Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation: is there a role for serum thyroglobulin measurement?
| Autor: | Cosimo, Durante, Teresa, Montesano, Marco, Attard, Massimo, Torlontano, Fabio, Monzani, Giuseppe, Costante, Domenico, Meringolo, Marco, Ferdeghini, Salvatore, Tumino, Livia, Lamartina, Alessandra, Paciaroni, Michela, Massa, Laura, Giacomelli, Giuseppe, Ronga, Sebastiano, Filetti, Leonardo, D'Aloiso |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Endocrinology Diabetes and Metabolism medicine.medical_treatment Papillary Clinical Biochemistry Biochemistry Papillary thyroid cancer Iodine Radioisotopes radioiodine thyroid remnant ablation Endocrinology 80 and over whole-body scan Tg Child Thyroid cancer DTC Differentiated thyroid cancer RRA radioiodine thyroid remnant ablation Tg thyroglobulin US ultrasonography WBS Aged 80 and over Immunoradiometric assay Thyroglobulin Measurement Thyroid ultrasonography Middle Aged Differentiated thyroid cancer Diabetes and Metabolism medicine.anatomical_structure Thyroid Cancer Papillary Thyroidectomy Female Adult medicine.medical_specialty Adolescent Context (language use) Thyroglobulin Internal medicine medicine Humans Aged Carcinoma Carcinoma Papillary Follow-Up Studies Retrospective Studies Thyroid Neoplasms Biochemistry (medical) WBS US business.industry medicine.disease business RRA |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 97(8) |
| ISSN: | 1945-7197 |
| Popis: | Serum thyroglobulin (Tg) assays are considered fundamental in postoperative surveillance of differentiated thyroid cancer (DTC) patients. However, the postsurgical profile of Tg levels has never been specifically investigated in patients who do not undergo radioiodine remnant ablation (RRA).Our objective was to explore the evolution of Tg levels over time in DTC patients treated with total or near-total thyroidectomy without RRA.We retrospectively analyzed 290 consecutively diagnosed cases of low-risk (American Thyroid Association criteria) DTC treated with thyroidectomy alone and followed yearly with neck ultrasonography and serum Tg assays. We compared final Tg values in this group and a matched group of 495 RRA-positive patients. Temporal trends of serial Tg levels were also analyzed in 78 of the RRA-negative patients monitored with a high-sensitivity immunoradiometric assay.After follow-up of 2.5-22 yr (median 5 yr), final Tg levels were undetectable (1 ng/ml) in 274 of 290 RRA-negative patients (95%) and 492 of 495 RRA-positive controls (99%). In the subset of 78 RRA-negative patients, undetectable Tg levels (0.2 ng/ml) were recorded in 60% at the first postoperative evaluation (3-12 months) and in 79% after 5 yr. Tg levels increased in the single patient who experienced disease recurrence during the observation period.In most RRA-negative patients, postoperative serum Tg values spontaneously drop to undetectable levels within 5-7 yr after thyroidectomy. Thus, in later phases, Tg assays may be a valuable tool for follow-up even in patients who do not undergo RRA. |
| Databáze: | OpenAIRE |
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