Prognosis of Thyroid Cancer Related to Pregnancy: A Systematic Review

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 delivery^d	(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 delivery^e	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.