Release: July 29, 2000
Contact: Kenneth Satterfield
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In San Francisco (7/28-8/2)
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NEW STUDY PROVIDES CLUES AFFECTING TREATMENT AND SURVIVAL FOR PATIENTS WITH THYROID CANCER
San Francisco, CA -- Elderly patients who have thyroid cancer and those electing to have a partial-thyroidectomy are at higher risk for cancer recurrence, according to a study by researchers at the M.D. Anderson Cancer Center in Houston, TX.
The authors of the study, "Advanced Well-Differentiated Thyroid Cancer: A Review of the M.D. Anderson Experience," are Andrew J. Nemechek MD, Dianna Roberts PhD, Helmuth Goepfert MD, and Chad Johnson. The findings were presented before the 5th International Conference on Head and Neck Cancer, being held July 29 through August 2, at the San Francisco Marriott, San Francisco, CA. More than 1,500 leading head and neck surgeons from the United States and 46 nations will gather to hear the latest medical research in the diagnosis, treatment, and reconstruction associated with head and neck cancer. The medical conference is sponsored by the American Head and Neck Society, www.headandneckcancer.org.
The purpose of the study was to establish trends and clinical outcomes for patients with locally and regionally advanced well-differentiated thyroid carcinoma which includes both papillary and follicular types.
Methodology: To achieve the research goal, a retrospective chart review (a review of past patients' evaluation, treatment, and clinical outcomes) was conducted on 158 patients (64 men and 94 women) who had been diagnosed with cervical soft tissue involvement and/or metastasis to lymph nodes from papillary or follicular thyroid cancer. All patients had sought initial treatment for the disease at the M.D. Anderson Cancer Center between 1951 and 1996. The median age of the study cohort was 36; average follow-up time was 156.5 months (range 4.9-481.8 months).
Of the cohort, 149 either underwent surgery or surgery and radioactive iodine, known as "surgery+I131". This is a procedure where surgery is followed by radioactive ablation of remnant or residual thyroid tissue with I131, iodine that is radioactive and concentrates in thyroid tissue. Four patients underwent external beam radiotherapy and two patient had, respectively, surgery+radiotherapy and surgery +I131, alone.
Results: The clinical review revealed the following:
-- One hundred, fifty-three patients had effective initial responses regardless of what therapy was used. However, 21 percent of surgery-only patients had cancer recur in the neck compared to the nine percent who received surgery and radioactive iodine.
-- Those undergoing partial-thyroidectomy had significantly higher neck recurrence rates when compared against those who received a total thyroidectomy. Age had no impact on local/regional recurrence; however, age was a predictor of survival rates, with a worse rate as the patient's age increased.
-- Salvage surgery following recurrence did increase survival rates. Patients who developed metastases (cancers in other body areas) had significantly worse survival.
Conclusions: The study concluded that patients undergoing thyroidectomy followed by radioactive iodine therapy had improved rates of cancer control; patients with low rates of local and regional recurrence subsequently had a higher chance of survival. Additionally, adverse factors affecting survival included advanced age and the decision to have a partial-thyroidectomy as surgical treatment.
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