@phdthesis{Verburg2008, author = {Verburg, Frederik Anton}, title = {The course of differentiated thyroid carcinoma in patients in whom the initial I-131 ablative treatment was successful}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-33346}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2008}, abstract = {Objective: The objective of this study was to study recurrence in patients with differentiated thyroid carcinoma who after initial therapy consisting of total thyroidectomy and I-131 ablation, were cured defined as a negative TSH-stimulated Tg-levels and a negative I-131 whole body scan (WBS) at the first follow-up after ablation. Methods: Retrospective data for differentiated thyroid carcinoma patients from three university hospitals were pooled. Out of 1993 patients, 526 cured patients were included. All patients received at least one more TSH-stimulated WBS and Tg-measurement within 5 years after initial treatment. Results: 12 patients (2.1\%) developed a recurrence after an average interval of 35 months (range: 12-59 months) following administration I-131 ablation. Overall disease-free survival according to the method of Kaplan-Meier was 96.6\%. There was no difference in disease-free survival between high- and low-risk patients (p=0.61). Recurrence was first discovered by Tg-measurement during levothyroxin therapy in 7 patients, and by TSH-stimulated Tg-measurement in 5 patients. I-131 WBS did not contribute to the detection of recurrences. Multivariate analysis showed that age TNM-stage (p=0.015) and histology (p=0.032) were independent predictors of disease-free survival. Conclusion: Recurrence is a rare event in patients with DTC who received total thyroidectomy with subsequent I-131 ablation, and who had a negative first follow-up TSH-stimulated I-131 WBS and negative concurrent Tg. In the study population there were no recurrences after more than 5 years of follow-up.}, subject = {Schilddr{\"u}senkrebs}, language = {en} } @article{WernerSchmidMueggeetal.2015, author = {Werner, R.A. and Schmid, J.S. and Muegge, D.O. and L{\"u}ckerath, K. and Higuchi, T. and H{\"a}nscheid, H. and Grelle, I. and Reiners, C. and Herrmann, K. and Buck, A.K. and Lapa, C.}, title = {Prognostic value of serum tumor markers in medullary thyroid cancer patients undergoing vandetanib treatment}, series = {Medicine}, volume = {94}, journal = {Medicine}, number = {45}, doi = {10.1097/MD.0000000000002016}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145154}, pages = {e2016}, year = {2015}, abstract = {Tyrosine kinase inhibitors (TKIs) such as vandetanib have shown clinical effectiveness in advanced medullary thyroid cancer (MTC). During TKI treatment, fluctuations in the tumor markers carcinoembryonic antigen (CEA) and calcitonin (CTN) are frequently observed. Their role for treatment monitoring and the decision-making process has not been fully elucidated yet. Twenty-one patients (male, 16, female, 5; mean age, 49±13 years) with progressive MTC receiving vandetanib (300mg orally per day) were considered. Tumor restaging was performed every 3 months including contrast-enhanced computed tomography (CT). Response was assessed according to recent criteria (Response Evaluation Criteria in Solid Tumors, RECIST 1.1). Additionally, CEA and CTN were measured at the day of CT imaging and alterations observed in tumor markers were compared to respective imaging findings (partial response, PR; stable disease, SD; progressive disease, PD). During long-term follow-up (510±350 days [range, 97-1140 days]), CTN and CEA levels initially dropped in 71.4\% and 61.9\% of the patients followed by fluctuations in serum marker levels. A rise in CTN ≥39.5\% between 2 subsequent measurements (defined by ROC analysis) had a sensitivity of 70.6\% and a specificity of 83.2\% in predicting PD with an accuracy of 82.0\% (area under the curve (AUC), 0.76). Oscillations in CEA levels were not predictive for PD. Whereas tumor marker fluctuations in MTC patients undergoing TKI treatment are a frequent phenomenon, a significant rise in CTN ≥40\% turns out to as an early indicator of tumor progression.}, language = {en} }