Session: SAT 270-310-Thyroid Neoplasia (posters)
Poster Board SAT 302
Overall, structural disease progression/recurrence after pregnancy was documented in only 5% (11/235) of the patients with no significant change in the mean serum thyroglobulin levels (3.8 +/- 27 ng/mL pre-partum vs 3.7 +/-15 ng/mL post-partum). When evaluated 3-12 months after delivery, none of the patients with excellent, indeterminate or biochemical incomplete response developed structurally identifiable disease. Conversely, in those patients documented to have a structural incomplete response to therapy prior to pregnancy, structural disease progression (defined as ≥3mm increase in the size of known disease or identification of new metastatic foci) was identified after delivery in 29% (11/38): 13% with a 4-6 mm increase in the size of previously identified abnormal cervical lymph nodes, 8% with newly identified abnormal cervical lymph nodes, 5% with both increase in previously identified and newly identified abnormal cervical lymph nodes and one patient (3%) with an increase in known pulmonary metastases. However, additional therapy was recommended during the first post-partum year in only 8% (3/38) of those patients that had a structural incomplete response to therapy prior to pregnancy while the remainder (92%) continued to be followed with observation.
In summary, none of the patients with an excellent, indeterminate or biochemical incomplete response prior to pregnancy developed structurally identifiable disease after a full term delivery. Furthermore, only 8% of patients with a structural incomplete response to therapy required additional therapies during the first post-partum years. These data confirm that pre-pregnancy response to therapy status is an excellent predictor of pregnancy associated disease progression in patients previously treated for DTC.
Disclosure: RMT: Consultant, Veracyte, Inc., Consultant, Astra Zeneca, Consultant, Bayer, Inc., Consultant, Eisai, Consultant, Genzyme Corporation, Consultant, Novo Nordisk. Nothing to Disclose: LR, SF
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