Early Post-operative Stimulated Serum Thyroglobulin: Role in Preventing Unnecessary Radioactive Iodine Treatment in Low to Intermediate Risk Papillary Thyroid Cancer.

Autor:	Sezer H; Department of Endocrinology and Medicine, Koç University, Istanbul, Turkey., Yazıcı D; Department of Endocrinology and Medicine, Koç University, Istanbul, Turkey., Terzioğlu T; Department of General Surgery, American Hospital, Istanbul, Turkey., Tezelman S; Department of General Surgery, American Hospital, Istanbul, Turkey., Canbaz HB; Department of Medical Nursing, Koç University, Istanbul, Turkey., Yerlikaya A; Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, USA., Demirkol MO; Department of Nuclear Medicine, Koc University, Istanbul, Turkey., Kapran Y; Department of Pathology, Koc University, Istanbul, Turkey., Çolakoğlu B; Department of Radyology, American Hospital, Istanbul, Turkey., Çilingiroğlu EN; Department of Medical Nursing, Koç University, Istanbul, Turkey., Alagöl F; Department of Endocrinology and Medicine, Koç University, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2023 Dec; Vol. 89 (12), pp. 5996-6004. Date of Electronic Publication: 2023 Jun 13.
DOI:	10.1177/00031348231157816
Abstrakt:	Aim: The aims of the study are to evaluate the predictive value of early post-operative stimulated thyroglobulin (sTg) analysis on the recurrence risk, and to define a cut-off value that is related to recurrence risk in low to intermediate risk papillary thyroid cancer (PTC). Methods: This retrospective cohort study included individuals who were diagnosed with PTC aged 18 years or older and had been operated by experienced surgeons of a tertiary university hospital between the years 2011 and 2021. The American Thyroid Association thyroid cancer guidelines version 2015 was used as the risk stratification system. Early sTg measurement obtained at 3-4 weeks after surgery when TSH >30 µIU/mL. Data was collected from the hospital database. A total of 328 patients who had post-operative early sTg values with negative anti-Tg antibodies were included. Results: The median age was 44 years. Of the 328 patients, 223 (68%) were women. The median tumor diameter was 11 mm. One hundred ninety-one patients (58.2%) had low risk and 137 (41.8%) had intermediate risk for recurrent disease. Of the 328 patients, 4.0% had recurrent disease. In multivariate Cox regression, post-operative early sTg value [OR: 1.070 (1.038-1.116), P = .000], and the pre-operative malign cytology [OR: 1.483 (1.080-2.245), P = .042] were independent risk factors for recurrence. On the ROC curve analysis, the cut-off value of early sTg was 4.1 ng/mL for those with recurrent disease. Conclusion: This study demonstrated that early sTg could predict recurrent disease in patients with low to intermediate risk PTC. A cut-off of 4.1 ng/mL was identified with a high negative predictive value. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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