Prognostic value of an increase in the serum thyroglobulin level at the time of the first ablative radioiodine treatment in patients with differentiated thyroid cancer

Autor: Pierre Jallet, Christian Jeanguillaume, Philippe Giraud, Patrice Rodien, Vincent Rohmer, Olivier Morel, J. C. Bigorgne, Jean-Pierre Muratet, Marie-Odile Bernier
Přispěvatelé: Laboratoire d'InfoRmatique en Image et Systèmes d'information (LIRIS), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-École Centrale de Lyon (ECL), Université de Lyon-Université Lumière - Lyon 2 (UL2), Laboratoire d'Ingéniérie des Systèmes Automatisés (LISA), Université d'Angers (UA), Gerard, Marie-Françoise
Rok vydání: 2005
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Statistics as Topic
Urology
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
Iodine Radioisotopes
Thyroid carcinoma
03 medical and health sciences
0302 clinical medicine
Thyroid Hormone Treatment
Internal medicine
Biomarkers
Tumor
medicine
Humans
Radiology
Nuclear Medicine and imaging
Thyroid Neoplasms
Radionuclide Imaging
Thyroid cancer
ComputingMilieux_MISCELLANEOUS
Aged
Retrospective Studies
Aged
80 and over
Univariate analysis
business.industry
Thyroid
Reproducibility of Results
Retrospective cohort study
General Medicine
Middle Aged
Prognosis
Ablation
medicine.disease
3. Good health
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Thyroglobulin
Radiopharmaceuticals
business
Zdroj: European Journal of Nuclear Medicine and Molecular Imaging
European Journal of Nuclear Medicine and Molecular Imaging, Springer Verlag (Germany), 2005, 32, pp.1418-1421
ISSN: 1619-7089
1619-7070
Popis: The aim of this study was to assess the prognostic factors for treatment efficacy, and in particular the increase in serum thyroglobulin (Tg) level at the time of the first ablative radioiodine treatment, in patients with differentiated thyroid carcinoma (DTC).A retrospective chart review was performed on 407 patients treated for DTC by total thyroidectomy and (131)I ablation between 1995 and 2002, and examined 5-12 months later with diagnostic (131)I whole-body scan and serum Tg measurement after thyroid hormone treatment withdrawal. At the time of the ablative radioiodine treatment, serum Tg level was determined just before (131)I administration (TgD0) and 5 days later (TgD5); Tg variation was expressed as the ratio TgD5/TgD0. At the first post-ablation follow-up examination, unsuccessful ablation was defined by a Tg levelor =2 ng/ml and/or abnormal (131)I uptake.Ablation was unsuccessful in 51 patients. Univariate analysis showed high TgD0 level, low TgD5/TgD0 ratio extrathyroidal invasion, (131)I uptake in the neck (excluding the thyroid bed) during the ablative treatment and distant metastases to be significantly associated with unsuccessful ablation. On logistic multivariate analysis, TgD0 level5 ng/ml and TgD5/TgD0 ratioor =20 were independently associated with successful ablation. A receiver operating characteristic curve analysis determined that a TgD5/TgD0 ratio greater than 20 had a 97% positive predictive value for successful ablation. When both TgD0 and TgD5/TgD0 ratio were considered, that is, TgD05 ng/ml or TgD0or =5 ng/ml but TgD5/TgD0 ratio20, ablation was unsuccessful in only 12/301 patients.Our data show that the TgD5/TgD0 ratio may be used as a new prognostic indicator of (131)I treatment efficacy in patients with DTC.
Databáze: OpenAIRE
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