 222 patients with high-risk DTC who initially underwent therapy between 2000 and 2010 in a single tertiary center in Korea. We evaluated the prognostic parameters associated with progression-free survival (PFS) and disease-specific survival (DSS) with a focus on age and achieving an excellent response (ER).
Results: During the median follow-up period of 11.3 years, disease progression was detected in 77 patients (34.7%), and disease-specific mortality was reported in 31 patients (14.0%). Older age (≥55 years) and not achieving ER (not-ER) were independent risk factors associated with PFS (age, p < .001; not-ER, p < .001) and DSS (age, p < .001; not-ER, p = .015). Of the 74 patients in the ER group, 7 (9.5%) displayed disease progression and 1 (1.4%) died from DTC. There were no significant differences in PFS and DSS according to age in the ER group. However, older patients had significantly worse PFS and DSS than younger patients in the not-ER group (p = .002 and p < .001, respectively).
Conclusions: Response to therapy classification is important for predicting PFS and DSS in patients with high-risk DTC. Patients in the ER group had a relatively good prognosis, but disease progression occurred in 9.5% of patients. Age was a key predictor of both PFS and DSS in high-risk patients who did not achieve ER.
Author(s)
김미화송동은안종화이유미성태연김태용정기욱류진숙김원배송영기전민지김원구
Issued Date
2021
Type
Article
Keyword
ageCancerCarcinomaCare and treatmentDevelopment and progressionhigh-risk of recurrenceMedical researchMedicineExperimentalrespose to therapyRisk factorsThyroid cancer
DOI
10.1111/cen.14543
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7203
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2544458929&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Clinical%20implications%20of%20age%20and%20excellent%20response%20to%20therapy%20in%20patients%20with%20high-risk%20differentiated%20thyroid%20carcinoma&amp;offset=0&amp;pcAvailability=true
Publisher
CLINICAL ENDOCRINOLOGY
Location
영국
Language
영어
ISSN
0300-0664
Citation Volume
95
Citation Number
6
Citation Start Page
882
Citation End Page
890
Appears in Collections:
Medicine > Medicine
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