Clinical studies on treatment and follow-up in differentiated thyroid carcinoma

Abstract

In this thesis several studies on the treatment and follow-up of differentiated thyroid carcinoma are reported. Several results are worth noticing. In this thesis it is shown that administering 40 MBq I-131 before I-131 ablation reduces the success rate of I-131 ablation by half. Furthermore, it is shown that successful ablation is an important indicator of favourable prognosis: recurrence and mortality rates are clearly lower among those in whom the first, ablative I-131 activity is successful in eradicating all disease. It is shown that patients can effectively be considered 'cured' after successful ablation. Another noteworthy results in this thesis concerns the finding that Heterophile antibodies interfere in the measurement of thyroglobulin (a tumour marker used in the follow-up of differentiated thyroid carcinoma) in a significant percentage of patients; so much so that treatment should be changed in nearly 10 percent of patients. The thesis concludes with a discussion on the implications of the current findings as well as a view on the future of differentiated thyroid carcinoma research.