Is Thyroid Cancer Recurrence Risk Increased After Transplantation?

Context: An increased cancer mortality is reported in transplanted patients. Objective: This multicentric study aimed to investigate the rate of thyroid cancer recurrence after transplantation. Results: Sixty-eight patients (35 male/33 female) with a history of both thyroid cancer and organ transpla...

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Published in:The journal of clinical endocrinology and metabolism 2013-10, Vol.98 (10), p.3981-3988
Main Authors: Tisset, Hélène, Kamar, Nassim, Faugeron, Isabelle, Roy, Pascal, Pouteil-Noble, Claire, Klein, Marc, Mourad, Georges, Drui, Delphine, Do Cao, Christine, Leenhardt, Laurence, Allix, Ingrid, Bonichon, Françoise, Morelon, Emmanuel, Leboulleux, Sophie, Kelly, Antony, Niccoli, Patricia, Toubert, Marie-Elisabeth, Frimat, Luc, Vantyghem, Marie-Christine, Bournaud, Claire, Schlumberger, Martin, Borson-Chazot, Françoise, the TUTHYREF network
Format: Article
Language:English
Subjects:
Adenocarcinoma, Follicular - epidemiology
Adenocarcinoma, Follicular - pathology
Adenocarcinoma, Follicular - surgery
Adolescent
Adult
Aged
Biological and medical sciences
Carcinoma, Papillary - epidemiology
Carcinoma, Papillary - pathology
Carcinoma, Papillary - surgery
Child
Disease-Free Survival
Endocrinopathies
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Humans
Incidence
Male
Malignant tumors
Medical sciences
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - etiology
Neoplasm Recurrence, Local - pathology
Organ Transplantation - adverse effects
Risk
Thyroid Neoplasms - epidemiology
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroid. Thyroid axis (diseases)
Treatment Outcome
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vertebrates: endocrinology
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Summary:Context: An increased cancer mortality is reported in transplanted patients. Objective: This multicentric study aimed to investigate the rate of thyroid cancer recurrence after transplantation. Results: Sixty-eight patients (35 male/33 female) with a history of both thyroid cancer and organ transplantation were recruited via two nationwide French networks. Histological analysis identified 58 papillary (88%), 5 follicular (7.5%), and 3 poorly differentiated cancer cases (4.5 %). Thirty-one patients (52%) presented high recurrence risk tumors. In the 36 patients with thyroid cancer diagnosed after transplantation, the 5-year disease-free survival (DFS) was 74.7% (SE: 7.3%). One patient died after progression of a poorly differentiated cancer. Persistent disease was observed in six high-risk patients. One of them underwent a second transplantation and disease remained stable after 5 years of follow-up. Thyroid cancer had been diagnosed before transplantation in 32 patients. One patient with cystic fibrosis and thyroid lung metastases at the time of lung transplantation underwent a 4-year remission. For the 31 patients in remission at the time of transplantation, the 5-year DFS was 93.1% (SE: 4.8%). Two patients with local recurrence presented subsequent remission. For the entire study population, the 5-year and 9-year DFS were 81.9% (SE: 5.5%) and 75.6% (SE: 7.9%), respectively. Recurrence or persistent disease occurred in patients with high-risk tumors. Conclusions: The prognosis of thyroid cancer does not seem to be altered by transplantation. This suggests that a history of thyroid cancer should not be considered a contraindication.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2013-1357