PERSISTED /
RECURRENT DISEASE IN DIFFERENTIATED THYROID CANCER (DTC) – TWO DIFFERENT
CONDITIONS WITH DIFFERENT OUCTOMES
Despite the
excellent prognosis of DTC, it is estimated that a significant percentage of
patients (up to 20 %) will have disease events after initial treatment, defined
as ‘persistent/residual’ disease. The term ‘recurrent’ disease following
treatment of DTC refers to the development of relapse after 12 months
disease-free, in contrast to ‘persistent’ disease which is the result of residual
lesions after initial treatment. Persistent disease is associated with an
increased incidence of distant metastases compared to recurrent disease (38 %
vs. 17 %). Male gender, older age, follicular histology, T status, and N status
are independently associated with persistent disease. In contrast, only N
status is associated with recurrent disease. Persistent disease has a worse
prognosis than recurrent disease. For this reason, careful evaluation of the
patient during the first-year follow-up have important clinical implications
for planning therapeutic strategy, evaluating prognosis and selecting
appropriate follow-up schedule.
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