08:00 EDT 14th August 2019 | BioPortfolio


Regional nodal metastases carry prognostic significance in papillary thyroid cancer (PTC). However, whether different locational nodal metastases correlate with different therapeutic responses remains controversial. We innovatively applied the response to therapy re-stratification system (RTRS) to evaluate the dynamic disease status after surgery and radioiodine (RAI) therapy in PTC patients with different locational nodal metastases. A total of 585 non-distant-metastatic PTC patients who underwent total thyroidectomy and RAI therapy were retrospectively enrolled. Patients with nodal metastases were categorized into N1a and N1b groups. Propensity score matching (PSM) was used to balance the bias between two groups. Therapeutic responses were dynamically evaluated, and responses to RAI therapy were classified into excellent(ER), indeterminate(IDR), biochemical incomplete(BIR) and structural incomplete response(SIR). N1b group patients showed a significantly higher pre-ablation stimulated thyroglobulin (Ps-Tg) level than N1a group patients (7.4ng/mL vs 3.2ng/mL, <0.001). After RAI therapy, N1b group patients took longer time to achieve ER (9.86 months vs 3.29 months, <0.001) and exhibited a higher proportion of non-ER (IDR, BIR and SIR) (39.15% vs 17.46%, <0.001) compared to N1a group patients. In logistic regression, N1b and Ps-Tg≥10ng/mL were confirmed to be independent factors predicting non-ER (Odds Ratio, 2.591, 9.196, respectively). In Cox regression, patients with N1b disease and Ps-Tg≥10ng/mL showed significantly lower hazards for achieving ER (Hazard Ratio, 0.564, 0.223, respectively). N1b PTC patients showed inferior responses to surgery and RAI therapy compared to N1a patients. N1b was confirmed to be an independent factor predicting unfavorable responses to RAI therapy.


Journal Details

This article was published in the following journal.

Name: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
ISSN: 1530-891X


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