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Determinants of successful ablation and complete remission after total thyroidectomy and 131I therapy of paediatric differentiated thyroid cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

In adult differentiated thyroid cancer (DTC) patients, successful ablation and the number of 131I therapies needed carry a prognostic significance. The goal was to assess the prognosis of DTC in children and adolescents treated in our centre in relation to the number of treatments needed and to establish the determinants of both complete remission (CR) and successful ablation.

Methods

Seventy-six DTC patients <21 years of age at diagnosis were included. Recurrence and death rates, rates of CR (=negative stimulated thyroglobulin, negative neck ultrasound and negative 131I whole-body scintigraphy) and successful ablation (=CR after initial 131I therapy) were studied.

Results

No patients died of DTC. Seven patients were treated by surgery alone and did not show signs of recurrence during follow-up. Of the 69 patients also treated with 131I therapy, 47 patients achieved CR, 25 of whom had successful ablation. In multivariate analysis, female gender and the absence of distant metastases were independent determinants of a higher CR rate. Female gender, lower T stage and higher 131I activity (successful ablation, median activity 3.1 GBq, unsuccessful ablation 2.6 GBq) were determinants of a higher rate of successful ablation. After 131I therapy no patient showed recurrence after reaching CR or disease progression if CR was not reached.

Conclusion

In our paediatric DTC population prognosis is extremely good with no deaths or recurrences occurring regardless of the number of 131I therapies needed or whether CR was reached. The determinants of CR and successful ablation can be used to optimize the chance of therapy success.

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Conflicts of interest

FAV has accepted consultancy fees from Roche Healthcare and is a paid consultant to Bayer Healthcare. ML is a paid consultant to Genzyme, a Sanofi company, and to Bayer Healthcare, Sobi Swedish Orphan Biovitrum AB, AstraZeneca and has accepted speaker’s fees and research support from Genzyme, Merck and Henning, a Sanofi company.

UM, HH and CR have no conflicts of interest to declare.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany

    Frederik A. Verburg, Heribert Hänscheid & Christoph Reiners

  2. Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany

    Uwe Mäder

  3. Department of Nuclear Medicine, RWTH University Hospital Aachen, Pauwelsstraße 30, 52062, Aachen, Germany

    Frederik A. Verburg

  4. Department of Nuclear Medicine, University Hospital Giessen and Marburg, Marburg, Germany

    Markus Luster

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  1. Frederik A. Verburg
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Correspondence to Frederik A. Verburg.

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Verburg, F.A., Mäder, U., Luster, M. et al. Determinants of successful ablation and complete remission after total thyroidectomy and 131I therapy of paediatric differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 42, 1390–1398 (2015). https://doi.org/10.1007/s00259-015-3076-8

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  • DOI: https://doi.org/10.1007/s00259-015-3076-8

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