Table 2.
Main outcomes in patients with differentiated thyroid cancer (DTC) diagnosed during pregnancy or within 12 months of childbirth.
| Study | Timing of surgery (study group) | Outcomes | Main study results | Comments and others outcomes |
|---|---|---|---|---|
| Vannucchi et al., 2010 [1] | (i) 11 patients operated during pregnancy and (ii) 4 patients operated after deliveryd |
(i) Persistent or recurrent disease detected by highly sensitive Tg and rhTSH (ii) ERα tumor expression by IHC |
(i) ↑Persistent/recurrent disease in G2 versus G1 and G3 (60% versus 4.2% and 13.1%)a (ii) ↑ERα tumor expression in G2 versus G1 and G3 (87.5% versus 31% and 0%)b |
(i) PTC more frequent in G1 and G3 versus G2 (97.8% and 98.3% versus 80%)c (ii) DTC was an incidental finding more frequently in G1 and G3 (iii) More sensitive methods for detecting recurrence were used in this study when compared with others (iv) Conclusion: pregnancy has a negative impact on the outcome of DTC |
| Yasmeen et al., 2005 [2] | (i) 96 patients operated during pregnancy and (ii) 27 patients operated after deliverye |
Overall survival | No difference in survival between pregnancy-associated thyroid cancer and aged-matched nonpregnant women with DTC | Persistent/recurrent disease was not evaluated |
| Moosa and Mazzaferri, 1997 [3] | (i) 14 patients operated during pregnancy and (ii) 47 patients operated after delivery |
(i) Death (ii) Recurrence diagnosed by biopsy, or by 131I uptake in distant site |
No difference in cancer recurrence and death in study and control groups | (i) Outcomes similar in patients operated after delivery and during pregnancy (ii) Fewer pregnant patients showed symptoms associated with thyroid nodules when compared with nonpregnant (74% versus 43%)b |
| Herzon et al., 1994 [4] | (i) 6 patients operated during pregnancy and (ii) 16 patients operated after delivery |
Overall survival | No difference in survival between pregnancy-associated thyroid cancer and aged-matched nonpregnant women with DTC | |
PTC: papillary histotype; Tg: serum thyroglobulin; rhTSH: recombinant human TSH; ERα: estrogen receptor alfa; G: group; G1: DTC diagnosed at least one year after pregnancy, G2: DTC diagnosed during pregnancy, G3: DTC diagnosed in nulliparous women or before pregnancy; aP < 0.0001; bP = 0.01; cP < 0.0001; d1 patient was considered twice: she had two tumors in two different pregnancies; eIn patients with DTC diagnosed during pregnancy.