Thyroglobulin assay 4 weeks after thyroidectomy predicts outcome in low-risk papillary thyroid carcinoma

Giovanella, Luca; Ceriani, Luca; Ghelfo, Antonella; Keller, Franco

doi:10.1515/cclm.2005.142

Cited by 47 publications

(40 citation statements)

References 16 publications

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“…In 12% of the patients with initially M0 disease tumor recurrence was seen during follow-up, which is in agreement with previous publications by others (10)(11)(12). All patients had been treated by near-total thyroidectomy and subsequent ablation with radioiodine approximately 6 weeks after surgery.…”

Section: Discussionsupporting

confidence: 92%

“…values measured after hormonal withdrawal, clearly identifies persistent or recurrent disease. In a study by Giovanella et al (11), post-surgery Tg levels above 4.5 mg/l identified 94% of patients with metastasis, which, according to the authors, could be taken into account in treatment planning. Bernier et al showed that Tg values measured at the time of ablation and 5 days later expressed as TgD5/TgD0 ratio were highly suggestive for treatment failure (22).…”

Section: Discussionmentioning

confidence: 99%

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

Verkooijen¹,

Rietbergen²,

Smit³

et al. 2007

eur j endocrinol

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

Verkooijen¹,

Rietbergen²,

Smit³

et al. 2007

eur j endocrinol

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show abstract

“…This is significantly lower than 82.7% achieved by Lee at al (2010). Possible explanation for this discordance is significantly lower baseline median STg level of 2.6 ng/ml in their study and it is an established fact that baseline STg level is a direct indicator of bulk of residual functioning tissue in low risk patients and residual tissue over neck and functioning nodal and distant metastasis in high risk patients (Giovanella et al, 2005). Researchers have failed to prove association between mRNA based marker oncofetal fibronectin (onfFN mRNA) with thyroid metastases (Sritara et al, 2012).…”

Section: Discussionmentioning

confidence: 91%

Baseline Stimulated Thyroglobulin Level as a Good Predictor of Successful Ablation after Adjuvant Radioiodine Treatment for Differentiated Thyroid Cancers

Fatima

Zaman²,

Ikram³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To determine the predictive value of the baseline stimulated thyroglobulin (STg) level for ablation outcome in patients undergoing adjuvant remnant radioiodine ablation (RRA) for differentiated thyroid carcinoma (DTC). Materials and Methods: This retrospective study accrued 64 patients (23 male and 41 female; mean age of 40±14 years) who had total thyroidectomy followed by RRA for DTC from January 2012 till April 2014. Patients with positive anti-Tg antibodies and distant metastasis on post-ablative whole body iodine scans (TWBIS) were excluded. Baseline STg was used to predict successful ablation (follow-up STg <2 ng/ml, negative diagnostic WBIS and negative ultrasound neck) at 7-12 months follow-up. Results: Overall, successful ablation was noted in 37 (58%) patients while ablation failed in 27 (42%). Using the ROC curve, a cut-off level of baseline STg level of ≤14.5 ng/ml was found to be most sensitive and specific for predicting successful ablation. Successful ablation was thus noted in 25/28 (89%) of patients with baseline STg ≤ 14.5 ng/ml and 12/36 (33%) patients with baseline STg >14.5 ng/ml ((p value <0.05). Age >40 years, female gender, PTS >2 cm, papillary histopathology, positive cervical nodes and positive TWBIS were significant predictors of ablation failure. Conclusions: We conclude that in patients with total thyroidectomy followed by I-131 ablation for DTC, the baseline STg level is a good predictor of successful ablation based on a stringent triple negative criteria (i.e. follow-up STg < 2 ng/ ml, a negative DWBIS and a negative US neck).

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“…analizaron 156 pacientes a 12 meses, obteniendo un VPN y VPP de 99% y 51% respectivamente con un punto de corte de pTg de 4,5 ng/mL. Piccardo y cols., en el año 2010 evaluaron 169 pacientes con seguimiento de 2 años, obteniendo un VPN de 100% para un punto de corte de pTg de 10 ng/mL 12,13 . Estos serían pacientes en los que eventualmente podría no ser necesario realizar sTg estimulada durante el seguimiento, considerando el bajo riesgo de recurrencia que le otorgaría el tener una pTg baja.…”

Section: Discussionunclassified

Importancia de la tiroglobulina sérica preablativa en la predicción de sobrevida libre de enfermedad en cáncer diferenciado de tiroides

2013

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Thyroglobulin assay 4 weeks after thyroidectomy predicts outcome in low-risk papillary thyroid carcinoma

Abstract: The post-surgery thyroglobulin level could be systematically assayed in patients with pT1-papillary thyroid carcinoma and taken into account in planning treatment.

Cited by 47 publications

References 16 publications

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

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

Baseline Stimulated Thyroglobulin Level as a Good Predictor of Successful Ablation after Adjuvant Radioiodine Treatment for Differentiated Thyroid Cancers

Importancia de la tiroglobulina sérica preablativa en la predicción de sobrevida libre de enfermedad en cáncer diferenciado de tiroides

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