Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study,Annals of Nuclear Medicine

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Outcome of patients with differentiated thyroid cancer treated with empirical radioiodine therapy on the basis of Thyroglobulin Elevation Negative Iodine Scintigraphy (TENIS) syndrome without structural disease: a retrospective cohort study
Annals of Nuclear Medicine ( IF 2.5 ) Pub Date : 2022-11-01 , DOI: 10.1007/s12149-022-01799-5
Liyi Yuan ₁ , Jing Wang ₁ , Liqin Pan ₁ , Huijuan Feng ₁ , Pan Chen ₁ , Jiaxin Luo ₁ , Jiahao Xie ₁ , Xiaoli Xiong ₁ , Juqing Wu ₁ , Wei Ouyang ₁

Affiliation

Background

For differentiated thyroid cancer (DTC) patients with thyroglobulin (Tg) elevation and negative iodine scintigraphy (commonly termed "TENIS" syndrome) after thyroidectomy, radioactive iodine (RAI) therapy, and thyroid-stimulating hormone (TSH) suppression therapy, empirical RAI therapy may be considered. However, the outcome data of TENIS syndrome without structural disease after empirical RAI therapy have not shown clear evidence of improvement in survival. We assessed the efficacy of such empirical RAI therapy in TENIS syndrome without structural disease and evaluated the progression-free survival (PFS).

Methods

A total of 80 papillary thyroid cancer (PTC) patients with TENIS syndrome without structural disease were included in this retrospective study. 52 patients were treated with empirical RAI therapy while another 28 patients were untreated. The progression-free survival (PFS) of both groups was defined as the main outcome. The secondary outcome was the comparison of serum Tg levels 12 months after being diagnosed as TENIS syndrome.

Results

The PFS of the empirical RAI therapy group was better than the untreated group (p < 0.001). Moreover, there was significant difference in Tg normalization between patients treated with empirical therapy and without treatment (p = 0.001). Empirical RAI therapy (p = 0.001) predicts better PFS. Male gender (p = 0.041) and empirical RAI therapy (p = 0.002) predict better remission in serum Tg level.

Conclusion

Patients with TENIS syndrome without structural disease can benefit from empirical RAI therapy in both PFS and Tg normalization.

中文翻译：

基于甲状腺球蛋白升高负碘闪烁显像 (TENIS) 综合征，无结构性疾病的分化型甲状腺癌患者接受经验性放射性碘治疗的结果：一项回顾性队列研究

背景

对于甲状腺切除术、放射性碘 (RAI) 治疗和促甲状腺激素 (TSH) 抑制治疗后出现甲状腺球蛋白 (Tg) 升高和负碘显像（通常称为“TENIS”综合征）的分化型甲状腺癌 (DTC) 患者，经验性 RAI 治疗可以考虑。然而，经验性 RAI 治疗后没有结构性疾病的 TENIS 综合征的结果数据并未显示出生存改善的明确证据。我们评估了这种经验性 RAI 治疗在无结构性疾病的 TENIS 综合征中的疗效，并评估了无进展生存期 (PFS)。

方法

共有 80 名患有 TENIS 综合征且无结构性疾病的乳头状甲状腺癌 (PTC) 患者被纳入该回顾性研究。52 名患者接受了经验性 RAI 治疗，另外 28 名患者未接受治疗。两组的无进展生存期（PFS）被定义为主要结果。次要结果是比较被诊断为 TENIS 综合征后 12 个月的血清 Tg 水平。

结果

经验性 RAI 治疗组的 PFS 优于未治疗组 ( p < 0.001)。此外，接受经验性治疗和未接受治疗的患者之间的 Tg 正常化存在显着差异 ( p = 0.001)。经验性 RAI 治疗 ( p = 0.001) 预测更好的 PFS。男性 ( p = 0.041) 和经验性 RAI 治疗 ( p = 0.002) 预测血清 Tg 水平的缓解更好。