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Publications (2)12.62 Total impact

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    ABSTRACT: Background:No long-term follow-up data are available for differentiated thyroid carcinoma (DTC) patients prepared with either exogenous or endogenous TSH and treated with low-activity (1.1 GBq [30 mCi]) radioiodine ((131)I).Aim:The aim of this study was to evaluate the 10-year follow-up of DTC patients who underwent remnant ablation with 1.1 GBq of (131)I after levothyroxine (LT4) withdrawal, or following recombinant human TSH (rhTSH) administration, or both.Patients:159 DTC patients treated with total thyroidectomy and 1.1 GBq (30 mCi) of (131)I for remnant ablation and stimulated with rhTSH and/or endogenous TSH were separated into ablated (n=115) and not ablated (n=44) patients and prospectively followed-up for at least 10 years. Besides, we evaluated several features that could correlate with the final status of patients.Results:During the follow-up, 4/115 (3.5%) ablated patients showed a recurrence and one was successfully cured. Among not ablated patients, 16/44 (36.4%) had a persistent disease. At the end of the 10-year follow-up, 140/159 (88.1%) patients were disease-free while 19/159 (11.9%) remained affected. No correlation was found with the type of TSH stimulation and no other clinical and pathological features showed any correlation with the final status. However, low levels of stimulated serum thyroglobulin (<5.4 ng/ml) at first control after remnant ablation identified a subgroup of not ablated patients who became spontaneously cured.Conclusions:Long-term outcomes are similar in DTC patients treated with 1.1 GBq (30 mCi) of (131)I and prepared either with rhTSH or endogenous TSH. It is of interest that serum thyroglobulin at first control after ablation can have a prognostic role.
    The Journal of Clinical Endocrinology and Metabolism 04/2013; · 6.31 Impact Factor
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    ABSTRACT: Background: Evidence for an increased prevalence of BRAF(V600E) mutations has been documented in recent decades. The aim of this study was to evaluate the prevalence of both RET/PTC rearrangements and BRAF(V600E) mutations in an Italian cohort of papillary thyroid carcinoma (PTC) patients followed at the Endocrine Units of Pisa, Milano, and Perugia from 1996-2010. Patients and Methods: In total, 401 PTC patients were examined and grouped according to the time of surgery: group 1, 1996-2000; group 2, 2001-2005; and group 3, 2006-2010. Patients were analyzed for clinical, pathological, and molecular features. In parallel, the molecular characteristics of 459 PTC from Sicily were studied. Results: The genetic profiles of the three groups were significantly different (P < 0.0001). In particular, the frequency of RET/PTC rearrangements decreased from 1996-2010, occurring in 33 of 100 (33%) of the patients in group 1, 26 of 148 (17%) in group 2, and 15 of 153 (9.8%) in group 3. The incidence of BRAF(V600E) mutations increased over the same period, from 28% in group 1 (28 of 100) to 48.9% in group 2 (73 of 148) and 58.1% in group 3 (89 of 153). A consistent increase in BRAF(V600E) prevalence was observed in the Sicilian group (P < 0.0001). Moreover, a statistically significant increase in the mean age at diagnosis and decrease in tumor size over the study period was observed. Conclusion: The genetic profile of PTC changed over the last 15 yr, with a significant decrease in the prevalence of RET/PTC rearrangements and an increase in BRAF(V600E) mutations. In addition, the mean age at diagnosis increased and tumor size decreased over the study period.
    The Journal of Clinical Endocrinology and Metabolism 06/2012; 97(9):E1758-65. · 6.31 Impact Factor