Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study

BackgroundR adioiodine-refractory (RR) disease drives morbidity and mortality in advanced differentiated thyroid cancer (aDTC) and yet real-world longitudinal data from the Iberian Peninsula are sparse. Objectives To characterize clinical features, multidisciplinary management, and outcomes of RR-DT...

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Autores: Lopez, CL, Sambo, M, Orcajo-Rincon, L, Durán-Poveda, M, García, JRV, Santos, RJ, Muñoz, ML, Navarro-González, E, Aller, J, Pubul, V, Guadalix, S, Crespo, G, González, C, Zafon, C, Navarro, M, Sandi, JS, Segura, A, Gajate, P, Gomez-Balaguer, M, Valdivia, J, Reverter, JL, Galofré, JC, Castelo, B, Villanueva, MJ, Argüelles, I, Casas, JAV
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p20063
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/20063
Access Level:acceso abierto
Palabra clave:Radioiodine-refractory differentiated thyroid cancer
Advanced differentiated thyroid cancer
Epidemiological study
Survival prognostic factors
ERUDIT study
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spelling Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT studyLopez, CLSambo, MOrcajo-Rincon, LDurán-Poveda, MGarcía, JRVSantos, RJMuñoz, MLNavarro-González, EAller, JPubul, VGuadalix, SCrespo, GGonzález, CZafon, CNavarro, MSandi, JSSegura, AGajate, PGomez-Balaguer, MValdivia, JReverter, JLGalofré, JCCastelo, BVillanueva, MJArgüelles, ICasas, JAVRadioiodine-refractory differentiated thyroid cancerAdvanced differentiated thyroid cancerEpidemiological studySurvival prognostic factorsERUDIT studyBackgroundR adioiodine-refractory (RR) disease drives morbidity and mortality in advanced differentiated thyroid cancer (aDTC) and yet real-world longitudinal data from the Iberian Peninsula are sparse. Objectives To characterize clinical features, multidisciplinary management, and outcomes of RR-DTC within a multicenter Iberian cohort, and to explore prognostic factors, including the impact of de novo versus recurrent/progressive presentation. Methods Multicenter, retrospective cohort of adults with aDTC diagnosed in 2007-2012 at 23 Spanish/Portuguese centers, with follow-up until 2017. Baseline demographic and clinical characteristics, local/systemic treatments used, progression-free survival (PFS) on first-line systemic therapy (ST), overall survival (OS) from RR-DTC, and survival prognostic factors were assessed. An exploratory illness-death multistate Markov model complemented Kaplan-Meier analyses for mortality from initial diagnosis. Missing data were not imputed. Results Of 213 aDTC patients, 165 (77.5%) met >= 1 RR-DTC criterion at any time during their follow-up. At RR-DTC diagnosis, ECOG was recorded in 92/165 (55.8%): 75 (81.5%) ECOG 0-1 and 17 (18.5%) ECOG 2-4. Management included watchful waiting (WW) in 79/165 (47.9%), locoregional therapy in 83/165 (50.3%), and ST in 61/165 (37.0%), predominantly sorafenib. Median PFS on first-line ST was 16.0 months (95% CI 9.2-29.9). Median OS from RR-DTC diagnosis was 4.7 years (3.4-8.0), shorter for de novo aDTC versus recurrent/progressive eDTC (3.0 vs 8.0 years; log-rank p < 0.0001). In multivariable analyses, age < 55 years and WW >= 30 months were associated with longer OS, while de novo aDTC and ECOG 2-4 were associated with higher mortality. From initial DTC diagnosis, the multistate model showed higher cumulative mortality for RR-DTC versus non-RR-DTC (HR 3.22; p < 0.001). Conclusions In this Iberian cohort, RR-DTC was frequent and often managed within MDTs, with substantial WW use. De novo aDTC and poor performance status were associated with worse survival. Prolonged WW appeared associated with longer OS, but this likely reflects selection and lead/immortal-time biases underscoring the need for prospective validation.SPRINGER INT PUBL AG2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/20063Clinical & Translational OncologyISSN: 1699048XISSNe: 16993055reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p200632026-06-11T12:45:17Z
dc.title.none.fl_str_mv Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
title Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
spellingShingle Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
Lopez, CL
Radioiodine-refractory differentiated thyroid cancer
Advanced differentiated thyroid cancer
Epidemiological study
Survival prognostic factors
ERUDIT study
