Postoperative-stimulated serum thyroglobulin measured at the time of 131I ablation is useful for the prediction of disease status in patients with differentiated thyroid carcinoma

Lee, Ji In; Chung, Yun Jae; Cho, Bo Youn; Chong, Semin; Seok, Ju Won; Park, Sung Jun

doi:10.1016/j.surg.2012.12.008

Cited by 61 publications

(37 citation statements)

References 21 publications

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“…In patients without evidence of TgAb, the TSH-stimulated Tg is a reliable marker for evaluating for the presence or absence of residual disease (see Section D2). In a recent study examining 218 consecutive adult DTC patients across all ATA risk stratification levels, a TSH-stimulated Tg < 2 ng/mL had a 94.9% predictive value for the absence of disease (201).…”

Section: Recommendation Rating: Bmentioning

confidence: 99%

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

1,011

1,365

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Background: Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. Methods: A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects £ 18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. Results: These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided.

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Section: Recommendation Rating: Bmentioning

confidence: 99%

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

1,011

1,365

View full text Add to dashboard Cite

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“…Stimulated thyroglobulin ranged from 0.5 to 273.4 ng/ml [17]. Remission was defined as the absence of a detectable biochemical disease (TSH-stimulated thyroglobulin <1.0 ng/ml), and structural disease as assessed by either a neck US or a repeat DxWBS.…”

Section: Methodsmentioning

confidence: 99%

Pediatric Thyroid Carcinoma in Patients with Graves' Disease: The Role of Ultrasound in Selecting Patients for Definitive Therapy

Aj²,

Ej³

et al. 2015

Horm Res Paediatr

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Background/Aims: Pediatric Graves' disease (GD) accounts for 10-15% of all thyroid disorders in patients ≤18 years and is treated with antithyroid medication or definitive therapy [radioactive iodine (RAI) ablation vs. surgery]. Patients with GD may have concurrent differentiated thyroid cancer (DTC). DTC prevalence in pediatric GD is not well established. We examined the prevalence of DTC in pediatric GD and the role of preoperative thyroid ultrasound (US) in selecting the appropriate definitive therapy. Methods: This is a single-institution, retrospective, cross-sectional study of 32 GD patients with a median age of 11 years (range 3-18) who underwent total thyroidectomy as the definitive treatment between 2005 and 2014. Results: DTC was identified in 22% of the GD patients. A total of 97% completed preoperative thyroid US, and thyroid nodules were identified in 13/32 patients (41%). Preoperative fine needle aspiration (FNA) biopsy was performed in 6/13 patients, accounting for four preoperative diagnoses of concurrent DTC. Extra-thyroidal extension was present in 4/7 (63%), regional lymph node metastasis in 3/7 (43%), and lung metastasis in 2/7 patients (29%). Conclusions: Concurrent DTC occurs in pediatric GD patients. Thyroid US is an efficient tool for selecting patients for thyroidectomy. For patients with a nodule on US before definitive therapy, FNA should be performed to appropriately select thyroidectomy versus RAI ablation.

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“…Appendix A; for all online supplementary material, see www. karger.com/doi/10.1159/000489849) [7]. Depending on clinicopathological tumor features, patients are divided into four risk categories.…”

Section: Risk Stratificationmentioning

confidence: 99%

Prognostic Value of Stimulated Thyroglobulin Levels at the Time of Radioiodine Administration in Differentiated Thyroid Cancer

et al. 2018

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Objective: The prognostic value of stimulated thyroglobulin (sTg) and Tg-related parameters prior to and immediately after radioactive iodine (RAI) administration was assessed in a cohort of patients presenting with differentiated thyroid cancer (DTC) as a predictor of recurrent or progressive structural disease. Methods: Clinical records of 180 DTC patients were retrospectively reviewed, and serum TSH, Tg, and Tg antibodies were recorded just before RAI administration (pre-) and at the time of whole body scanning (post-). Based on the results of initial staging and RAI scintigraphy, patients were divided into two groups: those who were considered to be structurally disease-free after thyroidectomy and RAI (group 1) and those who were not (group 2). Univariate analyses were performed for pre-Tg, ratioTg (post-Tg/pre-Tg), and other clinical and pathological markers for long-term outcome, as well as separate bivariate analyses focusing on pre-Tg to correct for possible confounders. Different pre-Tg cut-off values for predicting structural disease recurrence were assessed in a subgroup of patients in group 1 prepared with thyroid hormone withdrawal. Results: In group 1, (n = 166) male gender, higher T-stage and both Tg-related parameters proved to be significant risk factors for structural disease relapse. Of all candidate variables, only higher T-stage served to predict progressive structural disease in group 2 (n = 14). Subgroup analysis showed a negative predictive value of 91.67% for pre-Tg < 10 µg/L. Conclusion: The sTg value at the time of RAI administration may be helpful in predicting structural disease recurrence in patients with DTC.

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Postoperative-stimulated serum thyroglobulin measured at the time of 131I ablation is useful for the prediction of disease status in patients with differentiated thyroid carcinoma

Cited by 61 publications

References 21 publications

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Pediatric Thyroid Carcinoma in Patients with Graves' Disease: The Role of Ultrasound in Selecting Patients for Definitive Therapy

Prognostic Value of Stimulated Thyroglobulin Levels at the Time of Radioiodine Administration in Differentiated Thyroid Cancer

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