Tags

Type your tag names separated by a space and hit enter

Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive iodine ablation.
Thyroid. 2012 Nov; 22(11):1140-3.T

Abstract

BACKGROUND

Stimulated thyroglobulin (Tg) ≤1 ng/mL after thyroidectomy (after L-thyroxine [L-T4] withdrawal or administration of recombinant human thyrotropin [rhTSH]) has been proposed as a criterion to spare patients with papillary thyroid cancer (PTC), who are at low risk of recurrence, from ablation with iodine-131 ((131)I). The objective of this prospective study was to evaluate the recurrence rate using this approach.

METHODS

This prospective study included 136 patients with PTC who underwent total thyroidectomy with apparently complete tumor resection and who presented no signs of persistent disease after surgery. The patients were classified as low risk of recurrence (nonaggressive histology, T1b-3 N0 M0). All patients had stimulated Tg ≤1 ng/mL, negative anti-Tg antibodies (TgAb), and neck ultrasound (US) showing no anomalies ~16 weeks after thyroidectomy, and none of them were submitted to ablation with (131)I. The time of follow-up ranged from 12 to 72 months (median: 44 months).

RESULTS

Among the patients studied, 134 (98.5%) continued to have serum Tg concentrations of <1 ng/mL during therapy with L-T4 (Tg/T4) and had negative TgAb and neck US. Lymph node metastases were detected by neck US in one patient. An increase of TgAb was observed in another patient, but she has not developed apparent disease to date. There was only one case of recurrence even among the 60 patients with tumors >4 cm or minimal extrathyroid invasion (T3 N0 M0).

CONCLUSIONS

Low-risk patients with PTC who have stimulated Tg ≤1 ng/mL after thyroidectomy do not require ablation with (131)I.

Authors+Show Affiliations

Instituto de Ensino e Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil. pedrorosario@globo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23050786

Citation

Rosario, Pedro Weslley, et al. "Postoperative Stimulated Thyroglobulin of Less Than 1 Ng/ml as a Criterion to Spare Low-risk Patients With Papillary Thyroid Cancer From Radioactive Iodine Ablation." Thyroid : Official Journal of the American Thyroid Association, vol. 22, no. 11, 2012, pp. 1140-3.
Rosario PW, Mineiro Filho AF, Prates BS, et al. Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive iodine ablation. Thyroid. 2012;22(11):1140-3.
Rosario, P. W., Mineiro Filho, A. F., Prates, B. S., Silva, L. C., & Calsolari, M. R. (2012). Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive iodine ablation. Thyroid : Official Journal of the American Thyroid Association, 22(11), 1140-3. https://doi.org/10.1089/thy.2012.0190
Rosario PW, et al. Postoperative Stimulated Thyroglobulin of Less Than 1 Ng/ml as a Criterion to Spare Low-risk Patients With Papillary Thyroid Cancer From Radioactive Iodine Ablation. Thyroid. 2012;22(11):1140-3. PubMed PMID: 23050786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive iodine ablation. AU - Rosario,Pedro Weslley, AU - Mineiro Filho,Augusto Flávio Campos, AU - Prates,Brenda Sá Senna, AU - Silva,Lívia Cristina Oliveira, AU - Calsolari,Maria Regina, Y1 - 2012/10/10/ PY - 2012/10/12/entrez PY - 2012/10/12/pubmed PY - 2013/4/23/medline SP - 1140 EP - 3 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 22 IS - 11 N2 - BACKGROUND: Stimulated thyroglobulin (Tg) ≤1 ng/mL after thyroidectomy (after L-thyroxine [L-T4] withdrawal or administration of recombinant human thyrotropin [rhTSH]) has been proposed as a criterion to spare patients with papillary thyroid cancer (PTC), who are at low risk of recurrence, from ablation with iodine-131 ((131)I). The objective of this prospective study was to evaluate the recurrence rate using this approach. METHODS: This prospective study included 136 patients with PTC who underwent total thyroidectomy with apparently complete tumor resection and who presented no signs of persistent disease after surgery. The patients were classified as low risk of recurrence (nonaggressive histology, T1b-3 N0 M0). All patients had stimulated Tg ≤1 ng/mL, negative anti-Tg antibodies (TgAb), and neck ultrasound (US) showing no anomalies ~16 weeks after thyroidectomy, and none of them were submitted to ablation with (131)I. The time of follow-up ranged from 12 to 72 months (median: 44 months). RESULTS: Among the patients studied, 134 (98.5%) continued to have serum Tg concentrations of <1 ng/mL during therapy with L-T4 (Tg/T4) and had negative TgAb and neck US. Lymph node metastases were detected by neck US in one patient. An increase of TgAb was observed in another patient, but she has not developed apparent disease to date. There was only one case of recurrence even among the 60 patients with tumors >4 cm or minimal extrathyroid invasion (T3 N0 M0). CONCLUSIONS: Low-risk patients with PTC who have stimulated Tg ≤1 ng/mL after thyroidectomy do not require ablation with (131)I. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/23050786/Postoperative_stimulated_thyroglobulin_of_less_than_1_ng/ml_as_a_criterion_to_spare_low_risk_patients_with_papillary_thyroid_cancer_from_radioactive_iodine_ablation_ L2 - https://www.liebertpub.com/doi/10.1089/thy.2012.0190?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -