Outcomes of long-term combined treatment in follicular thyroid carcinoma

Zenonas Baranauskas, Konstantinas Povilas Valuckas, Sigitas Tiškevičius

Institute of Oncology, Vilnius University, Lithuania

Key words: follicular carcinoma; thyroidectomy; ¹³¹J; thyroxine; thyroglobulin.

Summary. The aim was to analyze the impact of combined treatment (thyroidectomy + radioactive iodine treatment + hormonotherapy with thyroxine) on the outcomes of patients with follicular thyroid carcinoma.

Material and methods. This retrospective study included 448 patients with follicular carcinoma (394 females, 54 males, mean age of 48 years (95% CI, 46–50 years) who were treated at the Institute of Oncology, Vilnius University, from 1982 to 2006. All the patients underwent thyroidectomy. Hypothyroid patients 3–12 weeks after surgical treatment were treated with moderate radioiodine doses (1.11–3.7 GBq), and these doses were administered every 3–4 months. The patients with follicular thyroid carcinoma were given suppressive doses of thyroxine after combined treatment. The patients treated were regularly observed by gamma camera; every 6–12 months, serum thyroglobulin was evaluated.

Results. The remnants of thyroid tissue were detected in all 448 patients after thyroidectomy and radioiodine therapy. Radioiodine at mean total doses of 5.6±0.2 GBq was used to destroy the remnants of thyroid tissue. For patients with disseminated forms of follicular thyroid carcinoma, mean total radioiodine doses of 19.5±3.1 GBq were used. Majority (91.2%) of the patients were euthyroid or hyperthyroid after the treatment with thyroid hormone. All the patients treated had the level of serum thyroglobulin of 1.1±0.2 ng/mL. The overall 10-, 20-, and 30-year survival of patients with follicular thyroid cancer, who received combined treatment, was 91.2%, 81.9%, and 77.1%, respectively.

Conclusion. Combined treatment (thyroidectomy + radioactive iodine treatment + hormonotherapy with thyroxine) administered to the patients with follicular thyroid carcinoma is highly effective, because overall 10-, 20-, 30-year survival was 91.2%, 81.9%, 77.1%, respectively.

Correspondence to Z. Baranauskas, Institute of Oncology, Vilnius Universitety, Santariškių 1, 08660 Vilnius, Lithuania. E-mail: zenonas.baranauskas@vuoi.lt

Received 15 April 2009, accepted 6 April 2010