Long-Term Follow-Up of Patients with Papillary and Follicular Thyroid Cancer: A Prospective Study on 715 Patients

Abstract

This large prospective cohort of patients presented a low rate of recurrence. Initial Tg measurements allow to predict long-term recurrence with an excellent specificity. Stimulated Tg determination presented a slightly higher sensitivity than Tg determination on LT4. TSH stimulation may be avoided when Tg measured 3 months after ablation is less than 0.27 ng/ml during LT4 treatment.

High Negative Predictive Value (NPV) Of Undetectable TSH Stimulated Tg For Disease Recurrence In Both Low And High Risk Differentiated Thyroid Cancer

“…There are several other studies confirming a high NPV of TSHstimulated Tg measurement [2,5,[9][10][11][12]. Although our center uses a different Tg measurement method, our results are consistent with recent publications about this subject.…”

Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors

“…Numerous studies have been performed on the diagnostic value of serum Tg measurement and have found that it is a highly sensitive means of detecting metastases (19). Moreover, Tg level was an independent prognostic indicator for disease-free remission and death (20,21). It was thought that the serum Tg level under TSH elevation (O30 mU/l) was the most reliable indicator for persistent or recurrent disease.…”

“…These corresponded well with the favorable prognostic factors of OS and suggested that decreased serum Tg indicates the effectiveness of radioiodine therapy. However, serum Tg was only reliable if TgAb was undetectable, otherwise serum Tg level could have been falsely lowered (21). Thus, patients with positive antibodies were excluded from the study.…”

Correlation of Consecutive Serum Thyroglobulin Levels During Hormone Withdrawal and Failure of Initial Radioiodine Ablation in Thyroid Cancer Patients

“…Among these predictors, preablation Tg >5 ng/ml was the most significant predictive factor for ablation failure [14]. A meta-analysis of 3,947 patients by Brassard et al demonstrated that the preablation Tg level was a useful negative predictor of persistent and recurrent DTC, with a negative predictive value (NPV) of 94 % when the preablation Tg value was less than 10 ng/ml [15]. These findings were in line with the results of our study, where preablation Tg greater than 5.6 ng/ml was a significant predictive factor for ablation failure.…”