Daniele Ceruti, Petronella B Ottevanger, Simone De Leo, Han J Bonenkamp, Carla Colombo, Martin Gotthardt, Laura Fugazzola, Romana T Netea-Maier
{"title":"两个欧洲转诊中心的分化甲状腺癌:不同诊断和治疗策略的影响。","authors":"Daniele Ceruti, Petronella B Ottevanger, Simone De Leo, Han J Bonenkamp, Carla Colombo, Martin Gotthardt, Laura Fugazzola, Romana T Netea-Maier","doi":"10.1530/ETJ-25-0161","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate differences in the presentation, diagnostic/therapeutic approaches and outcome of differentiated thyroid cancer (DTC) in an Italian and in a Dutch referral centre.</p><p><strong>Methods: </strong>We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the 2 cohorts as a whole, and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan Meyer curves were used to compare progression free survival (PFS) and disease-specific survival (DSS).</p><p><strong>Results: </strong>Several differences (P <.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment, and more additional treatments during follow up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P <.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10% and 1% for the Dutch and Italian cohort, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both.</p><p><strong>Conclusions: </strong>Data reported in the present comparison between two European countries highlight a different prevalence, presentation and outcome of DTC, likely due to variabilities in health care systems, iodine nutritional status, diagnostic and treatments approaches.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies.\",\"authors\":\"Daniele Ceruti, Petronella B Ottevanger, Simone De Leo, Han J Bonenkamp, Carla Colombo, Martin Gotthardt, Laura Fugazzola, Romana T Netea-Maier\",\"doi\":\"10.1530/ETJ-25-0161\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate differences in the presentation, diagnostic/therapeutic approaches and outcome of differentiated thyroid cancer (DTC) in an Italian and in a Dutch referral centre.</p><p><strong>Methods: </strong>We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the 2 cohorts as a whole, and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan Meyer curves were used to compare progression free survival (PFS) and disease-specific survival (DSS).</p><p><strong>Results: </strong>Several differences (P <.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment, and more additional treatments during follow up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P <.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10% and 1% for the Dutch and Italian cohort, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both.</p><p><strong>Conclusions: </strong>Data reported in the present comparison between two European countries highlight a different prevalence, presentation and outcome of DTC, likely due to variabilities in health care systems, iodine nutritional status, diagnostic and treatments approaches.</p>\",\"PeriodicalId\":12159,\"journal\":{\"name\":\"European Thyroid Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Thyroid Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1530/ETJ-25-0161\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Thyroid Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1530/ETJ-25-0161","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies.
Objective: To evaluate differences in the presentation, diagnostic/therapeutic approaches and outcome of differentiated thyroid cancer (DTC) in an Italian and in a Dutch referral centre.
Methods: We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the 2 cohorts as a whole, and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan Meyer curves were used to compare progression free survival (PFS) and disease-specific survival (DSS).
Results: Several differences (P <.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment, and more additional treatments during follow up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P <.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10% and 1% for the Dutch and Italian cohort, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both.
Conclusions: Data reported in the present comparison between two European countries highlight a different prevalence, presentation and outcome of DTC, likely due to variabilities in health care systems, iodine nutritional status, diagnostic and treatments approaches.
期刊介绍:
The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.