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Low postoperative nonstimulated thyroglobulin as a criterion for the indication of low radioiodine activity in patients with papillary thyroid cancer of intermediate risk 'with higher risk features'.
Clin Endocrinol (Oxf). 2016 09; 85(3):453-8.CE

Abstract

OBJECTIVE

This study evaluated low-activity (131) I therapy in patients with papillary thyroid carcinoma (PTC) of intermediate risk 'with higher risk features' who had low nonstimulated thyroglobulin (Tg) after thyroidectomy.

DESIGN AND PATIENTS

This was a prospective study including 102 patients with tumours >1 cm and aggressive histology; and/or >3 positive lymph node (LN) or LN >1·5 cm or exhibiting macroscopic extracapsular extension, and clinically apparent (cN1); and/or a combination of a tumour >4 cm, microscopic extrathyroidal extension and LN metastases (cN1). After thyroidectomy, all patients had nonstimulated Tg < 0·3 ng/ml and negative antithyroglobulin antibodies (TgAb) and neck ultrasonography (US). The patients were treated with a low activity of (131) I (1110 or 1850 MBq).

RESULTS

Post-therapy whole-body scanning (RxWBS) showed ectopic uptake in four patients. When evaluated 12 months after (131) I therapy, nonstimulated Tg ≤ 0·2 ng/ml with negative TgAb and US, defined as excellent response to initial therapy, was achieved in 101 patients (99%). Only one patient with positive initial RxWBS had structural disease. During follow-up, four patients (4%) relapsed, including LN metastases in two, pulmonary metastases in one, and elevated Tg in one. The other 98 patients remained with nonstimulated Tg ≤ 0·2 ng/ml and negative TgAb and US. There was no case of death due to the tumour.

CONCLUSIONS

We conclude that in intermediate-risk patients 'with higher risk features', low nonstimulated Tg measured with a second-generation assay can be used as criterion for the administration of low (131) I activities (1850 MBq or less).

Authors+Show Affiliations

Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26801644

Citation

Rosario, Pedro Weslley, et al. "Low Postoperative Nonstimulated Thyroglobulin as a Criterion for the Indication of Low Radioiodine Activity in Patients With Papillary Thyroid Cancer of Intermediate Risk 'with Higher Risk Features'." Clinical Endocrinology, vol. 85, no. 3, 2016, pp. 453-8.
Rosario PW, Mourão GF, Calsolari MR. Low postoperative nonstimulated thyroglobulin as a criterion for the indication of low radioiodine activity in patients with papillary thyroid cancer of intermediate risk 'with higher risk features'. Clin Endocrinol (Oxf). 2016;85(3):453-8.
Rosario, P. W., Mourão, G. F., & Calsolari, M. R. (2016). Low postoperative nonstimulated thyroglobulin as a criterion for the indication of low radioiodine activity in patients with papillary thyroid cancer of intermediate risk 'with higher risk features'. Clinical Endocrinology, 85(3), 453-8. https://doi.org/10.1111/cen.13024
Rosario PW, Mourão GF, Calsolari MR. Low Postoperative Nonstimulated Thyroglobulin as a Criterion for the Indication of Low Radioiodine Activity in Patients With Papillary Thyroid Cancer of Intermediate Risk 'with Higher Risk Features'. Clin Endocrinol (Oxf). 2016;85(3):453-8. PubMed PMID: 26801644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low postoperative nonstimulated thyroglobulin as a criterion for the indication of low radioiodine activity in patients with papillary thyroid cancer of intermediate risk 'with higher risk features'. AU - Rosario,Pedro Weslley, AU - Mourão,Gabriela Franco, AU - Calsolari,Maria Regina, Y1 - 2016/02/12/ PY - 2015/12/08/received PY - 2016/01/04/revised PY - 2016/01/11/revised PY - 2016/01/18/accepted PY - 2016/1/24/entrez PY - 2016/1/24/pubmed PY - 2017/9/25/medline SP - 453 EP - 8 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 85 IS - 3 N2 - OBJECTIVE: This study evaluated low-activity (131) I therapy in patients with papillary thyroid carcinoma (PTC) of intermediate risk 'with higher risk features' who had low nonstimulated thyroglobulin (Tg) after thyroidectomy. DESIGN AND PATIENTS: This was a prospective study including 102 patients with tumours >1 cm and aggressive histology; and/or >3 positive lymph node (LN) or LN >1·5 cm or exhibiting macroscopic extracapsular extension, and clinically apparent (cN1); and/or a combination of a tumour >4 cm, microscopic extrathyroidal extension and LN metastases (cN1). After thyroidectomy, all patients had nonstimulated Tg < 0·3 ng/ml and negative antithyroglobulin antibodies (TgAb) and neck ultrasonography (US). The patients were treated with a low activity of (131) I (1110 or 1850 MBq). RESULTS: Post-therapy whole-body scanning (RxWBS) showed ectopic uptake in four patients. When evaluated 12 months after (131) I therapy, nonstimulated Tg ≤ 0·2 ng/ml with negative TgAb and US, defined as excellent response to initial therapy, was achieved in 101 patients (99%). Only one patient with positive initial RxWBS had structural disease. During follow-up, four patients (4%) relapsed, including LN metastases in two, pulmonary metastases in one, and elevated Tg in one. The other 98 patients remained with nonstimulated Tg ≤ 0·2 ng/ml and negative TgAb and US. There was no case of death due to the tumour. CONCLUSIONS: We conclude that in intermediate-risk patients 'with higher risk features', low nonstimulated Tg measured with a second-generation assay can be used as criterion for the administration of low (131) I activities (1850 MBq or less). SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/26801644/Low_postoperative_nonstimulated_thyroglobulin_as_a_criterion_for_the_indication_of_low_radioiodine_activity_in_patients_with_papillary_thyroid_cancer_of_intermediate_risk_'with_higher_risk_features'_ L2 - https://doi.org/10.1111/cen.13024 DB - PRIME DP - Unbound Medicine ER -