Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0598934 (tumor growth)
 58,965 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prognostic factors and therapeutic results in a group of 268 patients with differentiated thyroid cancer (DTC) aged over 60 years are reported. These cases were selected from a total of 1457 DTC-patients seen at our Center from 1967 to 1987. All elderly patients underwent total thyroidectomy, and were treated with 131I therapy and suppressive hormonal therapy. Moreover, external radiotherapy was performed in 20% and chemotherapy in 3.8% of all cases. Follow-up included periodical clinical examination, serum Thyroglobulin (Tg) determination, 131I total body scan (TBS), and echographic and radiologic survey. Several unfavorable prognostic factors were identified in elderly patients with DTC. In comparison with data obtained in a group of patients under 60 years of age, 1) the follicular histologic type was increased, papillary/follicular ratio was 1.1 vs 2.6; 2) the F/M ratio was decreased, 1.5 vs 2.8 for papillary tumors, and 1.7 vs 3.6 for follicular tumors; 3) the rate of cases with local extrathyroid tumor growth and distant metastases was higher, and 4) rates of metastases to bone and metastases with low 131I uptake were increased. Moreover, the 10-year survival rate in elderly patients with lymph node and distant metastases was significantly reduced compared to younger patients, both for papillary and follicular cancer. The finding of detectable serum Tg levels was well correlated with the presence of metastatic disease. Moreover, Tg sensitivity was higher than TBS in showing the presence of metastatic foci. DTC in elderly people must be considered an aggressive tumor both for follicular and papillary histologic types. A radical approach is recommended: total thyroidectomy, 131I administration, and suppressive hormonal therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Differentiated thyroid carcinoma in the elderly. 129 48

Although thyroglobulin is generally recognized as a useful marker for metastases in cases of differentiated thyroid carcinoma, there have been few reports of the use of thyroglobulin determination for long-term follow-up. This report presents the results of long-term follow-up studies carried out for periods of up to 4 years in 18 patients, including 4 patients with local and 14 with distant metastases. After successful treatment, thyroglobulin fell to unmeasurable levels in the four patients with local metastases and in four of six patients with distant metastases. In some patients treated successfully with 131I, the thyroglobulin level remained elevated for several months before falling to within the normal range. Thyroglobulin levels correlated with tumor growth in six of eight patients with tumor progression, remained high with a slight downward trend in one patient, and declined to unmeasurable levels in another case. Only one patient in this group showed radioiodine uptake in the metastases at the end of the observation period. The lack of 131I uptake in the other patients probably reflects the low degree of differentiation of the metastases. The following conclusions regarding the use of thyroglobulin measurement for the long-term follow-up of thyroid carcinoma can be made: (1) Following 131I therapy for metastatic thyroid carcinoma, return of thyroglobulin levels to within the normal range may take several months. The trend observed in serial thyroglobulin determinations is more meaningful than the absolute values for evaluating the success of therapy. (2) Thyroglobulin levels correlate with tumor growth in most cases of tumor progression, even when changes in differentiation may have led to a loss of radioiodine uptake by the metastases. It may be concluded that serial thyroglobulin determinations are therefore useful for the detection of metastases that do not accumulate radioiodine.
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PMID:Long-term follow-up using serial serum thyroglobulin determinations in patients with differentiated thyroid carcinoma. 662 4