A new functional parameter measured at the time of ablation that can be used to predict differentiated thyroid cancer recurrence during follow-up

Abstract

Background: This study addresses the questions whether patients with a high risk for recurrent thyroid cancer can be identified at initial stage, i.e. at the time of ablation. Methods: We evaluated tumor recurrence in consecutive patients treated for differentiated thyroid cancer (DTC). Prognostic factors were statistically analyzed. We defined prognostic parameters based on thyroglobulin (Tg) levels, 24-h I-131 uptake rates and TSH values: (a) Tg/TSH, (b) Tg/24-h I-131 uptake value, and (c) Tg/(TSH!24-h I-131 uptake). Results: We included 190 patients (50 male, 140 female; mean age 47 years) with DTC for analysis, 146 without distant metastases and 44 with M1 tumor stage at initial presentation. The mean period of follow-up was 10.4 years (S.D.G3.7 years). In 18 out of the 146 DTC patients with M0 disease (12.4%), tumor recurrence was found during follow-up. Although tumor stage, age, and standard biochemical values significantly differ between patients with and without recurrent disease or between patients with M0 and M1 tumor stage, the newly defined parameter Tg/(TSH!24-h I-131 uptake) was the best independent significant prognostic parameter in the assessment whether patients will develop a tumor recurrence during follow-up or not. Conclusion: High Tg/(TSH!24-h I-131 uptake) ratios justify an adjustment of the I-131 activity for ablation therapy. To assess the optimal cut-off value for a dose adjustment, however, further studies are required in more patients, but the initial results are encouraging with respect to improving outcome in DTC patients.

Successful Complete Ablation Rate Post a Second Ablation Dose of 30 mCi Radioactive Iodine (I131) in Patients with Papillary Thyroid Cancer

“…Rubino et al, 2003 [17] hypothyroidism in addition to a longer time to achieve complete ablation [16] . Second, very high complete ablation rate [12] which may be related to small residual and absent stunning effects as well as other unknown factors related to individual differences.…”

Skull Base Metastasis From Follicular Thyroid Carcinoma -Two Case Reports-

“…33) Measurement of circulating TG to predict the recurrence of the differentiated thyroid carcinoma during follow up may be useful. 43) The calculation of TG/(TSH × 131 I uptake in 24 hrs) ratio has prognostic value in the treatment of FTC including 131 I ablation therapy.…”

The success rate of I-131 ablation in differentiated thyroid cancer: comparison of uptake-related and fixed-dose strategies

“…In the literature, it has been described that thyroid carcinoma cells take up and process iodine less efficiently than normal thyroid cells due to a lower expression of the sodium-iodine symporter (23)(24)(25). In a recently published study on prognostic parameters in thyroid cancer, both N1 and T4 tumour stages significantly correlated with a high chance on local tumour recurrences (26). Consequently, minimal residual disease could be a thorough explanation for the fact that our study did not show a statistically significant difference in ablation results between the two protocols in case of T4 and/or N1 tumours.…”