title_short Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
title_full Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
title_fullStr Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
title_full_unstemmed Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
title_sort Clinical and treatment patterns of advanced and radioiodine-refractory differentiated thyroid cancer. ERUDIT study
dc.creator.none.fl_str_mv Lopez, CL
Sambo, M
Orcajo-Rincon, L
Durán-Poveda, M
García, JRV
Santos, RJ
Muñoz, ML
Navarro-González, E
Aller, J
Pubul, V
Guadalix, S
Crespo, G
González, C
Zafon, C
Navarro, M
Sandi, JS
Segura, A
Gajate, P
Gomez-Balaguer, M
Valdivia, J
Reverter, JL
Galofré, JC
Castelo, B
Villanueva, MJ
Argüelles, I
Casas, JAV
author Lopez, CL
author_facet Lopez, CL
Sambo, M
Orcajo-Rincon, L
Durán-Poveda, M
García, JRV
Santos, RJ
Muñoz, ML
Navarro-González, E
Aller, J
Pubul, V
Guadalix, S
Crespo, G
González, C
Zafon, C
Navarro, M
Sandi, JS
Segura, A
Gajate, P
Gomez-Balaguer, M
Valdivia, J
Reverter, JL
Galofré, JC
Castelo, B
Villanueva, MJ
Argüelles, I
Casas, JAV
author_role author
author2 Sambo, M
Orcajo-Rincon, L
Durán-Poveda, M
García, JRV
Santos, RJ
Muñoz, ML
Navarro-González, E
Aller, J
Pubul, V
Guadalix, S
Crespo, G
González, C
Zafon, C
Navarro, M
Sandi, JS
Segura, A
Gajate, P
Gomez-Balaguer, M
Valdivia, J
Reverter, JL
Galofré, JC
Castelo, B
Villanueva, MJ
Argüelles, I
Casas, JAV
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Radioiodine-refractory differentiated thyroid cancer
Advanced differentiated thyroid cancer
Epidemiological study
Survival prognostic factors
ERUDIT study
topic Radioiodine-refractory differentiated thyroid cancer
Advanced differentiated thyroid cancer
Epidemiological study
Survival prognostic factors
ERUDIT study
description BackgroundR adioiodine-refractory (RR) disease drives morbidity and mortality in advanced differentiated thyroid cancer (aDTC) and yet real-world longitudinal data from the Iberian Peninsula are sparse. Objectives To characterize clinical features, multidisciplinary management, and outcomes of RR-DTC within a multicenter Iberian cohort, and to explore prognostic factors, including the impact of de novo versus recurrent/progressive presentation. Methods Multicenter, retrospective cohort of adults with aDTC diagnosed in 2007-2012 at 23 Spanish/Portuguese centers, with follow-up until 2017. Baseline demographic and clinical characteristics, local/systemic treatments used, progression-free survival (PFS) on first-line systemic therapy (ST), overall survival (OS) from RR-DTC, and survival prognostic factors were assessed. An exploratory illness-death multistate Markov model complemented Kaplan-Meier analyses for mortality from initial diagnosis. Missing data were not imputed. Results Of 213 aDTC patients, 165 (77.5%) met >= 1 RR-DTC criterion at any time during their follow-up. At RR-DTC diagnosis, ECOG was recorded in 92/165 (55.8%): 75 (81.5%) ECOG 0-1 and 17 (18.5%) ECOG 2-4. Management included watchful waiting (WW) in 79/165 (47.9%), locoregional therapy in 83/165 (50.3%), and ST in 61/165 (37.0%), predominantly sorafenib. Median PFS on first-line ST was 16.0 months (95% CI 9.2-29.9). Median OS from RR-DTC diagnosis was 4.7 years (3.4-8.0), shorter for de novo aDTC versus recurrent/progressive eDTC (3.0 vs 8.0 years; log-rank p < 0.0001). In multivariable analyses, age < 55 years and WW >= 30 months were associated with longer OS, while de novo aDTC and ECOG 2-4 were associated with higher mortality. From initial DTC diagnosis, the multistate model showed higher cumulative mortality for RR-DTC versus non-RR-DTC (HR 3.22; p < 0.001). Conclusions In this Iberian cohort, RR-DTC was frequent and often managed within MDTs, with substantial WW use. De novo aDTC and poor performance status were associated with worse survival. Prolonged WW appeared associated with longer OS, but this likely reflects selection and lead/immortal-time biases underscoring the need for prospective validation.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/20063
url https://fisabio.portalinvestigacion.com/publicaciones/20063
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER INT PUBL AG
publisher.none.fl_str_mv SPRINGER INT PUBL AG
dc.source.none.fl_str_mv Clinical & Translational Oncology
ISSN: 1699048X
ISSNe: 16993055
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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