Tumor Volume Doubling Time in Active Surveillance of Papillary Thyroid Carcinoma

Rodrigo Arrangoiz MS, MD, FACS, FSSO

Presentation1

  • Background:
    • Tumor volume (TV) of papillary thyroid carcinoma (PTC) increases exponentially during active surveillance, and the growth rate differs for each patient.
    • TV doubling time (TVDT) is considered a strong dynamic marker for the prediction of the growth rate and progression of the tumor.
  • Methods:
    • This cohort study analyzed 273 PTC patients who underwent active surveillance for more than one year rather than immediate thyroid surgery.
    • TVDT was calculated in each patient, and patients were divided into two groups:
      • Rapid-growing (TVDT less than 5 years)
      • Stable (TVDT of 5 years or more)
    • Clinical and initial ultrasonography (US) features between the two groups were compared.
  • Results:
    • The median patient age was 51.1 years (interquartile range [IQR] 42.2–61.0 years)
    • 76% of the patients were women.
    • The initial TV of PTC was 62.1 mm3 (IQR 28.1–122.8 mm3)
    • During a median of 42 months (IQR 29– 61 months) of active surveillance:
      • 10.3% of the patients had a TVDT of less than two years
      • 5.1% had a TVDT between two and three years
      • 6.2% had a TVDT between three and four years
      • 6.6% had a TVDT between four and five years
      • 71.8% had a TVDT of five years or more
    • Patients in the rapid-growing group (77 patients; 28.2%) were:
      • Significantly younger ( p = 0.004) than those in the stable group (196 patients; 71.8%):
        • Being younger than 50 years of age was significantly associated with rapid tumor growth of PTC (odds ratio = 2.31 [confidence interval 1.30–4.31], p = 0.004) in multivariate analysis.
    • In ultrasound findings:
      • MacrocalcificatioN:
        • Was independently associated with rapid tumor growing of PTCs (odds ratio = 4.98 [confidence interval 2.19–11.69], p < 0.001)
  • Conclusions:
    • TVDT is a good indicator for presenting the growing velocity of PTCs during active surveillance
    • Younger age and macrocalcification in the initial US:
      • Were associated with rapid-growing PTCs
    • Determination of TVDT during the early phase of active surveillance may be helpful for the prediction of rapidly progressing PTCs and deciding whether to adopt an early surgical approach.

#Surgeon

#Cirujano

#ThyroidExpert

#ThyroidSurgeon

#CirujanodeTiroides

#ExpertoenTiroides

#ExpertoenParatiroides

#Paratiroides

#Hiperparatiroidismo

#CancerdeTiroides

#ThyroidCancer

#PapillaryThyroidCancer

#SurgicalOncologist

#CirujanoOncologo

#CancerSurgeon

#CirujanodeCancer

#HeadandNeckSurgeon

#CirugiaEndocrina

#EndocrineSurgery

#CirujanodeCabezayCuello

http://www.cirugiatiroides.com

http://www.hiperparatirodismo.info

http://www.sociedadquirurigca.com

Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment