Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies

Objective: To evaluate differences in the presentation, diagnostic/therapeutic approaches, and outcome of differentiated thyroid cancer (DTC) in an Italian and a Dutch referral centre. Methods: We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the two cohorts as a whole...

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Main Authors: Daniele Ceruti, Petronella B Ottevanger, Simone De Leo, Han J Bonenkamp, Carla Colombo, Martin Gotthardt, Laura Fugazzola, Romana T Netea-Maier
Format: Article
Language:English
Published: Bioscientifica 2025-08-01
Series:European Thyroid Journal
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Online Access:https://etj.bioscientifica.com/view/journals/etj/14/4/ETJ-25-0161.xml
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author Daniele Ceruti
Petronella B Ottevanger
Simone De Leo
Han J Bonenkamp
Carla Colombo
Martin Gotthardt
Laura Fugazzola
Romana T Netea-Maier
author_facet Daniele Ceruti
Petronella B Ottevanger
Simone De Leo
Han J Bonenkamp
Carla Colombo
Martin Gotthardt
Laura Fugazzola
Romana T Netea-Maier
author_sort Daniele Ceruti
collection DOAJ
description Objective: To evaluate differences in the presentation, diagnostic/therapeutic approaches, and outcome of differentiated thyroid cancer (DTC) in an Italian and a Dutch referral centre. Methods: We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the two cohorts as a whole and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan–Meier curves were used to compare progression-free survival (PFS) and disease-specific survival (DSS). Results: Several differences (P < 0.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high-risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment and more additional treatments during follow-up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P < 0.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10 and 1% for the Dutch and Italian cohorts, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both. Conclusion: Data reported in the present comparison between two European countries highlight a different prevalence, presentation, and outcome of DTC, likely due to variabilities in healthcare systems, iodine nutritional status, and diagnostic and treatment approaches.
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spelling doaj-art-532c272dd2df4993b8bcb95932bd41f42025-08-20T03:36:13ZengBioscientificaEuropean Thyroid Journal2235-08022025-08-0114410.1530/ETJ-25-01611Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategiesDaniele Ceruti0Petronella B Ottevanger1Simone De Leo2Han J Bonenkamp3Carla Colombo4Martin Gotthardt5Laura Fugazzola6Romana T Netea-Maier7Department of Biotechnology and Translational Medicine, University of Milan, Milan, ItalyDepartment of Medical Oncology, Radboud University Medical Centre, Nijmegen, The NetherlandsDepartment of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, ItalyDepartment of Surgery, Radboud University Medical Centre, Nijmegen, The NetherlandsDepartment of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, ItalyDeparment of Medical Imaging (Nuclear Medicine), Radboud University Medical Centre, Nijmegen, The NetherlandsDepartment of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, ItalyDivision of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The NetherlandsObjective: To evaluate differences in the presentation, diagnostic/therapeutic approaches, and outcome of differentiated thyroid cancer (DTC) in an Italian and a Dutch referral centre. Methods: We retrospectively included 919 patients (586 Italian, 333 Dutch), and compared the two cohorts as a whole and according to ATA risk classes. Dynamic risk stratification (DRS) and Kaplan–Meier curves were used to compare progression-free survival (PFS) and disease-specific survival (DSS). Results: Several differences (P < 0.001) were found in clinicopathological features and in diagnostic/therapeutic modalities. The Dutch cohort had a higher age at diagnosis, a higher number of patients presenting with metastatic disease, and patients with stage III/IV. Most Italian patients showed a low/intermediate ATA risk, while high-risk patients represented half of the Dutch cohort. The Dutch cohort received a more intensive first treatment and more additional treatments during follow-up (i.e. surgery, radiotherapy, and systemic treatments). DRS analysis showed comparable excellent and biochemical incomplete responses, while the Dutch cohort had a lower rate of indeterminate and a higher rate of structural incomplete responses (P < 0.001). The Dutch cohort had a significantly worse 5-year PFS, and TC-related mortality was 10 and 1% for the Dutch and Italian cohorts, respectively, in line with the higher rate of advanced disease at presentation, with DSS still excellent for both. Conclusion: Data reported in the present comparison between two European countries highlight a different prevalence, presentation, and outcome of DTC, likely due to variabilities in healthcare systems, iodine nutritional status, and diagnostic and treatment approaches.https://etj.bioscientifica.com/view/journals/etj/14/4/ETJ-25-0161.xmlthyroid canceroverdiagnosisoutcomeradioiodinethyroglobulin
spellingShingle Daniele Ceruti
Petronella B Ottevanger
Simone De Leo
Han J Bonenkamp
Carla Colombo
Martin Gotthardt
Laura Fugazzola
Romana T Netea-Maier
Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
European Thyroid Journal
thyroid cancer
overdiagnosis
outcome
radioiodine
thyroglobulin
title Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
title_full Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
title_fullStr Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
title_full_unstemmed Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
title_short Differentiated thyroid cancer in two European referral centres: impact of different diagnostic and therapeutic strategies
title_sort differentiated thyroid cancer in two european referral centres impact of different diagnostic and therapeutic strategies
topic thyroid cancer
overdiagnosis
outcome
radioiodine
thyroglobulin
url https://etj.bioscientifica.com/view/journals/etj/14/4/ETJ-25-0161.xml
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