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Prognostic role and characteristics of the indeterminate response in differentiated thyroid cancer: a systematic review

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Abstract

Purpose

The management of differentiated thyroid cancer (DTC) is actually based on a dynamic risk stratification based on classes of response to the therapy. Indeterminate response (IR) includes a heterogeneous group of patients with different characteristics, particularly different Tg and AbTg levels and/or imaging findings. The aim of systematic review (SR) is to evaluate the prognosis, diagnostic findings and other characteristics of patients in the IR class.

Methods

A wide literature search in the Scopus, PubMed/MEDLINE and Web of Science databases was performed to find published articles on patients with DTC and IR after treatment. The quality assessment of studies was carried out using QUADAS-2 evaluation.

Results

Eight articles were included in the systematic review. Six studies evaluated the prognosis and the prognostic factor in patients with IR, one study evaluated the role of 2-[18F]FDG PET-CT in the management of patients with IR and biochemical incomplete response and one study the risk factors for IR.

Conclusion

Patients with DTC and IR to therapy have a probability of disease relapse < 15%. Tg value could be a predictor of disease progression. The role of 2-[18F]FDG PET-CT needs to be further investigated.

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Author contributions

P.B., F.B., C.C. and V.Z. conceptualised the review; P.B. and F.D. wrote the search algorithm; P.B., F.D. and D.A. selected the studies for the review and performed the quality assessment; P.B., F.D. and E.G. wrote the main manuscript; P.B. prepared figures and tables; All authors reviewed the manuscript.

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Authors and Affiliations

  1. S.C. Medicina Nucleare, ASST Spedali Civili di Brescia, Brescia, Italy

    P. Bellini & V. Zilioli

  2. S.C. Medicina Nucleare, Università degli studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy

    F. Dondi, D. Albano & F. Bertagna

  3. S.S.D. Endocrinologia, Università degli studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy

    E. Gatta & C. Cappelli

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  1. P. Bellini
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Bellini, P., Dondi, F., Gatta, E. et al. Prognostic role and characteristics of the indeterminate response in differentiated thyroid cancer: a systematic review. Endocrine 84, 812–821 (2024). https://doi.org/10.1007/s12020-024-03688-5

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