Serum calcitonin nadirs to undetectable levels within 1 month of curative surgery in medullary thyroid cancer
Arch. endocrinol. metab. (Online)
;
63(2): 137-141, Mar.-Apr. 2019. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1001220
ABSTRACT
ABSTRACT Objective: Because serum calcitonin (CT) is a reliable marker of the presence, volume, and extent of disease in medullary thyroid cancer (MTC), both the ATA and NCCN guidelines use the 2-3 month post-operative CT value as the primary response to therapy variable that determines the type and intensity of follow up evaluations. We hypothesized that the calcitonin would nadir to undetectable levels within 1 month of a curative surgical procedure. Subjects and methods: This retrospective review identified 105 patients with hereditary and sporadic MTC who had at least two serial basal CT measurements done in the first three months after primary surgery. Results: When evaluated one year after initial surgery, 42 patients (42/105, 40%) achieved an undetectable basal calcitonin level without additional therapies and 56 patients (56/84, 67%) demonstrated a CEA within the normal reference range. In patients destined to have an undetectable CT as the best response to initial therapy, the calcitonin was undetectable by 1 month after surgery in 97% (41/42 patients). Similarly, in patients destined to have a normalize their CEA, the CEA was within the reference range by 1 month post-operatively in 63% and by 6 months in 98%. By 6 months after curative initial surgery, 100% of patients had achieved a nadir undetectable calcitonin, 98% had reached the CEA nadir, and 97% had achieved normalization of both the calcitonin and CEA. Conclusion: The 1 month CT value is a reliable marker of response to therapy that allows earlier risk stratification than the currently recommended 2-3 month CT measurement.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Calcitonina
/
Neoplasias da Glândula Tireoide
/
Carcinoma Neuroendócrino
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Idoso
/
Aged80
/
Criança
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Arch. endocrinol. metab. (Online)
Assunto da revista:
Endocrinologia
/
Metabolismo
Ano de publicação:
2019
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Canadá
/
Estados Unidos
Instituição/País de afiliação:
Instituto Nacional de Câncer/BR
/
Memorial Sloan-Kettering Cancer Center/US
/
l'Université de Montréal/CA
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